Advances in PH Journal
New Understandings...Better Treatments
Spring 2012 (Vol. 11 No1)
- PH Roundtable:
Imatinib: A Perspective on Its Potential for PAH Patients
- Self-Assessment Examination
- News to Use
- Clinical Trials Update:
The Use of cMRI to Evaluate Patients with PAH
- Review of the Latest Published Research
This study reports on the incidence, prevalence, and survival in pulmonary arterial hypertension (PAH) and in chronic thromboembolic pulmonary hypertension (CTEPH) among patients diagnosed in Spain between 1998 and 2008 who were included in the Spanish Registry on Pulmonary Arterial Hypertension (REHAP) registry.
- Ask the Expert:
Optimal Timing for Lung Transplantation: Why Not Include RVEF As an Indicator?
- Editor's Memo
Bridging the Gap
- Guest Editor's Memo
This issue of Advances is about looking forward, but I'd like to start by looking backward for some perspective. About 10 years ago, a small company called Actelion launched the first effective oral therapy for pulmonary arterial hypertension, bosentan, while another startup, United Therapeutics, launched subcutaneous treprostinil. Rather suddenly, our patients had 2 options other than intravenous epoprostenol, and a broader number of cardiology and pulmonary physicians became interested in recognizing, evaluating, and treating patients with pulmonary hypertension.
- The Role of Warfarin Anticoagulation in Pulmonary Hypertension
Anticoagulation, particularly warfarin, is often used in patients with pulmonary arterial hypertension (PAH). There is evidence that abnormalities of blood coagulation factors contribute to a prothrombotic state in patients with PAH.-1 Warfarin is the most widely prescribed anticoagulant for the prevention and treatment of arterial and venous thromboembolic diseases. Newer medications such as dabigatran or rivaroxaban, which do not require laboratory monitoring, have not been studied in the pulmonary hypertension population.
- CME Information
- Thrombin and Platelets in Pulmonary Hypertension: A Lot More Than Clot
Pulmonary arterial hypertension (PAH) is characterized by the marked elevation of pulmonary vascular resistance and a reduction in compliance. Vasomotor tone is increased throughout the pulmonary vascular bed, and small and medium arterioles are occluded by vascular and inflammatory cells. The progressive loss of the pulmonary circulation leads to exertional dyspnea, low cardiac output, and right ventricular heart failure.
- Potential Interventions Against BMPR2- Related Pulmonary Hypertension
For more than 60 years, researchers have sought to understand the molecularbasis of idiopathic pulmonary arterial hypertension (PAH). Recognition of theheritable form of the disease led to the creation of patient registries in the1980s and 1990s, and discovery of BMPR2 as the cause of roughly 80% ofheritable PAH in 2000. With discovery of the disease gene came opportunity forintervention, with focus on 2 alternative approaches.
- Cell Therapy for Pulmonary Arterial Hypertension: Potential Efficacy of Endothelial Progenitor Cells and Mesenchymal Stem Cells
Pulmonary arterial hypertension is a challenging disease, and our understanding of the underlying mechanisms and pathophysiology remains incomplete. However, there have been a number of important advances, which have greatly enriched our knowledge about the key mechanisms that contribute to the functional and pathological abnormalities of PAH. With each new wave of understanding come new opportunities for the rational design of therapies.