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Neurohormonal axis in patients with pulmonary arterial hypertension: friend or foe?
- Source :
-
American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2013 Jan 01; Vol. 187 (1), pp. 14-9. Date of Electronic Publication: 2012 Nov 09. - Publication Year :
- 2013
-
Abstract
- Despite its description some 25 years ago, neurohormonal activation has long been neglected as an important factor in the pathophysiology of pulmonary arterial hypertension (PAH). Neurohormonal activation was interpreted as a necessary compensatory response to maintain cardiac contractility and systemic blood pressure. Therefore, inhibitors of neurohormonal activity (like β-blockers or angiotensin-converting enzyme inhibitors) are considered contraindicated in current PAH management guidelines. However, recent data revealed that sympathetic overstimulation is strongly related to mortality, and blockade of neurohormonal activity in experimental PAH improved survival and cardiac function. These novel insights shed new light on the role of neurohormonal activity in PAH.
- Subjects :
- Adrenergic beta-Antagonists pharmacology
Angiotensin II physiology
Heart Atria physiopathology
Heart Atria surgery
Humans
Hypertension, Pulmonary drug therapy
Hypertension, Pulmonary mortality
Hypertension, Pulmonary surgery
Receptors, Angiotensin physiology
Renin-Angiotensin System physiology
Sympathetic Nervous System physiopathology
Hypertension, Pulmonary physiopathology
Neurotransmitter Agents physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1535-4970
- Volume :
- 187
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of respiratory and critical care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23144327
- Full Text :
- https://doi.org/10.1164/rccm.201209-1663PP