A Comparison of Two Long-Acting Vasoselective Calcium Antagonists in Pulmonary Hypertension Secondary to COPD

Sajkov, Dimitar; Frith, Peter; Rd, McEvoy; Wang, Tingting; Bune, Alexandra J.; Alpers, John A.

doi:10.1378/chest.111.6.1622

Cited by 26 publications

(18 citation statements)

References 31 publications

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“…Generally, calcium channel blockers are not indicated in patients with heart failure, but newer agents (e.g., amlodipine) have been shown to improve pulmonary hypertension in patients with chronic obstructive pulmonary disease, and these drugs are safe in patients with heart failure. 30,31 Clinical use of these agents remains theoretical, however, and further study is needed.…”

Section: Discussionmentioning

confidence: 99%

Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation

Butler

Stankewicz

et al. 2005

The Journal of Heart and Lung Transplantation

131

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Section: Discussionmentioning

confidence: 99%

Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation

Butler

Stankewicz

et al. 2005

The Journal of Heart and Lung Transplantation

131

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“…There is evidence to suggest that amlodipine may confer pulmonary specificity and has the advantage of being a once daily prescription (16). Amlodipine reduces pulmonary artery pressure and is well tolerated in patients with chronic obstructive pulmonary disease and PAH (17). The use of calcium-channel blockers in secondary PAH has been reported (18).…”

Section: Calcium-channel Blockersmentioning

confidence: 99%

The role of calcium channel blockers, steroids, anticoagulation, antiplatelet drugs, and endothelin receptor antagonists

Adatia

Shekerdemian

2010

Pediatric Critical Care Medicine

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The rationale for the drug therapy of pulmonary artery hypertension is to reduce mortality and morbidity caused by failure of right ventricular adaptation to an elevated pulmonary vascular resistance. We review the evidence for the use of calcium-channel blockers, steroids, anticoagulation, antiplatelet drugs, and endothelin receptor antagonists in the management of pulmonary artery hypertension. The drugs we discuss are more suited to long-term outpatient therapy. These drugs have not found a routine place in intensive care management, and calcium-channel blockers are contraindicated in patients with right-heart failure. The efficacy of many agents has been extrapolated from data acquired in adult patients and applied to children. All of us involved in the care of young patients with pulmonary artery hypertension should advocate for both the inclusion of younger patients in clinical trials and the design of distinctly pediatric trials with pharmaceutical and drug administration agencies. It is only with data derived from pediatric inclusive studies that we shall be able to recommend therapy with strong evidence. However, it is important to point out that the use of newer agents for the treatment of chronic pulmonary artery hypertension (prostacyclin, endothelin receptor antagonists, nitric oxide, and sildenafil) have not been shown to improve survival unequivocally and have relied on surrogates, such as exercise capacity. There are no long-term studies of survival benefit. Recent studies have included data on time to clinical worsening, which may be a more predictive surrogate of survival.

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“…39,40 In contrast, another study evaluating amlodipine and felodipine found that they decreased pulmonary pressures and increased oxygen delivery because cardiac output increased. 41 Despite this, the possible benefit of short-term increased cardiac output is overshadowed by the possibility of, worsened gas exchange, 42 and overall lack of proven long-term benefit. 43,44 Calcium channel antagonists should not be employed routinely in this patient population because of the absence of proven advantage and the risk of adverse effects such as systemic hypotension and cardiac conduction defects, in addition to those stated above.…”

Section: Oral Vasodilatorsmentioning

confidence: 99%

Pulmonary Hypertension Secondary to Chronic Respiratory Disease

Gerke¹,

Mandel²

2006

Pulmonary Vascular Disease

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A Comparison of Two Long-Acting Vasoselective Calcium Antagonists in Pulmonary Hypertension Secondary to COPD

Cited by 26 publications

References 31 publications

Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation

Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation

The role of calcium channel blockers, steroids, anticoagulation, antiplatelet drugs, and endothelin receptor antagonists

Pulmonary Hypertension Secondary to Chronic Respiratory Disease

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