Eplerenone attenuates pathological pulmonary vascular rather than right ventricular remodeling in pulmonary arterial hypertension

Böehm, Matthias; Arnold, Nadine; Braithwaite, Adam; Pickworth, Josephine; Lu, Chang-Wu; Novoyatleva, Tatyana; Kiely, David G.; Grimminger, Friedrich; Ghofrani, Hossein Ardeschir; Weißmann, Norbert; Seeger, Werner; Lawrie, Allan; Schermuly, Ralph T.; Kojonazarov, Baktybek

doi:10.1186/s12890-018-0604-x

Cited by 50 publications

(43 citation statements)

References 35 publications

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“…Elevated levels of aldosterone are present in adults with pulmonary hypertension, and in adults with severe disease hyperaldosteronism correlates positively with pulmonary vascular resistance, suggesting that aldosterone may contribute to the vasculopathy 26 . In several rodent models of pulmonary hypertension, including chronic hypoxia, treatment with spironolactone prevents pulmonary vascular muscularization and remodeling and lower right‐ventricle systolic pressure than in vehicle‐treated controls 25‐27 . Collectively, these findings provide strong support for aldosterone‐mineralocorticoid receptor influences on pulmonary vascular proliferation, remodeling, and altered pulmonary hemodynamics.…”

Section: Diuretics and The Renin‐angiotensin‐aldosterone Systemmentioning

confidence: 70%

Rethinking furosemide use for infants with bronchopulmonary dysplasia

Segar

2020

Pediatric Pulmonology

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Diuretics are commonly administered to infants with bronchopulmonary dysplasia (BPD) to improve respiratory function despite the absence of prospective data demonstrating long term benefits. While many potentially adverse effects of furosemide are known to clinicians, its direct and indirect impact on multiple pathophysiological processes need to be understood. While furosemide likely has a role in the management of infants with BPD, clinicians are encouraged to recognize these potential complications associated with furosemide administration. Specifically, a deeper understanding of the impact of diuretics on sodium metabolism neurohumoral regulation of cardiopulmonary physiology is required.

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Section: Diuretics and The Renin‐angiotensin‐aldosterone Systemmentioning

confidence: 70%

Rethinking furosemide use for infants with bronchopulmonary dysplasia

Segar

2020

Pediatric Pulmonology

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“…Consistent with this, renal denervation (modulating both sympathetic and RAAS activity) improves pulmonary hemodynamics along with attenuation of RV fibrosis and diastolic stiffness (183). However, the aldosterone antagonist eplerenone does not exert beneficial effects on the RV in PAB models in mice (184) and rats (68).…”

Section: Role Of Gpcrs In Rv Remodeling and Dysfunctionmentioning

confidence: 99%

The Role of G Protein-Coupled Receptors in the Right Ventricle in Pulmonary Hypertension

Viswanathan

Mamazhakypov

Schermuly

et al. 2018

Front. Cardiovasc. Med.

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Pressure overload of the right ventricle (RV) in pulmonary arterial hypertension (PAH) leads to RV remodeling and failure, an important determinant of outcome in patients with PAH. Several G protein-coupled receptors (GPCRs) are differentially regulated in the RV myocardium, contributing to the pathogenesis of RV adverse remodeling and dysfunction. Many pharmacological agents that target GPCRs have been demonstrated to result in beneficial effects on left ventricular (LV) failure, such as beta-adrenergic receptor and angiotensin receptor antagonists. However, the role of such drugs on RV remodeling and performance is not known at this time. Moreover, many of these same receptors are also expressed in the pulmonary vasculature, which could result in complex effects in PAH. This manuscript reviews the role of GPCRs in the RV remodeling and dysfunction and discusses activating and blocking GPCR signaling to potentially attenuate remodeling while promoting improvements of RV function in PAH.

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“…In addition, a role of MR in pulmonary hypertension has been recently identified. MRA treatment initiated at the time of the pulmonary arterial hypertension stimulus prevents the pulmonary vascular hyperplasia and reduces systemic BP [57,87]. Thus, MR activation may be equally important in patients with and without an established diagnosis of primary aldosteronism.…”

Section: Vascular Mr and Hypertensionmentioning

confidence: 99%

Mineralocorticoid Receptor in Calcium Handling of Vascular Smooth Muscle Cells

Salazar-Enciso¹,

Camacho-Concha²,

Mesquita³

et al. 2018

Calcium and Signal Transduction

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For decades, the mineralocorticoid receptor (MR) antagonists have been used for the management of cardiovascular diseases; however, the molecular mechanisms involved in their beneficial effects are not fully understood. Recent publications point to the fundamental role of aldosterone and vascular MR in the regulation of arterial tone, vascular contractility, and cell proliferation. However, the intricate transduction machinery activated by vascular MRs has begun to be revealed with the help of transgenic rodent models and novel transcriptional analysis approaches. Specifically, in this chapter, we review and discuss the most recent contributions about the fine-tuning that the MR exerts on the expression and function of ion channels that participate in calcium handling of vascular cells and the therapeutic implications for hypertension and cardiovascular diseases.

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Eplerenone attenuates pathological pulmonary vascular rather than right ventricular remodeling in pulmonary arterial hypertension

Cited by 50 publications

References 35 publications

Rethinking furosemide use for infants with bronchopulmonary dysplasia

Rethinking furosemide use for infants with bronchopulmonary dysplasia

The Role of G Protein-Coupled Receptors in the Right Ventricle in Pulmonary Hypertension

Mineralocorticoid Receptor in Calcium Handling of Vascular Smooth Muscle Cells

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