Is There Value in Repeating Inhaled Nitric Oxide Vasoreactivity Tests in Patients with Pulmonary Arterial Hypertension?

Inhaled nitric oxide: can it serve as a savior for COVID-19 and related respiratory and cardiovascular diseases?

“…iNO can be used to determine the response to calcium channel blockers in patients with pulmonary hypertension, and whether this test of vascular reactivity is indicative of patient prognosis was studied by Malhotra et al The results of the study showed that a decrease in PVR and mPAP after iNO implies better long-term survival, is an independent predictor of survival, and facilitates risk stratification of patients with pulmonary hypertension, even in patients who are not suitable for treatment with calcium channel blockers ( Malhotra et al, 2011 ). The clinical value of repeated iNO vascular reactivity testing in patients with pulmonary hypertension was first investigated by Tooba et al The results showed that the reactivity of the pulmonary vasculature to iNO decreased over time, which may be related to disease progression leading to vasoconstrictive hypoplasia and to the impact of vasodilatory reserve by specific treatments for pulmonary arterial hypertension ( Tooba et al, 2020 ). Ishii et al confirmed Tooba’s findings on altered pulmonary vascular reactivity but differed from them by suggesting that the results of vascular reactivity testing after treatment of pulmonary hypertension could suggest prognostic information.…”

Any possible role of phosphodiesterase type 5 inhibitors in the treatment of severe COVID19 infections? A lesson from urology

“…Indeed, PDE5-i represents the standard medical treatment for erectile dysfunctions; nevertheless, these drugs are currently used in other diseases, such as in the management of pulmonary fibrosis or arterial pulmonary hypertension [6]. Several animal tests confirmed that NO mitigates lung injury, decreasing concentrations of proin-flammatory cytokines and reducing the migration of polymorphonuclears into the lungs [7] A role of PDE5-I in anti-viral therapy has been already tested, demonstrating an inhibiting role in the Coronavirus replication [8].…”