Physiopathology of Pulmonary Hypertension: from Bio-Molecular Mechanism to Target Treatment

Abstract

Although the diagnosis and treatment of pulmonary hypertension (PH) is developed constantly in the last decade, PH remains an incurable and difficult to treat disease due to its high life disability and dreadful survival rate. The disease is characterized by sustained vasoconstriction, progressive vascular remodeling, and irreversible right heart dysfunction.The advanced knowledge in physiopathology and classification of PH in recent years is a useful tool helping physicians to improve the choice of target treatment. In addition, the remarkable progresses in understanding the molecular and cellular mechanisms of PH allow to develop new treatments. Actually, new therapeutic molecules have been discovered and their mechanisms of action are better understood and some are in preclinical and clinical trials. Preliminary results of these molecules with benefit effects on pulmonary arterial pressure and systemic hemodynamic gives a new hope for the future.

The Study of Correlation between Diurnal Blood Pressure with Nocturnal Oxygen Desaturation and Nitrite Production in Subjects with Obstructive Sleep Apnea (OSA)

“…Currently, endothelial dysfunction is defined as an imbalance between vasorelaxation (mediated mainly by nitric oxide pathway) and vasoconstriction (induced by endothelin-1 and its receptors), between anti-coagulant and pro-coagulant substances, or between growth-inhibiting and growth-promoting mediators [2]. It has been demonstrated that endothelial dysfunction is one of the earliest manifestations of vascular disease and atherosclerosis [3].…”

“…The last one is a potential risk factor for high blood pressure in adult. However, endothelial dysfunction is also associated with different forms of vascular diseases, such as systemic or regional arterial hypertension [2,4] and coronary arterial or peripheral vascular diseases [5][6][7][8].…”