Pilot study of losartan for pulmonary hypertension in chronic obstructive pulmonary disease

Morrell, Nicholas W.; Higham, Matthew; Phillips, Peter G.; Shakur, B H; Robinson, Paul; Beddoes, Ray J

doi:10.1186/1465-9921-6-88

Cited by 75 publications

(38 citation statements)

References 36 publications

(31 reference statements)

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“…Treatment with conventional vasodilators such as CCBs is not recommended because they may impair gas exchange due to the inhibition of hypoxic pulmonary vasoconstriction [406][407][408] and because of their lack of efficacy after long-term use [409,410].…”

Section: Therapymentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.

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Section: Therapymentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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“…ACE activity was increased and correlated with the degree of RV hypertrophy in the chronically hypoxic rat (6). The results of these studies led to the first double-blind placebo-controlled trial of losartan in patients with pulmonary hypertension associated with chronic obstructive pulmonary disease (7). Although this trial was underpowered, a post hoc analysis suggested benefit in patients with more severely elevated pulmonary hemodynamics.…”

Section: To the Editormentioning

confidence: 99%

The Renin–Angiotensin System in Pulmonary Hypertension

Morrell¹,

Stenmark²

2013

Am J Respir Crit Care Med

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“…In contrast, in a separate study 48 weeks of losartan led to little beneficial result in 40 COPD patients with PH. 59 Similarly, a single administration of nifedipine resulted in modest improvement in mean PAP without much change in PVR in 33 COPD patients. 60 Importantly, in a series of 6 patients with PH secondary to COPD, nifedipine reduced PVR but decreased arterial PaO 2 as a result of alteration in V/Q matching.…”

Section: Vasodilatorsmentioning

confidence: 99%

Pulmonary Diseases and the Heart

et al. 2007

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Abstract-The complex nature of interactions between the pulmonary and cardiovascular systems is becoming increasingly appreciated. Pulmonary vascular abnormalities are frequently present in patients with respiratory disorders, including chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, sarcoidosis, neuromuscular or chest wall disorders, and disorders of ventilatory control including sleep apnea syndromes and obesity hypoventilation syndrome. Pulmonary hypertension, classified as group III in the World Health Organization classification scheme for pulmonary hypertension, may result in severe right ventricular dysfunction caused by lung disease, also known as cor pulmonale. The development of cor pulmonale is generally associated with poorer prognosis and increased death. Systemic manifestations of lung disease, particularly obstructive disorders, are also particularly relevant because they are associated with increased cardiac death and impaired health status. This article will discuss the most common pulmonary diseases and disorders of ventilatory control that cause pulmonary vascular abnormalities and cor pulmonale, with particular concentration on how treatment of these diseases may affect the heart. In addition, the complex nature of cardiac and lung disease will also be explored, particularly with respect to the relationship between chronic obstructive pulmonary disease, systemic inflammation, atherosclerosis, and cardiovascular death, which is currently a very active focus of research. Key Words pulmonary heart disease Ⅲ pulmonary disease, chronic obstructive Ⅲ hypertension, pulmonary Ⅲ inflammation S ystemic manifestations have become increasingly recognized in lung diseases, particularly obstructive disorders. 1 Cardiovascular involvement is particularly relevant because it is associated with impaired health status and worsened mortality. In the present targeted review we will discuss evolving data regarding pulmonary vascular abnormalities in the most common respiratory disorders, including chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, sarcoidosis, neuromuscular or chest wall disorders, and disorders of ventilatory control. We will also explore the relationship between COPD and systemic inflammation, atherosclerosis, and cardiovascular death. Pulmonary Vascular Disease in Respiratory IllnessThe classification of pulmonary hypertension (PH) has recently been revised, and PH associated with hypoxemic pulmonary disorders falls into World Health Organization group III. 2 Cor pulmonale was defined by the World Health Organization in 1963 as "hypertrophy of the right ventricle (RV) resulting from diseases affecting the function and/or structure of the lungs, except when these pulmonary alterations are the result of diseases that primarily affect the left side of the heart, as in congenital heart disease." 3 Since then the definition has come to encompass both right ventricular hypertrophy, dilation, or both secondary to PH caused by pulmonary disorders. 4 Betw...

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Pilot study of losartan for pulmonary hypertension in chronic obstructive pulmonary disease

Cited by 75 publications

References 36 publications

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

The Renin–Angiotensin System in Pulmonary Hypertension

Pulmonary Diseases and the Heart

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