Pulmonary arterial hypertension: achievements and realities of modern treatment, a look into the future

Martynyuk, T V; Чазова, И Е

doi:10.26442/00403660.2021.09.201013

Terapevticheskii arkhiv

2021

DOI: 10.26442/00403660.2021.09.201013

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Pulmonary arterial hypertension: achievements and realities of modern treatment, a look into the future

T V Martynyuk

И Е Чазова

Abstract: The paper summarizes the most important aspects of modern treatment of patients with pulmonary arterial hypertension (PAH): the goals of therapy are indicated, the issues of risk stratification of PAH progression/mortality, the place of combination specific therapy and switching strategies are considered, as well as new promising approaches to therapy; features of the course of the new coronavirus infection COVID-19 in this category of patients are discussed.

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Cited by 3 publications

References 37 publications

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Combination therapy of newly diagnosed intermediate-risk pulmonary arterial hypertension: A review

2022

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Advancements in the specific therapy of pulmonary arterial hypertension (PAH) and new combination therapy strategies and escalation treatment over the past decade have significantly improved disease control, slowed its progression, and improved quality of life and patient survival. This review provides a detailed discussion of current strategies for PAH-specific therapy available in the Russian Federation for patients with classical and non-classical PAH who fail to achieve treatment goals and remain at intermediate risk of disease progression/mortality.

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Combination therapy of newly diagnosed intermediate-risk pulmonary arterial hypertension: A review

2022

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COVID-19 pandemic challenges: on the way to overcome obstacles in realization of PAH-specific therapy treatment goals

Rezukhina

Korobkova

Данилов

et al. 2021

Evrazijskij kardiologičeskij žurnal

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Our observation demonstrates a case of a 40-year-old female with idiopathic pulmonary arterial hypertension World Health Organization functional class III, who was admitted to NMRC of Cardiology repeatedly due to disease progression including dyspnea worsening and exercise tolerance decrease after previous COVID-19 infection on riociguat (7.5 mg daily), macitentan (10 mg daily) and selexipag (1600 mcg daily) therapy. Clinical examination demonstrated high-risk status according to the expected 1-year mortality. Due to unreleased treatment goals and high-risk status, we performed transition from selexipag to inhale iloprost. After therapy escalation the patient demonstrated a significant improvement in clinical condition, dyspnea reduction and exercise tolerance increase. The current treatment strategy for pulmonary arterial hypertension is based on regular multiparametric risk stratification approach in PAH patients. The impact of COVID-19 may become an important cause of clinical worsening in PAH patients during COVID-19 pandemic. Directed on vasodilatation and antiproliferation mechanisms of action of PAH-specific drugs are supposed to be protective in COVID-19 patients. However, the probability of clinical worsening in PAH patients despite PAH-specific therapy intake needs to be closely monitored to perform timely treatment correction in order to achieve low-risk status and to improve the prognosis of PAH patients.

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Pulmonary arterial hypertension: challenges and achievements 2021

Rezukhina

Martynyuk

Валиева

et al. 2022

Evrazijskij kardiologičeskij žurnal

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Symposium dedicated to pulmonary arterial hypertension took place at the 9th Russian Congress on Pulmonary hypertension on December 14, 2021. In this review key points from Chazova I.E., Martynyuk T.V., Valieva Z.S., Gramovich V.V.`s reports are presented, in which information about PAH treatment goals achievement, COVID-19 pandemic challenges impact on routine clinical practice is demonstrated. In this review current situation in pulmonary arterial hypertension treatment goals and regular risk stratification importance are observed, based on the latest clinical trials combined specific therapy including selective prostacyclin receptor agonist selexipag is demonstrated. special attention is paid to pulmonary hypertension patients’ treatment during COVID-19 pandemic, regular risk stratification necessity is mentioned including remote patient monitoring in order to perform timely escalation in PAH-specific treatment in order to achieve low-risk status and to improve the prognosis of PAH patients.

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Pulmonary arterial hypertension: achievements and realities of modern treatment, a look into the future

Cited by 3 publications

References 37 publications

Combination therapy of newly diagnosed intermediate-risk pulmonary arterial hypertension: A review

Combination therapy of newly diagnosed intermediate-risk pulmonary arterial hypertension: A review

COVID-19 pandemic challenges: on the way to overcome obstacles in realization of PAH-specific therapy treatment goals

Pulmonary arterial hypertension: challenges and achievements 2021

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