β-blockers in pulmonary arterial hypertension: generation might matter

Malenfant, Simon; Perros, Frédèric

doi:10.1183/13993003.01244-2015

Cited by 2 publications

(1 citation statement)

References 16 publications

(16 reference statements)

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“…Carvedilol was well tolerated, did not affect functional capacity, and improved RV function as well as expression of beta-1 adrenergic receptor in a dose dependent manner. Several reasons may explain the discordant findings between older and recent studies of BB therapy in RV dysfunction: small study population and detrimental effect of propranolol on cardiac function might have contributed to the functional and hemodynamic improvement after discontinuation of propranolol (20)(21)(22). Additionally, propranolol may increase RV afterload as beta-2 adrenergic receptor blockade heightens pulmonary vascular resistance (23).…”

Section: Introductionmentioning

confidence: 99%

Neurohormonal modulation as therapeutic avenue for right ventricular dysfunction in pulmonary artery hypertension: till the dawn, waiting

et al. 2018

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Neuro-hormonal activation may lead to or be associated with pulmonary arterial hypertension (PAH) and right ventricular dysfunction. Notwithstanding whether it is the cause or the consequence of PAH-related right ventricle (RV) dysfunction neurohormonal activation contributes to significant morbidity and mortality in patients with PAH and the progression of RV dysfunction. Experimental data regarding the use of beta adrenergic blockade and renin-angiotensin aldosterone system modulation are encouraging. However, clinical studies have largely been negative or neutral; and, neuro-hormonal modulation is discouraged in patients with PAH related RV dysfunction for fear of systemic hypotension. Herein, we summarize the pathophysiological background that supports the potential role of neuro-hormonal modulation in the management of PAH related RV dysfunction; also present current clinical experience; and, discuss the need for controlled studies to move forward. Lastly, we review potential non- pharmacological modalities for neuro-hormonal modulations in PAH patients with RV dysfunction.

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Section: Introductionmentioning

confidence: 99%

Neurohormonal modulation as therapeutic avenue for right ventricular dysfunction in pulmonary artery hypertension: till the dawn, waiting

et al. 2018

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Use of β-Blockers in Pulmonary Hypertension

Perros

Man

Bogaard

et al. 2017

Circ: Heart Failure

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Contrasting with the major attention that left heart failure has received, right heart failure remains understudied both at the preclinical and clinical levels. However, right ventricle failure is a major predictor of outcomes in patients with precapillary pulmonary hypertension because of pulmonary arterial hypertension, and in patients with postcapillary pulmonary hypertension because of left heart disease. In pulmonary hypertension, the status of the right ventricle is one of the most important predictors of both morbidity and mortality. Paradoxically, there are currently no approved therapies targeting the right ventricle in pulmonary hypertension. By analogy with the key role of β-blockers in the management of left heart failure, some authors have proposed to use these agents to support the right ventricle function in pulmonary hypertension. In this review, we summarize the current knowledge on the use of β-blockers in pulmonary hypertension.

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β-blockers in pulmonary arterial hypertension: generation might matter

Cited by 2 publications

References 16 publications

Neurohormonal modulation as therapeutic avenue for right ventricular dysfunction in pulmonary artery hypertension: till the dawn, waiting

Neurohormonal modulation as therapeutic avenue for right ventricular dysfunction in pulmonary artery hypertension: till the dawn, waiting

Use of β-Blockers in Pulmonary Hypertension

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