Document Type
Article
Publication Date
2022
Publication Title
Journal of Clinical Medicine
Volume
11
Issue
15
Pages
4568 (1-9)
DOI
10.3390/jcm11154568
Abstract
Exercise-induced increases in pulmonary blood flow normally increase pulmonary arterial pressure only minimally, largely due to a reserve of pulmonary capillaries that are available for recruitment to carry the flow. In pulmonary arterial hypertension, due to precapillary arteriolar obstruction, such recruitment is greatly reduced. In exercising pulmonary arterial hypertension patients, pulmonary arterial pressure remains high and may even increase further. Current pulmonary arterial hypertension therapies, acting principally as vasodilators, decrease calculated pulmonary vascular resistance by increasing pulmonary blood flow but have a minimal effect in lowering pulmonary arterial pressure and do not restore significant capillary recruitment. Novel pulmonary arterial hypertension therapies that have mainly antiproliferative properties are being developed to try and diminish proliferative cellular obstruction in precapillary arterioles. If effective, those agents should restore capillary recruitment and, during exercise testing, pulmonary arterial pressure should remain low despite increasing pulmonary blood flow. The effectiveness of every novel therapy for pulmonary arterial hypertension should be evaluated not only at rest, but with measurement of exercise pulmonary hemodynamics during clinical trials.
Original Publication Citation
Langleben, D., Orfanos, S. E., Fox, B. D., Messas, N., Giovinazzo, M., & Catravas, J. D. (2022). The paradox of pulmonary vascular resistance: Restoration of pulmonary capillary recruitment as a sine qua non for true therapeutic success in pulmonary arterial hypertension. Journal of Clinical Medicine, 11(15), 1-9, Article 4568. https://doi.org/10.3390/jcm11154568
Repository Citation
Langleben, David; Orfanos, Stylianos E.; Fox, Benjamin D.; Messas, Nathan; Giovinazzo, Michele; and Catravas, John D., "The Paradox of Pulmonary Vascular Resistance: Restoration of Pulmonary Capillary Recruitment as a Sine Qua Non for True Therapeutic Success in Pulmonary Arterial Hypertension" (2022). Bioelectrics Publications. 340.
https://digitalcommons.odu.edu/bioelectrics_pubs/340
ORCID
0000-0002-5098-295X (Catravas)
Included in
Bioelectrical and Neuroengineering Commons, Cardiovascular System Commons, Hematology Commons, Pulmonology Commons
Comments
This is an open access article distributed under the Creative Commons Attribution 4.0 International (CC BY 4.0) License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.