A narrative review of research advances in hypoxic pulmonary hypertension

Abstract

Background and Objective: Hypoxic pulmonary hypertension (HPH) is a pathological syndrome characterized by pulmonary vasoconstriction and pulmonary vascular remodeling caused by hypoxia, which eventually leads to right heart failure or death. There are 2 stages of onset of HPH: hypoxic pulmonary vasoconstriction (HPV) and hypoxic pulmonary vascular remodeling (HPVR). It is an important pathophysiological link in the pathogenesis of chronic obstructive pulmonary disease (COPD) and chronic mountain sickness (CMS), and its severity is closely related to the course and prognosis of COPD and CMS.However, there is a lack of systematic review on the diagnosis, pathogenesis and treatment of HPH. The objective of this paper is to review the diagnosis, pathogenesis, treatment of HPH.Methods: In this paper, the method of literature review is adopted to obtain the information about HPH. Based on the literature, comprehensive and systematic review is made. The diagnosis, pathogenesis, treatment of HPH are summarized.Key Content and Findings: Right heart catheterization is the gold standard for diagnosing HPH.Hypoxia-inducible factor, oxidative stress, metal metabolism, ion channel, inflammatory cytokines, cell apoptosis and vascular factors are the main pathogenesis of HPH. The treatment of HPH includes longterm oxygen therapy, statins, prostaglandins, phosphodiesterase inhibitor and ET receptor antagonists.Conclusions: Although great progress has been made in the pathophysiology and molecular biology of HPH, it is still unclear which factors play a leading role in the pathogenesis of HPH, and no breakthrough has been made in the treatment of HPH. It is believed that the specific mechanism will be revealed as the research continues, and earlier diagnosis and the development of more effective targeted drugs will be the focus of future research.

Salidroside promotes the eNOS-NO-sGC-cGMP-PKG pathway by correcting arginine metabolism and improves Monocrotaline-induced Pulmonary Arterial Hypertension

“…After the formation of PAH, as symptoms such as thickening of the pulmonary vascular wall, narrowing of the lumen, and right ventricular compensation worsen, chronic hypoxia induces oxidative stress and in ammatory responses. In ammation and oxidative stress further damage pulmonary vascular endothelial function, causing an imbalance in the expression of vasoconstrictors and further vasoconstriction, forming a vicious cycle [23,24]. Our study examined the effects of SAL on oxidative stress and in ammatory mediators in the lung tissue of PAH model rats.…”

Diagnosis and management of pulmonary hypertension related to chronic respiratory disease

“…Oxygen therapy is also recommended for high-altitude PH, although the ideal course of action is relocation to low-altitude areas [ 32 ].…”

Phoenixin 20 ameliorates pulmonary arterial hypertension via inhibiting inflammation and oxidative stress

“…In recent years, hypoxic pulmonary hypertension has become a research hotspot. The pathological process of PAH includes pulmonary vascular contraction and pulmonary vascular remodeling, and hypoxia is an important inducing factor in pulmonary vascular remodeling [ 2 ]. A previous study has shown that oxidative stress (OS) is a critical mechanism in the pathogenesis of PAH.…”