Pulmonary Artery Endovascular Device Compensates for Loss of Vascular Compliance in Pulmonary Arterial Hypertension

Gerges, Christian; Vollmers, Karl; Pritzker, Marc; Gainor, John; Scandurra, John; Weir, E. K.; Lang, Irene

doi:10.1016/j.jacc.2020.08.080

Cited by 6 publications

(15 citation statements)

References 4 publications

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“…In general, they are intended for use in Group 1 PAH, but their mechanisms of action may also be beneficial in Group 3 physiology. In one example, early clinical work suggests that a device‐based enhancement of compliance in the pulmonary vasculature may improve cardiac output and unload the right ventricle without worsening V/Q mismatch 106 . In the INCREASE trial, inhaled treprostinil/Tyvaso was delivered via an iNEB device 22 .…”

Section: Investigational Therapeutic and Device‐based Therapiesmentioning

confidence: 99%

Pulmonary hypertension in the setting of interstitial lung disease: Approach to management and treatment. A consensus statement from the Pulmonary Vascular Research Institute's Innovative Drug Development Initiative—Group 3 Pulmonary Hypertension

Shlobin,

Shen,

Wort

et al. 2024

Pulm. circ.

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Pulmonary hypertension (PH) due to interstitial lung disease (ILD), a commonly encountered complication of fibrotic ILDs, is associated with significant morbidity and mortality. Until recently, the studies of pulmonary vasodilator therapy in PH‐ILD have been largely disappointing, with some even demonstrating the potential for harm. This paper is part of a series of Consensus Statements from the Pulmonary Vascular Research Institute's Innovative Drug Development Initiative for Group 3 Pulmonary Hypertension, with prior publications covering pathogenesis, prevalence, clinical features, phenotyping, clinical trials, and impact of PH‐ILD. It offers a comprehensive review of and a holistic approach to treatment of PH‐ILD, including the management of underlying interstitial lung diseases, importance of treating the comorbidities, emphasis on importance of exercise and palliation of dyspnea, and review of the most up‐to‐date guidelines for referral for potential lung transplant work up. It also summarizes the prior, ongoing, and possibly future studies in treatment of the vascular derangement of this morbid condition.

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Section: Investigational Therapeutic and Device‐based Therapiesmentioning

confidence: 99%

Pulmonary hypertension in the setting of interstitial lung disease: Approach to management and treatment. A consensus statement from the Pulmonary Vascular Research Institute's Innovative Drug Development Initiative—Group 3 Pulmonary Hypertension

Shlobin,

Shen,

Wort

et al. 2024

Pulm. circ.

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“…245 As in left ventricular dysfunction, mechanical assist devices for the RV may one day provide symptomatic relief in endstage patients and serve as destination therapy or a bridge to transplant. Initial data is promising 246 and a feasibility trial is currently underway to examine the safety of a device targeting pulmonary arterial compliance in Group 3 PH patients (REGISTRATION: URL: https://www.clinicaltrials. gov; Unique identifier: NCT05001711).…”

Section: Emerging Therapiesmentioning

confidence: 99%

Group 3 Pulmonary Hypertension: From Bench to Bedside

Singh

Dorfmüller

Shlobin

et al. 2022

Circulation Research

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Pulmonary hypertension (PH) because of chronic lung disease is categorized as Group 3 PH in the most recent classification system. Prevalence of these diseases is increasing over time, creating a growing need for effective therapeutic options. Recent approval of the first pulmonary arterial hypertension therapy for the treatment of Group 3 PH related to interstitial lung disease represents an encouraging advancement. This review focuses on molecular mechanisms contributing to pulmonary vasculopathy in chronic hypoxia, the pathology and epidemiology of Group 3 PH, the right ventricular dysfunction observed in this population and clinical trial data that inform the use of pulmonary vasodilators in Group 3 PH.

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“…99 Another device with potential applicability to PH-HFpEF involves percutaneous mechanical unloading of the PA with a gas-filled balloon that inflates and deflates during each cardiac cycle, thereby restoring central PA compliance. 100 This device, which is under development in PAH, may also be a novel therapeutic in patients with PH-HFpEF in whom proximal PA stiffening is a major problem and more common than distal PA stiffening. Last, PA denervation improves PVR and increases 6MWD in patients with PAH and may be effective in patients with PH-HFpEF.…”

Section: Treatment Approachesmentioning

confidence: 99%

Elucidating the Clinical Implications and Pathophysiology of Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction: A Call to Action: A Science Advisory From the American Heart Association

Brittain¹,

Thenappan²,

Huston³

et al. 2022

Circulation

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This science advisory focuses on the need to better understand the epidemiology, pathophysiology, and treatment of pulmonary hypertension in patients with heart failure with preserved ejection fraction. This clinical phenotype is important because it is common, is strongly associated with adverse outcomes, and lacks evidence-based therapies. Our goal is to clarify key knowledge gaps in pulmonary hypertension attributable to heart failure with preserved ejection fraction and to suggest specific, actionable scientific directions for addressing such gaps. Areas in need of additional investigation include refined disease definitions and interpretation of hemodynamics, as well as greater insights into noncardiac contributors to pulmonary hypertension risk, optimized animal models, and further molecular studies in patients with combined precapillary and postcapillary pulmonary hypertension. We highlight translational approaches that may provide important biological insight into pathophysiology and reveal new therapeutic targets. Last, we discuss the current and future landscape of potential therapies for patients with heart failure with preserved ejection fraction and pulmonary vascular dysfunction, including considerations of precision medicine, novel trial design, and device-based therapies, among other considerations. This science advisory provides a synthesis of important knowledge gaps, culminating in a collection of specific research priorities that we argue warrant investment from the scientific community.

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Pulmonary Artery Endovascular Device Compensates for Loss of Vascular Compliance in Pulmonary Arterial Hypertension

Cited by 6 publications

References 4 publications

Pulmonary hypertension in the setting of interstitial lung disease: Approach to management and treatment. A consensus statement from the Pulmonary Vascular Research Institute's Innovative Drug Development Initiative—Group 3 Pulmonary Hypertension

Pulmonary hypertension in the setting of interstitial lung disease: Approach to management and treatment. A consensus statement from the Pulmonary Vascular Research Institute's Innovative Drug Development Initiative—Group 3 Pulmonary Hypertension

Group 3 Pulmonary Hypertension: From Bench to Bedside

Elucidating the Clinical Implications and Pathophysiology of Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction: A Call to Action: A Science Advisory From the American Heart Association

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