Therapeutic algorithms in pulmonary hypertension in the light of current guidelines

Okutucu, Sercan; Tokgözoğlu, Lâle

doi:10.5152/akd.2010.126

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Treatment options for PAH patients have significantly improved in the last 20 years in line with the approval of effective PAH-specific drugs ( 7 , 18 ). All currently available oral therapies for the treatment of PAH have been approved based on 6MWD changes in a 12–16-week study period.…”

Section: Introductionmentioning

confidence: 99%

Six-minute walk test in pulmonary arterial hypertension

Demir

Küçükoğlu²

2015

Anatol J Cardiol

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Exercise intolerance is the main characteristic of pulmonary arterial hypertension (PAH). The six-minute walk test (6MWT) and cardiopulmonary exercise test are widely used in assessing exercise capacity of PAH patients. Six-minute walk distance (6MWD) has been specified as the main clinical outcome in PAH and has been used as the primary end-point in many studies conducted for new PAH treatments. Using 6MWD as the end-point in clinical studies has many advantages. 6MWT is an inexpensive, easily applicable, and repeatable standardized test that is well-tolerated by PAH patients. Moreover, it is a valid measure of symptomatic improvement. It is correlated with variables of maximal cardiopulmonary exercise test as a measure of submaximal exercise capacity and disease severity markers such as functional class and pulmonary hemodynamics. It is widely used in clinical practice together with other invasive and non-invasive disease markers in assessing disease progression and response to treatment. In addition, it has prognostic importance and is a good prognostic marker. On the other hand, there are limitations to the use of 6MWD as the primary end-point in PAH treatment. It has decreased sensitivity in individuals with less severe disease and high 6MWD at baseline and decreased adequacy in assessing the effects of treatment in patients who are still under PAH treatment. Despite the limitations, 6MWD plays a key role in the evaluation and management of PAH patients.

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Section: Introductionmentioning

confidence: 99%

Six-minute walk test in pulmonary arterial hypertension

Demir

Küçükoğlu²

2015

Anatol J Cardiol

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“…Prostacyclin remains a mainstay in the treatment of PH. 15,16 The inhaler Iloprost was given to our patient in the preoperative period and pulmonary arterial pressure was seen to improve significantly in the follow-up period.…”

Section: Discussionmentioning

confidence: 88%

Severe Primary Pulmonary Hypertension in Pregnancy: Case Report

Güzel¹,

Tokgöz²,

Tüfek³

et al. 2015

Turkiye Klinikleri J Case Rep

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ardiac disease is one of the most important causes of maternal morbidity and mortality. Physiological changes that occur during pregnancy such as increased blood volume, decreased systemic vascular resistance, fluctuating cardiac output and predisposition to coagulation causes increases in the cardiac work load. The incidence of cardiac disease in pregnancy is reported as being 0,2-4% in the developed world.1,2 A dvances in the diagnosis and treatment of congenital and rheumatic cardiac diseases have resulted in more women being able to conceive. The physiological changes in the cardiovascular system during pregnancy, parturition and the postnatal period pose a health risk for patients.3,4 The incidence of cardiovascular system pathology also increases with the use of anesthesia.Pulmonary hypertension (PH) seen during pregnancy may be idiopathic or secondary to cardiovascular diseases and has a reported mortality rate of 30-56%. [5][6][7] The aim of this case report was to discuss the preoperative anesthesia method in a pregnant woman with PH and a high cardiac risk.Turkiye Klinikleri J Case Rep 2015;23 (2) 113 Severe Primary Pulmonary Hypertension in Pregnancy: Case Report A AB BS ST TR RA AC CT T In this case report, the management of a 35-week pregnant patient with primary pulmonary hypertension who had a cesarean section operation under regional anesthesia is discussed in the light of literature. In the preoperative examination, the patient suffered from severe dyspnea. She was discovered to have tricuspid insufficiency (4°) and her systolic pulmonary arterial pressure (PAP) was measured at 110 mmHg. The patient was successfully managed with combined spinal epidural anesthesia and was then referred to the cardiology intensive care unit.K Ke ey y W Wo or rd ds s: : Idiopathic pulmonary hypertension; pregnancy; anesthesia, spinal Ö ÖZ ZE ET T Bu olgu sunumunda 35 haftalık primer pulmoner hipertansiyonlu gebe bir hastada rejyonel anestezi altında sezaryen cerrahisi yönetimi literatür eşliğinde tartışılmıştır. Hastanın preoperatif değerlendirilmesinde ileri derecede dispneik olduğu görüldü. Ayrıca 4° triküspit yetersizliği mevcuttu ve sistolik pulmoner arter basıncı (PAP) 110 mmHg idi. Başarılı bir kombine spinal epidural anestezi yönetimi ile hasta sorunsuz bir şekilde kardiyoloji yoğun bakım ünitesine transfer edildi.A An na ah ht ta ar r K Ke el li im me el le er r: : İdiyopatik pulmoner hipertansiyon; gebelik; anestezi, spinal T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J C Ca as se e R Re ep p 2 20 01 15 5; ;2 23 3( (2 2) ): :1 11 13 3--6 6

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Pulmoner Arteri̇yel Hi̇pertansi̇yon Tedavi̇si̇nde Güncel Yaklaşimlar

Yıldız¹,

Devrim²

2021

Ankara Universitesi Eczacilik Fakultesi Dergisi

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Amaç: Pulmoner arteriyel hipertansiyon (PAH), yüksek morbidite ve mortaliteye sahip kronik bir hastalıktır. PAH için uygulanan tedavi stratejileri hastaların yaşam kalitesinin iyileşmesini sağlamakla birlikte, hastaların büyük çoğunluğu için PAH, tedavi olasılığı olmayan hayatı sınırlayan bir hastalık olmaya devam etmektedir. Mevcut PAH tedavisinde karşılaşılan en önemli sorunlar hasta uyuncunun düşük olması ve yan etkilerin görülmesidir. Bu derlemede, PAH tedavisinde rhoA/rho kinaz, tirozin kinaz, endotel progenitör hücreleri, vazoaktif bağırsak peptiti ve miRNA gibi çeşitli yeni moleküler yolakların potansiyeli tartışılmıştır. Ayrıca, tedavide kullanılmak üzere onaylanmış ve inceleme aşamasında olan etkin maddelerin etkinliğini artırmak için hedeflendirilmiş ilaç taşıyıcı sistemlerin kullanımına yönelik çeşitli yöntemler değerlendirilmiştir.Sonuç ve Tartışma: PAH, pulmoner vasküler direncin artması ve sonunda sağ kalp yetmezliği ve ölümle sonuçlanan ilerleyici pulmoner vasküler fonksiyonel ve yapısal değişikliklerle karakterize kronik bir hastalıktır. PAH patofizyolojisinden sorumlu hücresel ve moleküler mekanizmalar hakkındaki bilgilerin artması PAH tedavisinde yeni terapötik yaklaşımların oluşmasını sağlamıştır. Bu yaklaşımlar arasında rhoA/rho kinaz, tirozin kinaz, endotel progenitör hücreleri, vazoaktif bağırsak peptiti ve miRNA gibi çeşitli yeni moleküler yolakların kullanımı yer almaktadır. Ayrıca, PAH tedavisinde ilaç taşıyıcı sistemlerin kullanımı etkin maddelerin lokal olarak etki bölgesine hedeflendirilmesini sağlayarak optimum etkinin elde edilmesi ve yan etki görülme potansiyelinin azaltılması açısından umut verici olmuştur.

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Therapeutic algorithms in pulmonary hypertension in the light of current guidelines

Cited by 3 publications

References 23 publications

Six-minute walk test in pulmonary arterial hypertension

Six-minute walk test in pulmonary arterial hypertension

Severe Primary Pulmonary Hypertension in Pregnancy: Case Report

Pulmoner Arteri̇yel Hi̇pertansi̇yon Tedavi̇si̇nde Güncel Yaklaşimlar

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