Author:
Caputo Annalisa,Papa Silvia,Manzi Giovanna,Laviola Domenico,Recchioni Tommaso,Severino Paolo,Lavalle Carlo,Maestrini Viviana,Mancone Massimo,Badagliacca Roberto,Vizza Carmine Dario
Abstract
Abstract
Purpose of Review
The purpose of this review is to overview the most relevant and recent knowledge regarding medical management in pulmonary arterial hypertension (PAH).
Recent Findings
Evidence has shown that PAH patients’ quality of life and prognosis depend on the capability of the RV to adapt to increased afterload and to fully recover in response to substantially reduced pulmonary vascular resistance obtained with medical therapy.
Data from recent clinical studies show that more aggressive treatment strategies, especially in higher risk categories, determine larger afterload reductions, consequentially increasing the probability of achieving right heart reverse remodeling, therefore improving the patients’ survival and quality of life.
Remarkable progress has been observed over the past decades in the medical treatment of PAH, related to the development of drugs that target multiple biological pathways, strategies for earlier and more aggressive treatment interventions.
Summary
New hopes for treatment of patients who are unable to achieve low-risk status have been derived from the phase 2 trial PULSAR and the phase 3 trial STELLAR, which show improvement in the hemodynamic status of patients treated with sotatercept on top of background therapy. Promising results are expected from several ongoing clinical trials targeting new pathways involved in the pathophysiology of PAH.
Funder
Università degli Studi di Roma La Sapienza
Publisher
Springer Science and Business Media LLC
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine,Emergency Medicine