Modern treatment to reduce pulmonary arterial pressure in pulmonary arterial hypertension

摘要

Treatment goals in pulmonary arterial hypertension (PAH) include improved quality of life and exercise capacity as well as improved life prognosis. In our experience, only remarkable reductions in pulmonary arterial pressure (PAP) improve long-term survival. Lowering PAP could contribute to reverse remodeling by reducing hemodynamic stress. Proper and prompt use of PAH-specific drugs lowers PAP in patients with PAH. Upfront combination therapy with different PAH-specific drugs and quickly establishing high dose epoprostenol lowers PAP sufficiently to improve prognosis in patients with PAH. PAH is often a comorbidity with other diseases including congenital heart defect, connective tissue diseases, and pulmonary arterial aneurysm. It is essential in these conditions to lower PAP to allow the next treatment strategy. In this report, we review modern treatments to lower PAP in patients with PAH. (C) 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.