PMID- 17124557
OWN - NLM
STAT- MEDLINE
DCOM- 20070518
LR  - 20220309
IS  - 0920-3206 (Print)
IS  - 0920-3206 (Linking)
VI  - 20
IP  - 5
DP  - 2006 Oct
TI  - New insights in the treatment strategy for pulmonary arterial hypertension.
PG  - 377-86
AB  - INTRODUCTION: Recent advances in our understanding of the pathophysiological and 
      molecular mechanisms involved in pulmonary arterial hypertension have led to the 
      development of novel and rational pharmacological therapies. In addition to 
      conventional therapy (i.e., supplemental oxygen and calcium channel blockers), 
      prostacyclin or endothelin receptor antagonists have been recommended as a 
      first-line therapy for pulmonary arterial hypertension. However, these treatments 
      have potential limitations with regard to their long-term efficacy and 
      improvement in survival. Furthermore, intravenous prostacyclin (epoprostenol) 
      therapy, which is recommended by most experts for patients with New York Heart 
      Association (NYHA) functional class IV, is complicated, uncomfortable for 
      patients, and expensive because of the cumbersome administration system. 
      Considering these circumstances, it is necessary to develop additional novel 
      therapeutic approaches that target the various components of this multifactorial 
      disease. CASE REPORT: In this short review, we present an overview of the current 
      treatment options for pulmonary arterial hypertension and describe a case report 
      with primary pulmonary hypertension. A male patient with NYHA functional class IV 
      and showing no response to calcium channel blockers and prostacyclin exhibited 
      significantly improved exercise tolerance and hemodynamics and long-term survival 
      for more than 2.5 years after receiving an oral combination therapy of a 
      phosphodiesterase type 5 inhibitor (sildenafil), phosphodiesterase type 3 
      inhibitor (pimobendan), and nicorandil. FUTURE PERSPECTIVE: We also discuss the 
      background and plausible potential mechanisms involved in this case, as well as 
      future perspectives in the treatment of pulmonary arterial hypertension.
FAU - Sahara, Makoto
AU  - Sahara M
AD  - Department of Cardiovascular Medicine, University of Tokyo Graduate School of 
      Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan. saharam-tky@umin.ac.jp
FAU - Takahashi, Toshiyuki
AU  - Takahashi T
FAU - Imai, Yasushi
AU  - Imai Y
FAU - Nakajima, Toshiaki
AU  - Nakajima T
FAU - Yao, Atsushi
AU  - Yao A
FAU - Morita, Toshihiro
AU  - Morita T
FAU - Hirata, Yasunobu
AU  - Hirata Y
FAU - Nagai, Ryozo
AU  - Nagai R
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Cardiovasc Drugs Ther
JT  - Cardiovascular drugs and therapy
JID - 8712220
RN  - 0 (Anticoagulants)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Diuretics)
RN  - 0 (Nitric Oxide Donors)
RN  - 0 (Phosphodiesterase Inhibitors)
RN  - 0 (Piperazines)
RN  - 0 (Purines)
RN  - 0 (Pyridazines)
RN  - 0 (Sulfones)
RN  - 0 (Vasodilator Agents)
RN  - 260456HAM0 (Nicorandil)
RN  - 34AP3BBP9T (pimobendan)
RN  - BW9B0ZE037 (Sildenafil Citrate)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - Antihypertensive Agents/*therapeutic use
MH  - Calcium Channel Blockers/therapeutic use
MH  - Diuretics/therapeutic use
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Hypertension, Pulmonary/*therapy
MH  - Male
MH  - Middle Aged
MH  - Nicorandil/therapeutic use
MH  - Nitric Oxide Donors/therapeutic use
MH  - Oxygen Inhalation Therapy
MH  - Phosphodiesterase Inhibitors/therapeutic use
MH  - Piperazines/therapeutic use
MH  - Purines/therapeutic use
MH  - Pyridazines/therapeutic use
MH  - Sildenafil Citrate
MH  - Sulfones/therapeutic use
MH  - Vasodilator Agents/therapeutic use
RF  - 54
EDAT- 2006/11/25 09:00
MHDA- 2007/05/19 09:00
CRDT- 2006/11/25 09:00
PHST- 2006/11/25 09:00 [pubmed]
PHST- 2007/05/19 09:00 [medline]
PHST- 2006/11/25 09:00 [entrez]
AID - 10.1007/s10557-006-0498-3 [doi]
PST - ppublish
SO  - Cardiovasc Drugs Ther. 2006 Oct;20(5):377-86. doi: 10.1007/s10557-006-0498-3.