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Autonomic nervous system involvement in pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Autonomic nervous system involvement in the pathogenesis of PAH has been demonstrated several years ago, however the...

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Autores principales: Vaillancourt, Mylène, Chia, Pamela, Sarji, Shervin, Nguyen, Jason, Hoftman, Nir, Ruffenach, Gregoire, Eghbali, Mansoureh, Mahajan, Aman, Umar, Soban
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715548/
https://www.ncbi.nlm.nih.gov/pubmed/29202826
http://dx.doi.org/10.1186/s12931-017-0679-6
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author Vaillancourt, Mylène
Chia, Pamela
Sarji, Shervin
Nguyen, Jason
Hoftman, Nir
Ruffenach, Gregoire
Eghbali, Mansoureh
Mahajan, Aman
Umar, Soban
author_facet Vaillancourt, Mylène
Chia, Pamela
Sarji, Shervin
Nguyen, Jason
Hoftman, Nir
Ruffenach, Gregoire
Eghbali, Mansoureh
Mahajan, Aman
Umar, Soban
author_sort Vaillancourt, Mylène
collection PubMed
description Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Autonomic nervous system involvement in the pathogenesis of PAH has been demonstrated several years ago, however the extent of this involvement is not fully understood. PAH is associated with increased sympathetic nervous system (SNS) activation, decreased heart rate variability, and presence of cardiac arrhythmias. There is also evidence for increased renin-angiotensin-aldosterone system (RAAS) activation in PAH patients associated with clinical worsening. Reduction of neurohormonal activation could be an effective therapeutic strategy for PAH. Although therapies targeting adrenergic receptors or RAAS signaling pathways have been shown to reverse cardiac remodeling and improve outcomes in experimental pulmonary hypertension (PH)-models, the effectiveness and safety of such treatments in clinical settings have been uncertain. Recently, novel direct methods such as cervical ganglion block, pulmonary artery denervation (PADN), and renal denervation have been employed to attenuate SNS activation in PAH. In this review, we intend to summarize the multiple aspects of autonomic nervous system involvement in PAH and overview the different pharmacological and invasive strategies used to target autonomic nervous system for the treatment of PAH.
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spelling pubmed-57155482017-12-08 Autonomic nervous system involvement in pulmonary arterial hypertension Vaillancourt, Mylène Chia, Pamela Sarji, Shervin Nguyen, Jason Hoftman, Nir Ruffenach, Gregoire Eghbali, Mansoureh Mahajan, Aman Umar, Soban Respir Res Review Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Autonomic nervous system involvement in the pathogenesis of PAH has been demonstrated several years ago, however the extent of this involvement is not fully understood. PAH is associated with increased sympathetic nervous system (SNS) activation, decreased heart rate variability, and presence of cardiac arrhythmias. There is also evidence for increased renin-angiotensin-aldosterone system (RAAS) activation in PAH patients associated with clinical worsening. Reduction of neurohormonal activation could be an effective therapeutic strategy for PAH. Although therapies targeting adrenergic receptors or RAAS signaling pathways have been shown to reverse cardiac remodeling and improve outcomes in experimental pulmonary hypertension (PH)-models, the effectiveness and safety of such treatments in clinical settings have been uncertain. Recently, novel direct methods such as cervical ganglion block, pulmonary artery denervation (PADN), and renal denervation have been employed to attenuate SNS activation in PAH. In this review, we intend to summarize the multiple aspects of autonomic nervous system involvement in PAH and overview the different pharmacological and invasive strategies used to target autonomic nervous system for the treatment of PAH. BioMed Central 2017-12-04 2017 /pmc/articles/PMC5715548/ /pubmed/29202826 http://dx.doi.org/10.1186/s12931-017-0679-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Vaillancourt, Mylène
Chia, Pamela
Sarji, Shervin
Nguyen, Jason
Hoftman, Nir
Ruffenach, Gregoire
Eghbali, Mansoureh
Mahajan, Aman
Umar, Soban
Autonomic nervous system involvement in pulmonary arterial hypertension
title Autonomic nervous system involvement in pulmonary arterial hypertension
title_full Autonomic nervous system involvement in pulmonary arterial hypertension
title_fullStr Autonomic nervous system involvement in pulmonary arterial hypertension
title_full_unstemmed Autonomic nervous system involvement in pulmonary arterial hypertension
title_short Autonomic nervous system involvement in pulmonary arterial hypertension
title_sort autonomic nervous system involvement in pulmonary arterial hypertension
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715548/
https://www.ncbi.nlm.nih.gov/pubmed/29202826
http://dx.doi.org/10.1186/s12931-017-0679-6
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