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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2017
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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. |
format | Online Article Text |
id | pubmed-5715548 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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