Pulmonary arterial hypertension: the clinical syndrome

Circ Res. 2014 Jun 20;115(1):115-30. doi: 10.1161/CIRCRESAHA.115.301146.

Abstract

Pulmonary arterial hypertension is a progressive disorder in which endothelial dysfunction and vascular remodeling obstruct small pulmonary arteries, resulting in increased pulmonary vascular resistance and pulmonary pressures. This leads to reduced cardiac output, right heart failure, and ultimately death. In this review, we attempt to answer some important questions commonly asked by patients diagnosed with pulmonary arterial hypertension pertaining to the disease, and aim to provide an explanation in terms of classification, diagnosis, pathophysiology, genetic causes, demographics, and prognostic factors. Furthermore, important molecular pathways that are central to the pathogenesis of pulmonary arterial hypertension are reviewed, including nitric oxide, prostacyclin, endothelin-1, reactive oxygen species, and endothelial and smooth muscle proliferation.

Keywords: hemodynamics; hypertension, pulmonary; nitric oxide.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bone Morphogenetic Protein Receptors, Type II / genetics
  • Bone Morphogenetic Protein Receptors, Type II / physiology
  • Familial Primary Pulmonary Hypertension
  • Female
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / etiology*
  • Hypertension, Pulmonary / genetics
  • Hypertension, Pulmonary / mortality
  • Hypertension, Pulmonary / physiopathology
  • Male
  • Mutation
  • Positron-Emission Tomography
  • Prognosis
  • Sex Factors
  • Signal Transduction

Substances

  • Bone Morphogenetic Protein Receptors, Type II