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Antes Revista del Instituto Nacional de Enfermedades Respiratorias

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2006, Número S4

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Neumol Cir Torax 2006; 65 (S4)


Manejo médico y tratamiento farmacológico de la hipertensión arterial pulmonar

Pulido ZT, Domínguez CE, del Valle ZK

Idioma: Español
Referencias bibliográficas: 71
Paginas: 58-67
Archivo PDF: 90.14 Kb.


RESUMEN

El tratamiento de la hipertensión arterial pulmonar (HAP) ha evolucionado en los últimos años gracias al mejor conocimiento en su fisiopatología. En general, el manejo de la HAP se puede dividir en medidas generales que incluyen cambios en el estilo de vida; tratamiento convencional que deberá ser siempre individualizado y dentro del cual se encuentran la digoxina, los diuréticos y la oxigenoterapia; y, finalmente, tratamiento específico como calcioantagonistas en aquellos pacientes respondedores durante el reto vasodilatador agudo, prostanoides, antagonistas de endotelina e inhibidores de la fosfodiesterasa-5. Algunos de estos fármacos han demostrado mejoría en la sobrevida de los pacientes, sin embargo la mortalidad sigue siendo elevada. Por este motivo, actualmente se están realizando estudios que incluyen la combinación de diferentes medicamentos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Rubin LJ. Primary pulmonary hypertension. N Engl J Med 1997; 336: 111-117.

  2. Humbert M, Jäis X, Sitbon O, Parent F, Hervé P, Simonneau G. Pulmonary arterial hypertension. Breathe 2005; 2: 127-135.

  3. Tuder RM, Zaiman AL. Pathology of pulmonary vascular disease. In: Peackok AJ, Rubin LJ. Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold publishers, 2004: 25-32.

  4. Humbert M, Sitbon O, Simonneau G. An integrated approach to the treatment of pulmonary arterial hypertension. In: Peackok AJ, Rubin LJ. Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold Publishers, 2004: 334-344.

  5. Mereles D, Ehlken N, Kreuscher S, Ghofrani S, Hoeper MM, Halank M, et al. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation 2006; 114: 1482-89.

  6. Galié N, Manes A, Branzi A. Conventional medical therapies. In: Peackok AJ, Rubin LJ. Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold Publishers, 2004: 244-254.

  7. Nelson DM, Main E, Crafford W, et al. Peripartum heart failure due to primary pulmonary hypertension. Obstet Gynecol 1983; 62(Suppl 3): 58s-63s.

  8. Nootens M, Rich S. Successful management of labor and delivery in primary pulmonary hypertension. Am J Cardiol 1993; 71: 1124-1125.

  9. Galié N, Torbicki A, Barst R, Dartevelle P, Haworth S, Higenbottam T, et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Eur Heart J 2004; 25: 2243-78.

  10. Humbert M, Sitbon O, Simonneau G. Treatment of pulmonary arterial hypertension. N Engl J Med 2004; 351(14): 1425-36.

  11. Badesch DB, Barst RJ, McCrory DC, Simonneau G, McLaughlin W. American College of Chest Physicians. Medical therapy for pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest 2004; 126(Suppl 1): 35S-62S.

  12. Rich S, Seidlitz M, Dodin E, et al. The short-term effects of digoxin in patients with right ventricular dysfunction from pulmonary hypertension. Chest 1998; 114: 787-792.

  13. Fuster V, Steele PM, Edwards WD, et al. Primary pulmonary hypertension. Natural history and the importance of thrombosis. Circulation 1984; 70: 580-587.

  14. Rich S, Kaufman E, Levy PS, et al. The effect of high doses of calcium-channel blockers on survival in primary pulmonary hypertension. N Engl J Med 1992; 327: 76-81.

  15. Rubin L, Badesch D. Evaluation and management of the patients with pulmonary arterial hypertension. Ann Intern Med 2005; 143: 282-92.

  16. Sitbon O, Humbert M, Jäis X, et al. Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension. Circulation 2005; 111: 3105-3111.

  17. Christman BW, McPherson CD, Newman JH, et al. An imbalance between the excretion of thromboxane and prostacyclin metabolites in pulmonary hypertension. N Engl J Med 1992; 237: 70-75.

  18. Moncada S, Gryglewski R, Bunting S, et al. An enzyme isolated form arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation. Nature 1976; 263: 663-665.

  19. Fortin TA, Tapson VF. Intravenous prostacyclin for pulmonary arterial hypertension. In: Peackok AJ, Rubin LJ. Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold Publishers, 2004: 255-267.

  20. Rubin LJ, Mendoza J, Hood M, McGoon M, Barst R, William W, et al. Treatment of primary pulmonary hypertension with continuous intravenous prostacyclin (epoprostenol). Ann Intern Med 1990; 112: 485-91.

  21. Barst RJ, Rubin LJ, Long WA, McGoon MD, Rich S, Badesch DB, et al. A comparison of continuous intravenous epoprostenol with conventional therapy for primary pulmonary hypertension. The Primary Pulmonary Hypertension Study Group. N Engl J Med 1996; 334(5): 296-302.

  22. Badesch DB, Tapson VF, McGoon MD, Rubin LJ, et al. Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease. A randomized, controlled trial. Ann Intern Med 2000; 132(6): 425-34.

  23. Sitbon O, Humbert M, Nunes H, Parent F, Simonneau G. Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival. J Am Coll Cardiol 2002; 40: 780-8.

  24. McLaughlin V, Genthner DE, Panella MM, Rich S. Reduction in pulmonary vascular resistance with long-term epoprostenol therapy in primary pulmonary hypertension. N Engl J Med 1998; 338: 273-7.

  25. Rosenzweig EB, Kerstein D, Barst R. Long-term prostacyclin for pulmonary hypertension with associated congenital heart defects. Circulation 1999; 99: 1858-65.

  26. Nunes H, Humbert M, Sitbon O, Barst RJ, Simonneau G. Prognostic factors for survival in human immunodeficiency virus-associated pulmonary arterial hypertension. Am J Respir Crit Care Med 2003; 167(10): 1433-9.

  27. Krowka MJ, Frantz RP, McGoon MD, Severson C. Improvement in pulmonary hemodynamics during intravenous epoprostenol. A study of 15 patients with moderate to severe portopulmonary hypertension. Hepatology 1999; 30: 641-8.

  28. McLaughlin V, Gaine SP, Barst RJ, et al. For the Treprostinil Study Group. Efficacy and safety of treprostinil: An epoprostenol analog for primary pulmonary hypertension. J Cardiovasc Pharmacol 2003; 41(2): 293-9.

  29. Simonneau G, Barst RJ, Galié N, Naeije R, Rich S, Rubin LJ, Treprostinil Study Group. Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension: a double-blind, randomized, placebo-controlled trial. Am J Respir Crit Care Med 2002; 165(6): 800-4.

  30. Lang I, Gómez-Sánchez M, Kneussl M, et al. Efficacy of long-term subcutaneous treprostinil sodium therapy in pulmonary hypertension. Chest 2006; 129: 1636-1643.

  31. Barst RJ, Galié N, Naeije R, et al. Long-term outcome in pulmonary arterial hypertension patients treated with treprostinil. Eur Respir J 2006, e-publication August 9. Doi: 10.1183/ 09031936.06.00044406.

  32. Tapson VF, Gomberg-Maitland M, McLaughlin VV, et al. Safety and efficacy of IV treprostinil for pulmonary arterial hypertension. A prospective, multicenter, open-label, 12-week trial. Chest 2006; 129: 683-688.

  33. Channick RN, Olschewski H, Seeger W, Staub T, Voswinckel R, Rubin LJ. Safety and efficacy of inhaled treprostinil as add-on therapy to bosentan in pulmonary arterial hypertension. J Am Coll Cardiol 2006; 48: 1422-1437.

  34. Olschewski H, Seeger W. Inhaled ilprost. In: Peackok AJ, Rubin LJ, Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold Publishers, 2004: 268-277.

  35. Nikkho S, Seeger W, Baumgartner R, et al. One-year observation of iloprost therapy in patients with pulmonary hypertension. Eur Respir J 2001; 18(Suppl): 324s.

  36. Behr J, Baumgartner R, Borst M, et al. Consistency of acute hemodynamic response to inhaled iloprost in pulmonary hypertension patients treated long-term with iloprost aerosol. Eur Respir J 2001; 18(Suppl): 324s.

  37. Olschewski H, Simonneau G, Galié N, et al. Inhaled iloprost for severe pulmonary hypertension. N Engl J Med 2002; 347: 322-329.

  38. McLaughlin VV. Oral and subcutaneous prostacyclin analogues. In: Peackok AJ, Rubin LJ. Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold Publishers, 2004: 278-282.

  39. Galié N, Humber M, Vachiéry JL, et al. Effects of beraprost sodium, an oral prostacyclin analogue, in patients with pulmonary arterial hypertension: A randomized, double-blind, placebo-controlled trial. J Am Coll Cardiol 2002; 39: 1496-1502.

  40. Barst RJ, McGoon M, Mc Laughlin VV, et al. Beraprost therapy for pulmonary arterial hypertension. J Am Coll Cardiol 2003; 41: 2119-2125.

  41. Dupuis J. Endothelin in the pathophysiology of pulmonary hypertension. Clozel M, Rubin L, editors. Switzerland: Druck Basel; 2003: 129-143.

  42. Channick R, Sitbon O, Barst R, Manes A, Rubin L. Endothelin receptor antagonist in pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43: 62S-68S.

  43. Channick RN, Simonneau G, Sitbon O, et al. Effects of the dual endothelin-receptor antagonist bosentan in patients with pulmonary hypertension: A randomized placebo-controlled study. Lancet 2001; 358: 1119-23.

  44. Rubin LJ, Badesch D, Barst R, et al. Bosentan therapy for pulmonary arterial hypertension. N Engl J Med 2002; 346: 896-903.

  45. McLaughlin V, Sitbon O, Badesch DB, Barst RJ, Simonneau G, Rubin LJ. Survival with first-line bosentan in patients with primary pulmonary hypertension. Eur Respir J 2005; 25: 244-249.

  46. Barst RJ, Ivy D, Dingemanse J, et al. Pharmacokinetics, safety, and efficacy of bosentan in pediatric patients with pulmonary arterial hypertension. Clin Pharmacol Ther 2003; 73: 372-82.

  47. Sitbon O, Gressin V, Speich R, et al. Bosentan for the treatment of human immunodeficiency virus-associated pulmonary arterial hypertension. Am J Respir Crit Care Med 2004; 170: 1212-7.

  48. Galié N, Beghetti M, Gatzolius M, et al. BREATHE-5: Bosentan improves hemodynamics and exercise capacity in the first randomized placebo-controlled trial in eisenmenger physiology. Chest 2005; 129: 496S.

  49. Hoeper MM, Halank M, Marx C, Niedermeyer J, Winkler J. Bosentan therapy for portopulmonary hypertension. Eur Respir J 2005; 25: 502-8.

  50. Hoeper MM, Schulze C, Schafers HJ, Welte T, Mayer E. Bosentan therapy for inoperable chronic thromboembolic pulmonary hypertension. Chest 2005; 128: 2363-2367.

  51. Helmersen D, Channick RN, Rubin LJ. Endothelin receptor antagonists. In: Peackok AJ, Rubin LJ. Pulmonary circulation: Diseases and their treatment. 2nd edition. London: Arnold Publishers, 2004: 294-301.

  52. Barst RJ, Rich S, Horn EM, McLaughlin V, McFarland J. Clinical efficacy of sitaxsentan, an endothelin-A receptor antagonist, in patients with pulmonary arterial hypertension: Open-label pilot study. Chest 2002; 121: 1860-8.

  53. Barst RJ, Langleben D, Frost A, Shapiro S, et al. Sitaxsentan, therapy for pulmonary arterial hypertension. Am J Respir Crit Care Med 2004; 169: 441-7.

  54. Langleben D, Dixon R, Barst R. STRIDE-1 study group. STRIDE-1: Effects of the selective ETA receptor antagonist, sitaxsentan sodium, in a patient population with pulmonary arterial hypertension that meets traditional inclusion criteria of previous pulmonary arterial hypertension trials. J Cardiovasc Pharmacol 2004; 44: S80-S84.

  55. Barst RJ, Langleben D, Badesch D, et al. Treatment of pulmonary arterial hypertension with the selective endothelin-A receptor antagonist sitaxsentan. J Am Coll Cardiol 2006; 47: 2049-2056.

  56. Vatter H, Seifert V. Ambrisentan, a non-peptide endothelin receptor antagonist. Cardiovasc Drug Rev 2006; 24: o63-76.

  57. Galié N, Badesch D, Oudiz R, et al. Ambrisentan therapy for pulmonary arterial hypertension. J Am Coll Cardiol 2005; 46: 529-535.

  58. Ghofrani H, Pepke-Zaba J, Barbera J, Channick R, Gómez-Sánchez MA, et al. Nitric oxide pathway and phosphodiesterase inhibitors in pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43: 68S-72S.

  59. Carlsen J, Gerstoft J. Sildenafil as a successful treatment of otherwise fatal HIV-related pulmonary hypertension. AIDS 2002; 16: 1568-9.

  60. Sastry BK, Narasimhan C, Reddy K, Raju S. Clinical efficacy of sildenafil controlled, double-blind, crossover study. J Am Coll Cardiol 2004; 43: 1149-53.

  61. Beneficial effect of oral sildenafil therapy on childhood pulmonary arterial hypertension: twelve-month clinical trial of a single-drug, open-label, pilot study. Circulation 2005; 111: 3274-80.

  62. Galié N, Ghofrani HA, Torbicki A, et al. Sildenafil citrate therapy for pulmonary arterial hypertension. N Engl J Med 2005; 353: 2148-57.

  63. Hoeper MM, Dinh-Xuan AT. Combination therapy for pulmonary arterial hypertension: still more questions than answers. Eur Resp J 2004; 24: 339-40.

  64. Galié N, Branzi A. Pulmonary arterial hypertension: therapeutic algorithm. Ital Heart J 2005; 6(10): 856-60.

  65. Hoeper MM, Welte J, Niedermeyer J. Goal-oriented treatment and combination therapy for pulmonary arterial hypertension. Eur Respir J 2005; 26: 858-63.

  66. McLaughlin VV, Oudiz RJ, Frost A, et al. Randomized study of adding inhaled iloprost to existing bosentan in pulmonary arterial hypertension. Am J Respir Crit Care med 2006. Published on August 31 as doi: 10.1164/rccm.200603-358OC.

  67. Humbert M, Barst RJ, Galié N, et al. Combination of bosentan with epoprostenol in pulmonary arterial hyper- tension: BREATHE-2. Eur Respir J 2004; 24: 353-9.

  68. Hoeper MM, Welte T, Niedermeyer J. Combination therapy with bosentan and sildenafil in idiopathic pulmonary arterial hypertension. Eur Respir J 2004; 24: 1007-10.

  69. Ghofrani A, Rose F, Shermuly RT, et al. Oral sildenafil as long-term adjunct therapy to inhaled iloprost in severe pulmonary arterial hypertension. J Am Coll Cardiol 2003; 42: 158-64.

  70. Rubin LJ. Pulmonary arterial hypertension. Proc Am Thorac Soc 2006; 3: 111-115.

  71. Klepetko W, Mayer E, Sandoval J, et al. Interventional and surgical modalities for treatment in pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43: 73s-80s.




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