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01-11-2019 | Bosentan

Advances in targeted therapy for chronic thromboembolic pulmonary hypertension

Authors: Yi Zhang, Xue Yu, Qi Jin, Qin Luo, Zhihui Zhao, Qing Zhao, Lu Yan, Zhihong Liu

Published in: Heart Failure Reviews | Issue 6/2019

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by unresolved thrombi in the pulmonary arteries and microvasculopathy in nonoccluded areas. If left untreated, progressive pulmonary hypertension will induce right heart failure and, finally, death. Currently, pulmonary endarterectomy (PEA) remains the only method that has the potential to cure CTEPH. Unfortunately, up to 40% of patients are ineligible for this procedure for various reasons. In recent years, refined balloon pulmonary angioplasty (BPA) has become an alternative option for inoperable CTEPH patients, and it may be another curative treatment in the future, particularly in combination with prior PEA. Nevertheless, 23% of patients still suffer from persistent PH after BPA. Given that CTEPH shares many similarities with idiopathic pulmonary arterial hypertension (PAH), targeted drugs developed for PAH are also attractive options for CTEPH, especially for inoperable or persistent/recurrent CTEPH patients. To date, riociguat, macitentan, and subcutaneous treprostinil are the only drugs proven by randomized control trials to be capable of improving the exercise capacity (6-min walking distance) of CTEPH patients. In this review, we summarize the achievements and unresolved problems of PAH-targeted therapy for CTEPH over the last decade.

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Title: Advances in targeted therapy for chronic thromboembolic pulmonary hypertension
Authors: Yi Zhang
Xue Yu
Qi Jin
Qin Luo
Zhihui Zhao
Qing Zhao
Lu Yan
Zhihong Liu
Publication date: 01-11-2019
Publisher: Springer US
Keywords: Bosentan
Sildenafil
Pulmonary Hypertension
Iloprost
Targeted Therapy
Pulmonary Hypertension
Hypertension
Riociguat
Pulmonary Hypertension
Pulmonary Hypertension
Arterial Hypertension
Arterial Hypertension
Published in: Heart Failure Reviews / Issue 6/2019
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-019-09798-x

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