Pulmonary Arterial Hypertension (eBook)

Diagnosis and Evidence-Based Treatment

Robyn Barst (Herausgeber)

eBook Download: PDF

2008
John Wiley & Sons (Verlag)
978-0-470-99738-3 (ISBN)

Infos

• First book dedicated to this disease, previously thought to be incurable, but with the advent of new drugs, now amenable to management and a much improved prognosis for patients
• From the PAH Association, the leading experts in field
• Incorporates the latest AACP management guidelines
• Includes evidence-based treatment algorithms based on the recently updated ACCP Guidelines for Medical Treatment
• Aimed at specialists in pulmonology and cardiovascular disease, this volume provides the clinician with the most up to date information on the effective management of PAH

Robyn J. Barst, MD, Professor of Pediatrics (in Medicine); Director, Pulmonary Hypertension Center, Columbia University Medical Center, New York, NY, USA
Dr Barst is chair of the 'Scientific Leadership Council' of the Pulmonary Hypertension Association, a group of more than twenty internationally recognized leaders in the field of PAH. The mission of the SLC is 'to provide medical and scientific leadership for the Association by proactively facilitating the development of new knowledge about pulmonary hypertension, actively disseminating knowledge about pulmonary hypertension to medical and public audiences, and advocating and raising awareness about pulmonary hypertension. The editor and contributors are all members of the SLC, and include many well-known names including Lewis Rubin, George Simmoneau, Nazarino Galie, and David Badesch. This text is intended to be the 'official' work on the subject.
Further evidence of the standing of the contributors is the medical centers involved in the SLC, which include the Mayo Clinic, Columbia Presbyterian Medical Center, University of California San Diego, UCLA, Duke, Rush Presbyterian, University of Colorado, University of Utah, Vanderbilt, the University of Alabama at Birmingham, and the University of Pennsylvania. The SLC also has international members from Italy, Ireland, Germany, and Canada.
Dr Barst is? on the Editorial Board of Circulation, the official Journal of the American Heart Association, and for Chest, the official journal for the American Thoracic Society. Member of European Society of Cardiology Task Force for Primary Pulmonary Hypertension, Board Member of the International Society for Heart and Lung Transplantation.

Inhalt

Pulmonary Arterial Hypertension 1
Contents 7
Preface 11
Contributors 13
1 Introduction 17
2 Diagnosis and assessment of pulmonary arterial hypertension 23
2.1 Hemodynamics of pulmonary hypertension 23
2.2 Venice classification 24
2.3 Overview of the diagnostic process (algorithm) 26
2.4 Screening (identifying a pre-existing risk) 27
2.5 Detection (discovering pulmonary hypertension) 29
2.6 Definition (diagnosing the clinical context) 30
2.7 Prediction (estimating prognosis) 30
2.8 Principles of follow-up (evaluating and responding to outcome) 32
2.9 Specific tests in the evaluation of pulmonary hypertension 36
3 Conventional therapy in pulmonary arterial hypertension 63
3.1 Calcium channel antagonists 64
3.2 Diuretics 68
3.3 Warfarin 68
3.4 Supplemental oxygen 70
3.5 Inotropic therapy 71
3.6 General measures 72
3.7 Conclusions 73
4 Prostanoid treatment for pulmonary arterial hypertension 77
4.1 Epoprostenol 79
4.2 Treprostinil 93
4.3 Iloprost 96
4.4 Beraprost 97
4.5 Treatment selection 98
4.6 Conclusions 99
5 Endothelin receptor antagonists in pulmonary arterial hypertension 105
5.1 Bosentan 108
5.2 Sitaxsentan 112
5.3 Ambrisentan 115
5.4 Safety and tolerability with endothelin receptor antagonists 117
5.5 Conclusions 118
6 Phosphodiesterase-5 inhibitors in pulmonary arterial hypertension 121
6.1 The origins of phosphodiesterase-5 inhibitor development 121
6.2 Pulmonary hypertension as a new indication for phosphodiesterase-5 inhibitor treatment 124
6.3 Role of phosphodiesterase-5 in the pulmonary vasculature 125
6.4 Clinical experience with sildenafil for the treatment of chronic pulmonary hypertension 126
6.5 Pivotal trial and approval of sildenafil for the treatment of pulmonary arterial hypertension (SUPER-1 study) 127
6.6 Other phosphodiesterase-5 inhibitors 128
6.7 Combination therapy 130
6.8 Potential new indications for phosphodiesterase-5 inhibitors outside pulmonary arterial hypertension 132
6.9 Conclusions 134
7 Combination therapy for pulmonary arterial hypertension 143
7.1 Background 143
7.2 Combination therapy to date 146
7.3 Conclusions 158
8 Interventional and surgical modalities of treatment for pulmonary arterial hypertension 163
8.1 Introduction 163
8.2 Atrial septostomy 164
8.3 Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension 173
8.4 Lung transplantation for pulmonary hypertension 177
8.5 Conclusions 188
9 End points and clinical trial design in pulmonary arterial hypertension: Clinical and regulatory perspectives 195
9.1 Introduction 195
9.2 Trial design 196
9.3 End points in trials of therapy for pulmonary arterial hypertension 201
9.4 Conclusions 213
10 Comparative analysis of clinical trials and evidence-based treatment algorithm for pulmonary arterial hypertension 219
10.1 Introduction 219
10.2 Randomized controlled studies 223
10.3 Long-term continuation studies 225
10.4 Combination studies 229
10.5 Evidence-based treatment algorithm 230
10.6 Conclusions 232
11 Diagnosis and assessment of non-pulmonary arterial hypertension masquerading as idiopathic pulmonary arterial hypertension: Diastolic heart failure - evaluation and interactions 239
11.1 Definition of heart failure 239
11.2 Epidemiology 240
11.3 Physiology 241
11.4 Evaluation of diastolic heart failure: Invasive and noninvasive techniques 242
11.5 Diagnosis and treatment of diastolic dysfunction 245
11.6 Pulmonary hypertension and diastolic dysfunction 246
11.7 Conclusions 248
12 Treatment of pulmonary arterial hypertension: A look to the future 253
12.1 Therapy of pulmonary arterial hypertension 256
12.2 Measuring outcomes and monitoring the course of therapy 259
12.3 Conclusions 259
Index 263
Colour Plate 273

Produkt-Details

• Erscheint lt. Verlag: 15.9.2008
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizinische Fachgebiete ► Innere Medizin ► Kardiologie / Angiologie
• Themenwelt: Medizinische Fachgebiete ► Innere Medizin ► Pneumologie
• Schlagworte: available • Cardiovascular Disease • Data • demonstrate • Diagnosis • frequently • Good • Hypertension • IMPROVE • Kardiovaskuläre Erkrankung • Kardiovaskuläre Erkrankungen • Kardiovaskuläre Erkrankung • Kardiovaskuläre Erkrankungen • Late • Life • Long • Medical Science • Medizin • Misdiagnosed • New • overall • patients • Poor • prognosis • Pulmonary • quality • stage • Survival • therefore • Time • Treatments • untreatable • years
• ISBN-10: 0-470-99738-9 / 0470997389
• ISBN-13: 978-0-470-99738-3 / 9780470997383