Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Asthma and COPD
- Part II Diffuse parenchymal lung disease
- Part III Infection
- Part IV Pulmonary vascular diseases
- 17 Pathophysiology of pulmonary vascular disease
- 18 Current treatment of pulmonary vascular diseases
- 19 Future treatment of pulmonary vascular diseases
- Part V Lung cancer
- Part VI Cough
- Index
19 - Future treatment of pulmonary vascular diseases
from Part IV - Pulmonary vascular diseases
Published online by Cambridge University Press: 15 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Asthma and COPD
- Part II Diffuse parenchymal lung disease
- Part III Infection
- Part IV Pulmonary vascular diseases
- 17 Pathophysiology of pulmonary vascular disease
- 18 Current treatment of pulmonary vascular diseases
- 19 Future treatment of pulmonary vascular diseases
- Part V Lung cancer
- Part VI Cough
- Index
Summary
Introduction
Different parts of the pulmonary vasculature can be affected or involved during the course of a variety of lung diseases, for example, small pulmonary arteries show frequently in situ thrombosis and the capillary endothelium is leaky in the lungs of patients with the adult respiratory distress syndrome (ARDS). The pulmonary vasculature is certainly involved and structurally altered in COPD and emphysema. There is pulmonary vascular involvement in eosinophilic granulomatosis, and it is often overlooked that there is significant vascular involvement in many forms of interstitial fibrosis, as well as in collagen vascular disorders. Table 19.1 gives a list of lung diseases with pulmonary vascular involvement.
Pulmonary vascular remodelling is also a prominent feature of mitral valve stenosis, chronic left ventricular dysfunction, kyphoscoliosis and sleep apnea syndromes.
The recommendation for treatment of the pulmonary vascular disease component in these conditions has been and continues to be to treat the underlying primary lung disease. Unfortunately, some of the disorders that are associated with pulmonary hypertension or pulmonary vascular abnormalities are difficult to treat, for example interstitial lung diseases (ILD) or ARDS. On the other hand, treatment of patients with COPD with supplemental continuous oxygen has been shown to improve pulmonary hypertension (PH) and patient survival yet it is not at all clear whether the patient survival is causally related to a reduced pulmonary arterial pressure.
- Type
- Chapter
- Information
- Drugs for the Treatment of Respiratory Diseases , pp. 504 - 516Publisher: Cambridge University PressPrint publication year: 2003