Pulmonary hypertension: view from the past to nowadays
E.V. Filippov
Ryazan State Medical University
Pulmonary hypertension (PH) is a disease associated with increased pressure in the lung vessels. In most cases, it is secondary, however, there are idiopathic PH forms. If symptoms associated with PH or other organic heart diseases are detected, all patients should undergo EchoCG. This disease probability is estimated by the peak rate of tricuspid regurgitation on EchoCG and characteristic PH signs. EchoCG use allows you to quickly identify PH and refer the patient to an Expert or Regional Center for further diagnosis and treatment. The main task of the Regional Centers is to determine the PH group (according to the classification), its hemodynamic parameters, as well as to decide on the indication for specific therapy. Patients attending these centers should be further examined. For the PH diagnosis, right heart invasive catheterization is necessary, which is available in Expert or large Regional Medical Centers. A vasoreactivity test is also performed during this procedure to assess the possibility of prescribing calcium-channel blockers to patients. In the case of the negative vasoreactivity test, the patient is indicated for specific therapy. They are expensive and can only be prescribed by an Expert center for the treatment of patients with PH. Given the PH therapy high cost, the emergence of the quality generic can significantly reduce the cost of patient treatment, while obtaining comparable effectiveness. In 2017, a new drug from an endothelin receptor antagonists (bosentan) class — Bosenex, which has proven bioequivalence with the original drug, has been registered in Russia.
Keywords: pulmonary hypertension, pulmonary arterial hypertension, treatment of pulmonary hypertension, specific therapy, bosentan, Bosenex.
For citation: Filippov E.V. Pulmonary hypertension: view from the past to nowadays. RMJ. Medical Review. 2019;10(I):27–32.
2. Gérald Simonneau G., Montani D., Celermajer D.S. et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019;53:1801913. DOI: 10.1183/13993003.01913-2018.
3. Frost A., Badesch D., Gibbs J.S.R. et al. Diagnosis of pulmonary hypertension. Eur Respir J. 2019;53:1801904. DOI: 10.1183/13993003.01904-2018.
4. Babu A.S., Arena R., Morris N.R. Evidence on Exercise Training in Pulmonary Hypertension. Adv Exp Med Biol. 2017;1000:153–172. DOI: 10.1007/978-981-10-4304-8_10.
5. Dunlap B., Weyer G. Pulmonary Hypertension: Diagnosis and Treatment. Am Fam Physician. 2016;94(6):463–469. PMID: 27637122.
6. Sitbon O., Gaine S. Beyond a single pathway: combination therapy in pulmonary arterial hypertension. Eur Respir Rev. 2016;25(142):408–417. DOI: 10.1183/16000617.0085-2016.
7. Ponikowski P., Voors A.A., Anker S.D. et al. Рекомендации ESC по диагностике и лечению острой и хронической сердечной недостаточности 2016. Российский кардиологический журнал. 2017;1:7–81. [Ponikowski P., Voors A.A., Anker S.D. et al. ESC recommendations for the diagnosis and treatment of acute and chronic heart failure 2016. Russian Journal of Cardiology. 2017;1:7–81 (in Russ.)]. DOI: 10.15829/1560-4071-2017-1-7-81.
8. Чазова И.Е., Авдеев С.Н., Царева Н.А. и др. Клинические рекомендации по диагностике и лечению легочной гипертонии. Терапевтический архив. 2014;86(9):4–23. [Chazova I.E., Avdeev S.N., Tsareva N.A. et al. Clinical guidelines for the diagnosis and treatment of pulmonary hypertension. Therapeutic Archive. 2014;86(9):4–23 (in Russ.)].
9. Prior D.L., Adams H., Williams T.J. Update on pharmacotherapy for pulmonary hypertension. Med J Aust. 2016;205(6):271–276. DOI: 10.5694/mja16.00468.
10. Galiè N., Channick R.N., Frantz R.P. et al. Risk stratification and medical therapy of pulmonary arterial hypertension. Eur Respir J. 2019;531801889. DOI: 10.1183/13993003.01889-2018.
11. Архипова О.А., Грацианская С.Е., Мартынюк Т.В. Оценка эффективности и безопасности первого российского генерического бозентана у пациентов с легочной артериальной гипертензией. Системные гипертензии. 2018;15(4):53–58. [Arkhipova O.A., Grazianskaya S.E., Martynyuk T.V. Evaluation of the effectiveness and safety of the first Russian generic bosentan in patients with pulmonary arterial hypertension. Systemic hypertension. 2018;15(4):53–58 (in Russ.)]. DOI: 10.26442/2075082X.2018.4.000049.
12. Бокерия Л.А., Горбачевский С.В., Иванов А.С. и др. Легочная артериальная гипертензия, ассоциированная с врожденными пороками сердца у взрослых. (Электронный ресурс). URL: https://racvs.ru/clinic/files/lg.pdf. Дата обращения: 01.09.2019. [Bokeria L.A., Gorbachevsky S.V., Ivanov A.S. et al. Pulmonary arterial hypertension associated with congenital heart defects in adults (Electronic resource). URL: https://racvs.ru/clinic/files/lg.pdf. Access date: 01.09.2019 (in Russ.)].
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