Pulmonary Hypertension Flashcards
pHTN definition
mPAP > 20 mm Hg
Pre-capillary PH definition
mPAP > 20
PAWP <= 15
PVR >= 3
Post-capillary PH definition
mPAP > 20
PCWP > 15
PVR < 3
Combined pre and post capillary PH definition
mPAP > 20
PCWP > 15
PVR >= 3
PVR equation
mPAP - mPCWP / CO
Trans pulmonary gradient
mPAP - PCWP
Normal trans pulmonary gradient
<7
Vasodilator response for pHTN on RHC
Decrease in mPAP by >= 10
Decrease mPAP to 40 mm Hg or less
CO does not get worse
CCB for PAH responders
Nidefipine
Amlodipine
Diltiazem
Prostacyclin pathway features PAH
Prostacycline -> adenyl cyclase, converts ATP to cAMP
Vasodilation
Anti-proliferation
Inhibition of platelet aggregation
Prostacyclin analogues
Epoprostenol (IV)
Treprostinil (IV, PO, SC, inhaled)
Selexipag (PO)
Iloprost (inhaled)
Nitric oxide pathway features PAH
Activates cGMP which is degraded by PDE
Vasodilator
anti-proliferation
PDE5 inhibitors for PH
NO pathway
Sildenafil, tadalafil
Guanylate cyclase stim for PH
NO pathway
Riociguat
Endothelin pathway features PAH
Vasoconstriction
Smooth muscle proliferation
Vascular remodeling