Recent insights

Question 1

Recent insights proposing reversible RhoA/ROCK-mediated vasoconstriction as the

Answer 1

primary contributor of elevated PVR in healthy lungs suggest use of vasodilator therapy to patients with HPH as a result of chronic hypoxic lung diseases

Question 2

Rho kinase inhibitors have been shown to produce a

Answer 2

marked reduction in pulmonary vascular pressure with inhibition shown to restore eNOS to cause vasodilation and potentially alleviate HPH

Question 3

A problem with use of vasodilators in COPD however

Answer 3

is risk of exacerbating hypoxaemia where restoration of PAP may remove beneficial effect of HPV on V/Q matching in lungs

Question 4

FM, systemic vasodilation can lead to systemic hypotension therefore potentially pharmacological targets include

Answer 4

vasoconstrictor pathways selective to pulmonary circulation such as lung specific calcium channels and the rhokinase pathway (Reviewed by Rowan et al 2016)

Question 5

Recent developments in treatment of PH include inhalation therapy of prostacyclin analogue

Answer 5

treprostinil, shown to produce vasodilation in well ventilated regions with improved V/Q matching and reduced RV workload (Waxman, 2021)