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Diagnosis and Management of Pulmonary Hypertension pp 303–321Cite as

Adjunct Therapy and Calcium Channel Blockers

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Part of the book series: Respiratory Medicine ((RM,volume 12))

Abstract

Before the era of pulmonary arterial hypertension (PAH)-specific therapies, clinicians treating patients with pulmonary hypertension (PH) employed nonspecific, time-honored treatments in an effort to help these unfortunate patients. While the role of these therapies has not been rigorously studied they are still commonly used as adjuncts to PAH-specific therapies. This chapter outlines the logic and rationale behind the use of digoxin therapy, anticoagulation, oxygen therapy, diuretic therapy, and high-dose calcium channel blocker therapy and reviews the limited data supporting the use of these therapies in patients with PAH.

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Abbreviations

ACCP:

American College of Chest Physicians

ACE:

Angiotensin-converting enzyme

APAH:

Associated pulmonary arterial hypertension

CCB:

Calcium channel blocker

CHD:

Congenital heart disease

CO:

Cardiac output

COPD:

Chronic obstructive pulmonary disease

CPAP:

Continuous positive airway pressure

HIF-1:

Hypoxia-inducible factor-1

iNO:

Inhaled nitric oxide

INR:

International normalized ratio

IPAH:

Idiopathic pulmonary arterial hypertension

LA:

Left atrium

LAP:

Left atrial pressure

LV:

Left ventricle

LVEF:

Left ventricular ejection fractions

mPAP:

Mean pulmonary artery pressure

OSA:

Obstructive sleep apnea

PA:

Pulmonary artery

PAH:

Pulmonary arterial hypertension

PASMC:

Pulmonary artery smooth muscle cells

PAWP:

Pulmonary artery wedge pressure

PH:

Pulmonary hypertension

PVR:

Pulmonary vascular resistance

RA:

Right atrial

RHF:

Right heart failure (RHF)

RV:

Right ventricle

RVEF:

Right ventricular ejection fraction

SSc:

Systemic sclerosis

WHO:

World Health Organization

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  1. Yale Pulmonary Vascular Disease Program, Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA

    Terence K. Trow M.D. (Director)

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  1. Terence K. Trow M.D.
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  1. Division of Pulmonary, Sleep and Critical Care Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island, USA

    James R. Klinger

  2. Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

    Robert P. Frantz

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Trow, T.K. (2015). Adjunct Therapy and Calcium Channel Blockers. In: Klinger, J., Frantz, R. (eds) Diagnosis and Management of Pulmonary Hypertension. Respiratory Medicine, vol 12. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-2636-7_12

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