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Heart Fail Rev. 2017 May;22(3):289-297. doi: 10.1007/s10741-017-9612-9.

Drug-induced pulmonary arterial hypertension: a review.

Author information

1
Department of Cardiovascular Medicine, Lehigh Valley Health Network, Allentown, PA, 18109, USA. garg.medicine@gmail.com.
2
, 1250 S. Cedar Crest Blvd, Suite 305, Allentown, PA, 18103, USA. garg.medicine@gmail.com.
3
Department of Cardiovascular Medicine, Lehigh Valley Health Network, Allentown, PA, 18109, USA.
4
Department of Cardiovascular Medicine, St. Luke's University Health Network, Bethlehem, PA, 18015, USA.
5
Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, 38103, USA.
6
Department of Internal Medicine, Beaumont Health, Royal Oak, MI, 48073, USA.
7
Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI, 48197, USA.
8
Department of Internal Medicine, St. Peter's University Hospital, New Brunswick, NJ, 08901, USA.
9
Department of Pulmonary Medicine, Beaumont Health, Royal Oak, MI, 48073, USA.

Abstract

Pulmonary arterial hypertension (PAH) is a subgroup of PH patients characterized hemodynamically by the presence of pre-capillary PH, defined by a pulmonary artery wedge pressure (PAWP) ≤15 mmHg and a PVR >3 Wood units (WU) in the absence of other causes of pre-capillary PH. According to the current classification, PAH can be associated with exposure to certain drugs or toxins such as anorectic agents, amphetamines, or selective serotonin reuptake inhibitors. With the improvement in awareness and recognition of the drug-induced PAH, it allowed the identification of additional drugs associated with an increased risk for the development of PAH. The supposed mechanism is an increase in the serotonin levels or activation of serotonin receptors that has been demonstrated to act as a growth factor for the pulmonary artery smooth muscle cells and cause progressive obliteration of the pulmonary vasculature. PAH remains a rare complication of several drugs, suggesting possible individual susceptibility, and further studies are needed to identify patients at risk of drug-induced PAH.

KEYWORDS:

Drug; Drug-related; Pulmonary arterial hypertension; Pulmonary hypertension

PMID:
28417295
DOI:
10.1007/s10741-017-9612-9
[Indexed for MEDLINE]

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