The disease-modifying therapy in idiopathic pulmonary arterial hypertension: clinical case of calcium channel blocker therapy in long-term vasoresponder
E. M. Korobchenko,
N. S. Goncharova,
K. B. Lapshin,
A. V. Berezina,
I. S. Zlobina,
A. V. Ryzhkov,
Olga M. Moiseeva https://doi.org/10.18705/1607-419X-2024-2470
EDN: VANQMX
Abstract
Rare vasoreactive test (VRT) performance limits the effective and cheap calcium channel blocker (CCB) therapy in potential long-term vasoresponders patients with idiopathic pulmonary arterial hypertension (PAH). Long-term vasoresponders exhibit the unique (5–7 %) idiopathic PAH population with the highest survival. We presented the clinical case of a young idiopathic PAH with positive VRT and a significant advantage of CCB therapy over PAH-specific therapy. Pulmonary artery pressure and exercise tolerance normalization, complete reverse right heart remodeling were achieved on CCB therapy. Our case emphasized the importance of careful identification of VRT positive idiopathic PAH patients and the meticulous follow-up during CCB treatment.
Keywords
idiopathic pulmonary arterial hypertension,
vasoresponders,
vasoactive test,
calcium channel blockers
Supporting agencies: Grant from the Russian Science Foundation, agreement No. 23–15–00–318.
About the Authors
E. M. Korobchenko
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Elizaveta M. Korobchenko, MD, Assistant Researcher, Noncoronary Disease Department
2 Akkuratov str., St Petersburg, 197341
N. S. Goncharova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Natalia S. Goncharova, MD, PhD, Senior Researcher, Noncoronary Disease Department
2 Akkuratov str., St Petersburg, 197341
K. B. Lapshin
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Kirill B. Lapshin, MD, Head, Intensive Care Unit Department
2 Akkuratov str., St Petersburg, 197341
A. V. Berezina
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Aelita V. Berezina, MD, PhD, Associate Professor, Cardiopulmonary Testing Department
2 Akkuratov str., St Petersburg, 197341
I. S. Zlobina
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Irina S. Zlobina, MD, Cardiologist
2 Akkuratov str., St Petersburg, 197341
A. V. Ryzhkov
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Anton V. Ryzhkov, MD, PhD, Head of Magnetic Resonance Imaging Department
2 Akkuratov str., St Petersburg, 197341
Olga M. Moiseeva
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Olga M. Moiseeva, MD, PhD, Associate Professor, Head, Noncoronary Disease Department, Head, Heart and Vessels Institute
2 Akkuratov str., St Petersburg, 197341
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Korobchenko E.M., Goncharova N.S., Lapshin K.B., Berezina A.V., Zlobina I.S., Ryzhkov A.V., Moiseeva O.M. The disease-modifying therapy in idiopathic pulmonary arterial hypertension: clinical case of calcium channel blocker therapy in long-term vasoresponder. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2024;30(6):589–599. (In Russ.) https://doi.org/10.18705/1607-419X-2024-2470. EDN: VANQMX
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