Abstract

Both primary pulmonary hypertension (PPH) and secondary pulmonary hypertension (SPH) have been shown to respond to vasodilator therapy.1-3 In selected patients identified by pulmonary vascular reactivity to an oral calcium-channel blocker challenge, treatment of PPH with high-dose calcium-channel blockers has been demonstrated to prolong survival and lead to regression of right ventricular hypertrophy.4 Subsequently, drugs more selective for the pulmonary vasculature, including prostacyclin, adenosine, and inhaled nitric oxide (INO) have been used to identify patients with a reactive pulmonary vascular bed,5,6 the presence of which has been shown to be of prognostic significance.

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