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Nitrogen oxide biochemical pathway in pulmonary arterial hypertension therapy and REPLACE trial results

https://doi.org/10.26442/2075-082X_2018.2.72-76

Abstract

Endogen nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) deficiency in pulmonary vessels walls plays essential role in pulmonary arterial hypertension (PAH) pathogenesis. Soluble guanylate cyclase stimulator riociguat and phosphodiesterase-5 (PDE5) inhibitor sildenafil increase cGMP content and have proven clinical efficacy in PAH treatment. The potentially beneficial mechanisms of riociguat mechanism of action include endogen NO independence in cGMP synthesis and its independence from other phosphodiesterase isoferments (other than PDE5). Clinical options, safety and effectiveness of iPDE5 - riociguat transition in patients with PAH were for the first time shown in non-controlled study RESPITE and the assessment is continued in randomized placebo-controlled trial REPLACE.

About the Authors

A. A. Shmalts
A.N.Bakulev National Medical Research Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation; Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation
Russian Federation


S. V. Gorbachevsky
A.N.Bakulev National Medical Research Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation; Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation
Russian Federation


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Shmalts A.A., Gorbachevsky S.V. Nitrogen oxide biochemical pathway in pulmonary arterial hypertension therapy and REPLACE trial results. Systemic Hypertension. 2018;15(2):72-76. https://doi.org/10.26442/2075-082X_2018.2.72-76

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ISSN 2075-082X (Print)
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