Pulmonary Hypertension and Hypoxic Pulmonary Vasoconstriction

This book describes the role of extracellular and intracellular calcium in hypoxic pulmonary vasoconstriction (HPV) which can lead to pulmonary hypertension. In the lungs, HPV can markedly raise pulmonary arterial pressure. A temporary, moderate rise in pressure may not be damaging; however, persistent hypertension (due to chronic hypoxia) can lead to right heart failure and pulmonary oedema. Acute HPV can arise from any clinical condition which results in alveolar hypoxia e.g. causes of airway obstruction including asthma, ventilatory insufficiency caused by neurological defects, deformities of the thoracic skeleton, or lung damage. Chronic HPV, by contrast, is usually irreversible due to re-modelling of the pulmonary vasculature casued by diseases such as emphysema. This book presents experimental data supporting the thesis that calcium sensitization mediates HPV. The role of caffeine, ryanodine, NADH and cyclic ADP ribose (cADPR) levels in calcium sensitization are explored as potential new therapeutic targets for pulmonary hypertension.