Dysregulated Renin–Angiotensin–Aldosterone System Contributes to Pulmonary Arterial Hypertension

Q: What is the clinical evidence from this study?

Study design: Observational. Population: idiopathic pulmonary arterial hypertension (iPAH) (n=72). Intervention: Systemic and pulmonary RAAS activity vs. Control subjects. Primary outcome: Disease progression and mortality (p=<0.05).

Frances S. de Man; Ly Tu; M. Louis Handoko; Silvia Rain; Gerrina Ruiter; C. François; Ingrid Schalij; Peter Dorfmüller; Gérald Simonneau; Élie Fadel; Frédéric Perros; Anco Boonstra; Piet E. Postmus; Jolanda van der Velden; Anton Vonk Noordegraaf; Marc Humbert; Saadia Eddahibi; Christophe Guignabert

doi:10.1164/rccm.201203-0411oc

Why the study?

Does RAAS dysregulation contribute to iPAH progression, and does RAAS inhibition with losartan improve outcomes in experimental PAH?

Study Design

Type

Observational (n=72)

Multicenter

No

Structured PICO

Does RAAS dysregulation contribute to iPAH progression, and does RAAS inhibition with losartan improve outcomes in experimental PAH?

P

Population

58 patients with iPAH and 14 control subjects assessed for systemic and pulmonary RAAS activity.

E

Exposure

Losartan (AT1 receptor antagonist) in the monocrotaline PAH rat model.

C

Comparator

Control subjects (undergoing lobectomy or pneumonectomy for cancer) for human lung specimens; untreated PAH rats for the experimental model.

O

Outcome

Systemic and pulmonary RAAS activity (renin, AngI, AngII levels), disease progression, and mortality in humans; right ventricular afterload and pulmonary vascular remodeling in rats.surrogate

Main Result

p-value: p=<0.05

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Implication

Systemic and pulmonary RAAS activities are up-regulated in iPAH and associated with disease progression and mortality, while RAAS inhibition with losartan shows beneficial effects in experimental PAH models.

Abstract

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Discussion

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Cite This Study

Man et al. (2012) conducted an observational in idiopathic pulmonary arterial hypertension (iPAH) (n=72). Systemic and pulmonary RAAS activity vs. Control subjects was evaluated on Disease progression and mortality (p=<0.05).

synapsesocial.com/papers/6a640e74b632d247be217374 https://doi.org/10.1164/rccm.201203-0411oc

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Dysregulated Renin–Angiotensin–Aldosterone System Contributes to Pulmonary Arterial Hypertension

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Dysregulated Renin–Angiotensin–Aldosterone System Contributes to Pulmonary Arterial Hypertension

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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