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Cited by 354

The DOI matches its Crossref record; 108 of the 108 references it cites were found in a registry or an index.

Primary Pulmonary Hypertension: A Vascular Biology and Translational Research “Work in Progress”

Open access
Archer, Stephen, Rich, Stuart·2000·Circulation

Abstract

Abstract—Primary pulmonary hypertension (PPH) is a syndrome of dyspnea, chest pain, and syncope defined by increased pulmonary vascular resistance and the absence of a known cause. It also occurs in a familial form, which is linked to unidentified genes on chromosome 2. This syndrome is characterized by abnormalities of pulmonary vascular biology in each compartment of the blood vessel. The lumen has a prothrombotic diathesis, the endothelium displays an excessive production of vasoconstrictors relative to vasodilators, and the smooth muscle cells are depolarized and calcium-overloaded, which is due in part to reduced expression of voltage-gated potassium channels (Kv). This causes vasoconstriction and may promote cell proliferation. The adventitia displays excessive remodeling, which is associated with exaggerated metalloproteinase and elastase activity. Conceptually, PPH seems to require a permissive genotype, a susceptible phenotype (eg, endothelial dysfunction) and, in many cases, an exogenous trigger (eg, an anorexigen). Although there is not a generally accepted, unifying hypothesis regarding its cause, impaired function and the expression of vascular and platelet Kv channels suggest PPH may be a disease of the ion channels. Abnormal matrix metalloproteinase and elastase activity could also explain the abnormal vascular tone, platelet activation, and remodeling in PPH. Although calcium-channel blockers and prostacyclin, particularly when coadministered with warfarin, improve survival, PPH has a 5-year mortality rate of ≈50%. Pharmacological and gene therapies aimed at enhancing the activity of prostacyclin, nitric oxide synthases, and Kv channels or at inhibiting endothelin and matrix metalloproteinases are promising areas for future development.

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Crossref · 10.1161/01.cir.102.22.2781

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Metadata

Authors
Archer, S., & Rich, S.
Venue
Circulation
Published
2000-11-28
Volume
102
Issue
22
Pages
2781-2791
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2010171666
Cited by
354
References
108
FWCI
15.74
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Primary Pulmonary Hypertension: A Vascular Biology and Translational Research “Work in Progress”. https://app.cochat.ai/papers/10.1161/01.cir.102.22.2781
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Archer, S., & Rich, S. (2000). Primary Pulmonary Hypertension: A Vascular Biology and Translational Research “Work in Progress”. Circulation. https://doi.org/10.1161/01.cir.102.22.2781

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.