The rationale of using angiotensin receptor blocker instead of pulmonary vasodilators to treat pulmonary hypertension in bronchopulmonary dysplasia: a case report and literature review
Abstract
This case report highlights the challenges in treating bronchopulmonary dysplasia (BPD) in a premature infant with severe pulmonary hypertension, recurrent pulmonary hypertensive crises, and the need of 100% oxygen to achieve acceptable arterial oxygen saturations. Key factors in the infant's improvement involved switching from pulmonary vasodilation to systemic afterload reduction using losartan, an angiotensin II type 1 receptor blocker. This alteration in treatment strategy led to a pronounced and prompt decrease in pulmonary arterial pressure, reduced oxygen dependency and resolution of pulmonary hypertensive crises. The infant's remarkable clinical response suggests that the pulmonary hypertension in BPD may have a pulmonary post-capillary cause, possibly driven by angiotensin II. A literature review corroborates this revision of the current understanding of the pathophysiologic mechanism involved in BPD and suggests that therapies targeting the renin-angiotensin-aldosterone system rather than pulmonary vasodilation may be an effective treatment strategy.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Drug repositioning: a brief overview
- Cyclic nucleotide phosphodiesterases in Drosophila melanogaster
- Time-resolved in silico modeling of fine-tuned cAMP signaling in platelets: feedback loops, titrated phosphorylations and pharmacological modulation
- Current View on Green Tea Catechins Formulations, Their Interactions with Selected Drugs, and Prospective Applications for Various Health Conditions
- In silico Structure-based Identification of Novel Acetylcholinesterase Inhibitors Against Alzheimer’s Disease
- Development and In Vitro Evaluation of Controlled Release Viagra® Containing Poloxamer-188 Using Gastroplus™ PBPK Modeling Software for In Vivo Predictions and Pharmacokinetic Assessments
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.