Education  |   May 2019
Inflammation Drives Pulmonary Arterial Hypertension
Author Notes
  • From the Department of Anesthesia and Pain Medicine, Hospital for Sick Children (Sickkids), and Sickkids Research Institute, Toronto, Ontario, Canada.
  • Address correspondence to Dr. Steinberg: benjamin.steinberg@sickkids.ca
Article Information
Education / Images in Anesthesiology / Respiratory System
Education   |   May 2019
Inflammation Drives Pulmonary Arterial Hypertension
Anesthesiology 5 2019, Vol.130, 820-821. doi:10.1097/ALN.0000000000002561
Anesthesiology 5 2019, Vol.130, 820-821. doi:10.1097/ALN.0000000000002561
Patients with pulmonary arterial hypertension (Group 1 pulmonary hypertension, including idiopathic, heritable, connective tissue disease–associated, congenital heart disease–associated pulmonary arterial hypertension, and others) present for noncardiac surgery with an exceptionally high risk of morbidity and mortality even when compared to patients with other forms of pulmonary hypertension.1  Current pulmonary arterial hypertension–specific therapies are primarily pulmonary vasodilators. Yet pulmonary vasoconstriction only partially explains disease pathology, and the development of better therapies necessitates a deeper understanding of pulmonary arterial hypertension pathogenesis. Indeed, evidence links the immune system to pulmonary arterial hypertension pathogenesis (see fig.) and has fundamentally shifted our understanding of the disease mechanism.2