Reactive oxygen species and antioxidants in pulmonary hypertension and right heart failure

Abstract

Pulmonary hypertension is a devastating condition, and currently available treatment options have not provided satisfactory results with regard to the prognosis of patients. Increased pulmonary arterial resistance stains the right heart, ultimately leading to right heart failure and death. Thus, new therapeutic strategies are needed. Evidence suggests that the mechanisms of the development of pulmonary hypertension, in particular pulmonary vascular remodeling, and the development of right heart remodeling involve reactive oxygen species. In animal models of pulmonary hypertension, various molecules with antioxidant properties have been shown to attenuate pulmonary vascular as well as right ventricular remodeling. Evidence for the benefit of antioxidant therapy in human pulmonary hypertension patients is, however, lacking. This chapter compiles information on cell, animal, and human studies that provide evidence for the role of reactive oxygen species and the beneficial effects of antioxidants in pulmonary hypertension and right heart failure.