Abstract

IMPACT OF ESTROGEN METABOLISM IN PULMONARY ARTERIAL HYPERTENSION (PAH)

Pooja Mukta*, Ashwini Sagar and Dr. Ajay Fugate

ABSTRACT

It is a progressive disease of the lung vascular system, primary affecting the small pulmonary arterioles. Worldwidely, pulmonary arterial hypertension (PAH) is estimated prevalence of 15 to 30 per million. A combination of endothelial dysfunction and increased contractility of small pulmonary arteries, proliferation and remodeling of endothelial and smooth muscles in situ thrombosis leads to progressive narrowing of blood vessels. This results in a progressive resistance to blood flow and an increase in pulmonary artery pressure. This leads to decreased cardiac output, right heart failure and ultimately death. It is one of the broader condition of the pulmonary hypertension. There have been found some links between hormones and development of pulmonary hypertension most specifically estrogen. Estrogen and their metabolites increase susceptibility to
pulmonary arterial hypertension by reducing BMPR2 (bone morphogenetic protein receptor type 2). It reduces contractility and increase relaxation of bronchial smooth muscles further estrogen withdrawal increases bronchial contractility hence, estrogen is the likely culprit for increased pulmonary arterial blood pressure. This review highlights the variable role of estrogen in the development pulmonary arterial hypertension and its complications in post-menopausal women.

Keywords: Pulmonary Arterial Hypertension, Estrogen, BMPR2, Post-Menopausal Women, Right Heart Failure.