Mechanisms of structural remodeling in chronic pulmonary hypertension

After completing this article, readers should be able to: 1. Explain the physiologic consequences of structural remodeling in chronic pulmonary hypertension. 2. Describe the two primary components of the structural changes that occur in the pulmonary vascular wall during chronic pulmonary hypertension. 3. List the substances produced by endothelial cells that are affected by hypoxia. 4. Describe the potential consequences of changes in hemodynamic stresses on endothelium. 5. Delineate the primary changes in smooth muscle cells that occur in pulmonary hypertension. 6. Describe the signaling pathways that regulate responses of smooth muscle cells to stimuli. 7. Delineate the mechanisms by which hypoxia stimulates proliferation of fibroblasts