Summary:
One of the most important differences between the pulmonary and systemic circulation is a considerably lower
blood pressure and hemodynamic resistance in the pulmonary circulation. After the discovery of the endogenous
vasodilatator, nitric oxide (NO), it had been assumed that pulmonary vasculature is characterized by a high
tonic NO production, which might contribute to the low basal tone of these vessels. Incapacity to maintain this
high NO production would then lead to the development of pulmonary hypertension. However, numerous studies
summarized in this review gradually proved that, in reality, this simple scheme does not apply. Healthy
pulmonary vessels usually produce only relatively small amounts of NO. In pulmonary hypertension, NO
synthesis increases. The rise in pulmonary artery pressure is partly blunted by this protective mechanism, at
least until the pulmonary endothelium (a major source of NO) is damaged by the permanent and severe elevation
of the intravascular pressure.
Key words:
pulmonary circulation, hypoxia, nitric oxide, regulation
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