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The determinants of severe pulmonary hypertension. The determinants of the elevation of the pulmonary arterial pressure in principle are vasoconstrictive reactivity which may be treatable with currently available vasodilator drugs. Fully developed and endstage disease may be characterized by complex vascular lesions and vasoconstriction that is refractory to treatment with presently available drugs. Ppa: pulmonary arterial perssure, PVR: pulmonary vascular resistance
