Document Detail


Combination therapy of prostacyclin for pulmonary hypertension in congenital heart disease.
MedLine Citation:
PMID:  16856428     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary arterial hypertension (PAH) is a recognized complication of congenital heart disease. Despite differences in etiology and pathophysiology, successful therapy for idiopathic PAH may benefit in patients with congenital heart disease. We theorized that combination of oral and aerosolization prostacyclin will benefit this group of patients in long-term. MATERIAL AND METHOD: The study design was single group and open label study with intention to treat for patients with congenital heart disease with pulmonary artery (PA pressure) more than 50% of systemic pressure. All patients were given a combination of orally given beraprost sodium and inhalation of iloprost for 12 months. Data were collected prospectively consisting of functional class, O2 saturation, 6-minute walk test and right ventricular systolic pressure (RVSP). RESULTS: There were 23 patients with an average right ventricular systolic pressure (+/- SD) of 94.8 +/- 14.5 mmHg and with average age of 27.8 +/- 14.9 years (2.5 to 50 years). The average oxygen saturation was 87.9 +/- 7 %. There were 12 patients with post surgical repair or cardiac catheterization interventional procedure and 11 with and Eisenmenger's syndrome. There were significant improvement of 6-minute-walk test from an average of 268 +/- 70 meters to 308 +/- 57 meters at the end of 12 months. The functional class of patients was also improving. However, there were no significant different in oxygen saturation. CONCLUSION: Combination therapy of oral and inhalation of aerosolized vasodilators is a fascinating concept in the therapy of pulmonary hypertension. Treated patients showed an improvement in exercise capacity and right ventricular systolic pressure without a worsening in oxygen saturation.
Authors:
Kritvikrom Durongpisitkul; Decho Jakrapanichakul; Duangmanee Laohaprasitiporn; Jarupim Soongswang; Prakul Chanthong; Apichart Nana
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  88 Suppl 8     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-07-21     Completed Date:  2006-08-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  S60-5     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikdr@mahidol.ac.th
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Administration, Oral
Adolescent
Adult
Child
Child, Preschool
Epoprostenol / administration & dosage,  analogs & derivatives*
Exercise Test
Heart Defects, Congenital / complications,  physiopathology
Humans
Hypertension, Pulmonary / drug therapy*,  etiology
Iloprost / administration & dosage*
Middle Aged
Oxygen / blood
Vasodilator Agents / administration & dosage*
Ventricular Pressure
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 35121-78-9/Epoprostenol; 7782-44-7/Oxygen; 78919-13-8/Iloprost; 88430-50-6/beraprost

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