Document Detail


Differential vasoactive response to endothelin receptor antagonists and prostacyclin in patients with severe pulmonary hypertension.
MedLine Citation:
PMID:  12193108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pulmonary hypertension (PH) is a rare disease of the pulmonary vasculature with diverse pathogenetic mechanisms. Vasoactive substances such as endothelin A receptor (ET(A)) antagonists and prostanoids have been used to improve haemodynamics and clinical outcome. We compared the hemodynamic response to BQ-123 (an ET(A) receptor antagonist) and prostacyclin or its analogue iloprost in ten patients (four men) with a mean age of 35.9+/-15.6 years. Seven patients had primary PH and three had PH owing to connective tissue disease. Patients underwent haemodynamic evaluation before and after administration of intra-atrial BQ-123 (200 mmol/min for 60 min), intravenous prostacyclin (3 ng x kg(-1) x min(-1) for 4 h) or iloprost as an aerosol (100 microg over 24 h). Response to vasodilator administration was defined as >15% decrease in pulmonary vascular resistance index (PVRI). Of the ten patients, five showed a response to BQ-123 and eight responded to prostanoids. Four patients were responders and one patient was a non-responder to both agents. PVRI decreased by 16.6+/-13.4% with BQ-123, and 24.4+/-15.7% with prostanoids (not statistically significant). The aetiology of PH did not affect the response to either drug. In conclusion, response to ET(A) antagonist or prostanoid administration can be achieved in a large group of patients with severe PH, however few patients respond identically to both agents. These findings are consistent with a multifactorial mechanism involved in this disease.
Authors:
Sotiria C Apostolopoulou; Georgios Kourgiannidis; Athanassios Manginas; Zenon S Kyriakides; David J Webb; Spyridon Rammos; Dimitrios T Kremastinos; Dennis V Cokkinos
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  103 Suppl 48     ISSN:  0143-5221     ISO Abbreviation:  Clin. Sci.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-23     Completed Date:  2002-11-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  298S-301S     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece. riapos@hol.gr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Epoprostenol / therapeutic use*
Female
Humans
Hypertension, Pulmonary / drug therapy*,  physiopathology
Iloprost / therapeutic use
Male
Middle Aged
Peptides, Cyclic / therapeutic use*
Receptor, Endothelin A
Receptors, Endothelin / antagonists & inhibitors*
Vascular Resistance / drug effects*
Vasodilator Agents / pharmacology*
Chemical
Reg. No./Substance:
0/Peptides, Cyclic; 0/Receptor, Endothelin A; 0/Receptors, Endothelin; 0/Vasodilator Agents; 136553-81-6/cyclo(Trp-Asp-Pro-Val-Leu); 35121-78-9/Epoprostenol; 78919-13-8/Iloprost

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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