Document Detail


Effect of beraprost sodium on pulmonary vascular resistance in candidates for a Fontan procedure: a preliminary study.
MedLine Citation:
PMID:  14651539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although long-term prostacyclin(PGI2) therapy in patients with severe pulmonary hypertension (PH)reduces pulmonary vascular resistance (PVR), there have been no reports on its therapeutic effects in patients with mild PH. We investigated the chronic effect of beraprost sodium (BPS), an oral PGI2 analog, in children with mild PH. METHODS: We studied 20 patients who were destined for a Fontan procedure with a mean pulmonary arterial pressure(PAP) of>20 mmHg and/or PVR of>3.0 Wood units. Both the PAP and the PVR in these cases were too high for patients to undergo a successful Fontan procedure. Seven patients received BPS (PG group) and 13 did not (control group). All patients underwent repeat cardiac catheterization to examine pulmonary hemodynamics. RESULTS: In the PG group, the pulmonary-to-systemic flow ratio (Qp/Qs) did not change after BPS administration(1.1 +/- 0.6 vs 1.3 +/- 0.9);however, the mean PAP decreased significantly (25.3 +/- 8.2 vs 19.9 +/- 6.5 mmHg; P < 0.05),as did PVR (3.7 +/- 1.3 vs 2.3 +/- 0.9 Wood units; P < 0.05), whereas the pulmonary artery (PA) index increased significantly (312 +/- 136 vs 375 +/- 165; P < 0.05). In the control group, the mean PAP decreased significantly (24.9 +/- 4.7 vs 19.8 +/- 6.3 mmHg; P < 0.05)and the PA index increased significantly (295 +/- 72 vs 362 +/- 114; P < 0.05). No significant changes in Qp/Qs (1.5 +/- 0.8 vs 1.4 +/- 0.6)or PVR (2.9 +/- 1.3 vs 2.5 +/- 0.8 Wood units) were observed. CONCLUSION: We conclude that long-term BPS administration probably reduces PVR in potential candidates for a Fontan procedure with mild PH. This treatment would reduce the risks associated with the Fontan procedure and would also improve its outcome.
Authors:
Kazuhiro Takahashi; Yoshiki Mori; Hideshi Yamamura; Toshio Nakanishi; Makoto Nakazawa
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  45     ISSN:  1328-8067     ISO Abbreviation:  Pediatr Int     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-02-26     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  671-5     Citation Subset:  IM    
Affiliation:
Pediatric Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. bigkaz@mua.biglobe.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Epoprostenol / analogs & derivatives*,  therapeutic use*
Female
Fontan Procedure* / contraindications
Heart Defects, Congenital / complications*,  surgery
Humans
Hypertension, Pulmonary / drug therapy*,  etiology,  physiopathology
Male
Pulmonary Circulation / drug effects*
Vascular Resistance / drug effects*
Vasodilator Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 35121-78-9/Epoprostenol; 88430-50-6/beraprost

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


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