| Intravenous epoprostenol in inoperable chronic thromboembolic pulmonary hypertension. | |
| | |
MedLine Citation:
|
PMID: 17403477 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Pulmonary thromboendarterectomy may be a cure for patients with chronic thromboembolic pulmonary hypertension (CTEPH) with proximal obstruction. Conversely, short-term prognosis is poor for inoperable CTEPH patients with distal obstruction. Vascular remodeling lesions can be found in lungs of patients with CTEPH. Little is known about epoprostenol therapy in inoperable distal CTEPH patients. METHODS: We conducted a retrospective analysis of 27 consecutive patients with inoperable distal CTEPH, who were in New York Heart Association Functional Class (NYHA FC) III (n = 20) or IV (n = 7) and treated with long-term intravenous epoprostenol. RESULTS: Before epoprostenol initiation (baseline), 6-minute walk distance (6MWD) was 265 +/- 117 m, right atrial pressure 13 +/- 5 mm Hg, mean pulmonary artery pressure (mPAP) 56 +/- 9 mm Hg, cardiac index (CI) 1.9 +/- 0.3 liters/min/m2, total pulmonary resistance (TPR) 29.3 +/- 7.0 U/m2 and mixed venous oxygen saturation 52 +/- 8%. After 3 months of epoprostenol (n = 23; mean epoprostenol dose 16 +/- 2 ng/kg/min), NYHA FC improved by one class in 11 of 23 patients, 6MWD increased by 66 m (p < 0.0001), and hemodynamics also improved (mPAP: 51 +/- 8 mm Hg, p = 0.001; CI: 2.3 +/- 0.4 liters/min/m2, p = 0.0003; TPR: 23.0 +/- 5.0 U/m2, p < 0.0001). At last evaluation (n = 18; 20 +/- 8 months), mean dose of epoprostenol was 30 +/- 8 ng/kg/min, NYHA FC was improved in 9 of 18 patients and there was sustained improvement in 6MWD (+46 m, p = 0.03) and hemodynamic parameters. Survival at 1, 2 and 3 years was 73%, 59% and 41%, respectively. CONCLUSIONS: Long-term treatment with intravenous epoprostenol improves exercise capacity and hemodynamic parameters in patients with inoperable distal CTEPH. Epoprostenol may be used as bridge therapy in CTEPH patients awaiting lung transplantation. |
| | |
Authors:
|
Ségolène Cabrol; Rogerio Souza; Xavier Jais; Elie Fadel; Ratiba Haddad Si Ali; Marc Humbert; Philippe Dartevelle; Gérald Simonneau; Olivier Sitbon |
Related Documents
:
|
7723157 - Temporal patterns of antihypertensive medication use among older adults, 1989 through 1... 10935777 - The value of repeated echocardiographic evaluation in patients with idiopathic dilated ... 3342647 - Prenalterol in severe congestive heart failure. ii. long-term oral treatment. results w... 20618197 - Does an acute care surgical model improve the management and outcome of acute cholecyst... 22271357 - Clinical outcomes after bariatric surgery: a five-year matched cohort analysis in seven... 8468997 - Long-term results of mitral commissurotomy. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 26 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2007 Apr |
Date Detail:
|
Created Date: 2007-04-03 Completed Date: 2007-04-19 Revised Date: 2008-04-22 |
Medline Journal Info:
|
Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
|
Languages: eng Pagination: 357-62 Citation Subset: IM |
Affiliation:
|
Centre des Maladies Vasculaires Pulmonaires (UPRES EA 2705), Service de Pneumologie et Réanimation, AP-HP, Université Paris-Sud, Hôpital Antoine Béclère, Clamart, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antihypertensive Agents / administration & dosage*, adverse effects, therapeutic use Cardiac Output Chronic Disease Drug Administration Schedule Epoprostenol / administration & dosage*, adverse effects, therapeutic use Female Humans Hypertension, Pulmonary / drug therapy*, etiology*, physiopathology, surgery Injections, Intravenous Kaplan-Meiers Estimate Lung Transplantation Male Middle Aged Physical Endurance Platelet Aggregation Inhibitors / administration & dosage*, adverse effects, therapeutic use Retrospective Studies Thromboembolism / complications*, drug therapy* Vascular Resistance |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents; 0/Platelet Aggregation Inhibitors; 35121-78-9/Epoprostenol |
| Comments/Corrections | |
Comment In:
|
J Heart Lung Transplant. 2007 Dec;26(12):1346-7
[PMID:
18096491
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Scedosporium apiospermum (Pseudoallescheria boydii) infection in lung transplant recipients.
Next Document: Long-term follow-up after conversion from intravenous epoprostenol to oral therapy with bosentan or ...