Document Detail

Treatment of primary pulmonary hypertension intravenous epoprostenol (prostacyclin).
MedLine Citation:
PMID:  3552006     Owner:  NLM     Status:  MEDLINE    
Ten patients with severe primary pulmonary hypertension and pronounced disability who were unresponsive to oral vasodilators were treated with intravenous epoprostenol (prostacyclin). All had been referred for heart and lung transplantation. Short term administration of epoprostenol (mean dose 5.5 ng/kg/min) increased the mean cardiac index from 1.8 to 2.2 1/min/m2, improved pulmonary artery oxygen saturation from 48% to 57%, and increased calculated tissue oxygen delivery from 10 to 11.8 ml/kg/min. The mean pulmonary vascular resistance fell by 18% while mean systemic artery pressure fell by 32%. Pulmonary artery pressure rose in only two patients. Continued intravenous infusion of epoprostenol for 1-25 months was associated with subjective and clinical improvement. Exercise tolerance improved as measured by an increase in the maximum rate of oxygen consumption during progressive exercise testing. In those six patients who were able to exercise before treatment it rose from a mean of 7 to 15 ml/kg/min. Those who had been unable to exercise before treatment achieved comparable rates of oxygen consumption after treatment. Two patients died on treatment, three have undergone heart-lung transplantation, and in five the treatment is continuing. Complications included episodes of septicaemia and ascites. In this uncontrolled study of patients with severe pulmonary hypertension epoprostenol seemed to offer a means of optimally dosing the patients with a vasodilator to reduce pulmonary vascular resistance and thus increasing cardiac output and oxygen tissue delivery. There was no evidence to suggest that this treatment influenced the progress of the disease.
D K Jones; T W Higenbottam; J Wallwork
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  57     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1987 Mar 
Date Detail:
Created Date:  1987-06-01     Completed Date:  1987-06-01     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  270-8     Citation Subset:  AIM; IM    
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MeSH Terms
Drug Administration Schedule
Epoprostenol / administration & dosage,  adverse effects,  therapeutic use*
Hemodynamics / drug effects
Hypertension, Pulmonary / drug therapy*
Infusions, Intravenous
Oxygen Consumption / drug effects
Physical Exertion
Reg. No./Substance:

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