Short-term Effect of Continuous Intravenous Prostacyclin (Epoprostenol) in Patients with Primary Pulmonary Hypertension Yoshiaki Okano 1 , Takao Yoshioka 1 , Akito Shimouchi 1 , Toru Satoh 1 , Syoji Inagaki 1 , Tatsuro Itoh 1 , Issei Uchida 1 , Takeshi Nakagawa 1 , Seiji Fukushima 1 , Noritoshi Nagaya 1 , Takashi Kubo 1 , Takeyoshi Kunieda 1 1Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center Keyword: 原発性肺高血圧症 , 血管拡張療法 , プロスタサイクリン(エポプロステノール) , primary pulmonary hypertension , vasodilating therapy , prostacyclin (epoprostenol) pp.73-79
Published Date 1997/1/15
DOI https://doi.org/10.11477/mf.1404901405
  • Abstract
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Continuous intravenous infusion of prostacyclin (epo-prostenol) is clinically established and considered to be the most effective vasodilating therapy in patients with primary pulmonary hypertension (PPH) in European and American countries.

Recently we have encountered 5 patients (one male, 4 females, 32±9 years old) with severe (NYHA functional class III or IV) PPH successfully treated with epopros-tenol. Hemodynamic measurements by means of cardiac catheterization were performed before and immediately after acute administration, and restudied after 1 to 3 months of chronic treatment.

(1) In the acute phase, there was an increase in cardiac output (CO) (3.2±1.1 to 4.3±1.8 l/min, +36%) and a decrease in total pulmonary resistance (TPR) (23.7±9.9 to 18.0±7.8 units, -24%), although pulmonary arterial pressure (PAP) (mean ; 67± 12 to 67±10 mmHg) was not altered at the point of maximum effect. In addition, systemic arterial pressure (SAP) (mean; 81±13 to 66±19 mmHg, -19%) decreased in all patients and obvious-ly in 1 patient. (2) In the chronic phase, PAP (mean; 58±9 mmHg, -13%) and TPR (16.7±6.7 units, -29%) decreased, and CO (3.8±1.1 l/min, +20%) increased. TPR decreased more than 20% in 4 of 5 patients and SAP (mean; 84±11 mmHg) was not reduced in any patient compared with baseline values. (3) Subjective symptoms also improved in all patients. (4) Three of 5 patients are alive and still in better condition more than one year after quitting the regimen. One patient died at 10 days after tapering off and one is still on the regimen.

In conclusion, epoprostenol could be a promising vasodilating remedy in patients with PPH in Japan, also.

Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.


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