[Acute effects of intravenous fasudil with different dosage on patients with congenital heart defects and severe pulmonary arterial hypertension].

Objective: To compare the acute hemodynamic effects of intravenous fasudil with different dosage on patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH). Methods: Sixty patients (37±17 years old) with CHD and PAH were consecutively enrolled. All patients underwent heart catheterization. The patients were randomly divided into two groups: the regular dosage group and the large dosage group. At initiation and 30 min after intravenous fasudil(30 mg and 60 mg respectively), the following hemodynamic parameters were measured and calculated: right atrial pressure(RAP), pulmonary arterypressure(PAP) , systemic artery pressure (SAP), pulmonary capillary wedge pressure(PCWP) , pulmonary vascular resistance(PVR) and systemic vascular resistance( SVR), cardiac index (CI) and artery oxygen saturation (SaO(2)). Results: Compared with pre-medication, both mPAP and PVR tended to reduce significantly in the regular dosage group and the large dosage group: mPAP from (63.7±8.6)to (58.3±8.5)mmHg(P<0.01) and from (62.9±8.8) to(55.1±7.8)mmHg (P<0.01), respectively; PVR from(9.9±4.3)to (7.7±3.9) Wood(P<0. 01) and from (9.5±4.9)to(6.1±4.8)Wood(P<0.01); CI tended to increase significantly in the two groups: from (2.9±0.9) to (3.1±1.1) L·min(-1)·m(-2)( P<0.05) and from(3.0±0.8) to (3.5±1.6) L·min(-1)·m(-2)( P<0.05), respectively . Compared with the regular dosage group, both mPAP and PVR tended to reduce significantly in the large dosage group: mPAP (8.2±1.8) vs (4.2±1. 0)mmHg (P<0.05); PVR(3.7±1.1) vs (2.1±0.8 ) Wood (P<0.05) .Meanwhile , there was no significant difference in CI, SAP, SVR and SaO(2) between the two groups. Conclusion: Fasudil could improve the acute hemodynamic effects of patients with CHD and severe PAH, especially in the large dosage group.