Treatment of pulmonary hypertension with the continuous infusion of a prostacyclin analogue, iloprost.
Heart
; 79(2): 175-9, 1998 Feb.
Article
in En
| MEDLINE
| ID: mdl-9538312
ABSTRACT
OBJECTIVE:
To compare prostacyclin with an analogue, iloprost, in treatment of severe pulmonary hypertension. PATIENTS Eight patients with severe pulmonary hypertension primary in five, thromboembolic pulmonary hypertension in three.METHODS:
All patients underwent right heart catheterisation. Mean (SEM) right atrial pressure was 9.9 (2.2) mm Hg, mean pulmonary artery pressure 67.4 (3.0) mm Hg, cardiac index 1.75 (0.13) l/min/m2 and mixed venous oxygen saturation 59.1(3.1)%. Continuous intravenous epoprostenol (prostacyclin, PGI2) or iloprost was given for phase I (three to six weeks); the patients were then crossed over to receive the alternate drug in an equivalent phase II. MAIN OUTCOMEMEASURES:
Exercise tolerance was measured at baseline and at the end of phase I and II with a 12 minute walk; distance covered, rest period, percentage drop in arterial oxygen saturation (delta Sao2%) and percentage rise in heart rate (delta HR%).RESULTS:
Walking distance covered rose from (mean (SEM)) 407.5 (73) to 591 (46) m with PGI2 (p = 0.004) and to 602.5 (60) m while on iloprost (p = 0.008). Rest period decreased from 192 (73) seconds at baseline to 16 (16) seconds with PGI2 (p = 0.01) and to 58 (34) seconds with iloprost (p = 0.008). Delta HR% was 37.5(6)% at baseline, 35(3)% on PGI2, and 24(6)% on iloprost (p = 0.04).CONCLUSIONS:
Both intravenous PGI2 and iloprost caused significant improvement in exercise tolerance. Iloprost offers an alternative to PGI2 treatment of severe pulmonary hypertension.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vasodilator Agents
/
Iloprost
/
Hypertension, Pulmonary
Type of study:
Clinical_trials
/
Observational_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Heart
Journal subject:
CARDIOLOGIA
Year:
1998
Document type:
Article
Affiliation country:
United kingdom