Acute vasoreactivity testing with nicardipine in patients with pulmonary arterial hypertension

Yukihiro Saito, Kazufumi Nakamura, Katsumasa Miyaji, Satoshi Akagi, Hiroki Mizoguchi, Aiko Ogawa, Soichiro Fuke, Hideki Fujio, Takahiko Kiyooka, Satoshi Nagase, Kunihisa Kohno, Hiroshi Morita, Kengo F. Kusano, Hiromi Matsubara, Tohru Ohe, Hiroshi Ito

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Abstract

Acute vasoreactivity testing for patients with pulmonary arterial hypertension (PAH) has been reported to be useful to identify patients with sustained beneficial response to oral calcium-channel blockers (CCBs), but there is a risk of exacerbation during the testing with oral CCBs. Therefore, we developed a testing method utilizing intravenous nicardipine, a short-acting CCB, and examined the safety and usefulness of acute vasoreactivity testing with nicardipine in PAH patients. Acute vasoreactivity testing with nicardipine was performed in 65 PAH patients. Nicardipine was administered by short-time continuous infusion (1 μg·kg-1·min-1 for 5 min and 2 μg·kg-1·min-1 for 5 min) followed by bolus injection (5 μg/kg). Hemodynamic responses were continuously measured using a right heart catheter. Acute responders were defined as patients who showed a decrease in mean pulmonary artery pressure of at least 10 mmHg to an absolute level below 40 mmHg with preserved or increased cardiac output. Two acute responders and sixty-three non-acute responders were identified. There was no hemodynamic instability requiring additional inotropic agents or death during the testing. Acute responders had good responses to long-term oral CCBs. The acute vasoreactivity testing with nicardipine might be safe and useful for identifying CCB responders in PAH patients.

Original languageEnglish
Pages (from-to)206-212
Number of pages7
JournalJournal of Pharmacological Sciences
Volume120
Issue number3
DOIs
Publication statusPublished - Nov 26 2012

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Keywords

  • Acute vasoreactivity testing
  • Calcium-channel blocker
  • Pulmonary arterial hypertension

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology

Cite this

Saito, Y., Nakamura, K., Miyaji, K., Akagi, S., Mizoguchi, H., Ogawa, A., Fuke, S., Fujio, H., Kiyooka, T., Nagase, S., Kohno, K., Morita, H., Kusano, K. F., Matsubara, H., Ohe, T., & Ito, H. (2012). Acute vasoreactivity testing with nicardipine in patients with pulmonary arterial hypertension. Journal of Pharmacological Sciences, 120(3), 206-212. https://doi.org/10.1254/jphs.12114FP