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 language | English |
|---|---|
| Pages (from-to) | 206-212 |
| Number of pages | 7 |
| Journal | Journal of Pharmacological Sciences |
| Volume | 120 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2012 |
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Keywords
- Acute vasoreactivity testing
- Calcium-channel blocker
- Pulmonary arterial hypertension
ASJC Scopus subject areas
- Pharmacology
- Molecular Medicine
Cite this
Acute vasoreactivity testing with nicardipine in patients with pulmonary arterial hypertension. / Saito, Yukihiro; Nakamura, Kazufumi; Miyaji, Katsumasa; Akagi, Satoshi; Mizoguchi, Hiroki; Ogawa, Aiko; Fuke, Soichiro; Fujio, Hideki; Kiyooka, Takahiko; Nagase, Satoshi; Kohno, Kunihisa; Morita, Hiroshi; Kusano, Kengo F.; Matsubara, Hiromi; Ohe, Tohru; Itoh, Hiroshi.
In: Journal of Pharmacological Sciences, Vol. 120, No. 3, 2012, p. 206-212.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acute vasoreactivity testing with nicardipine in patients with pulmonary arterial hypertension
AU - Saito, Yukihiro
AU - Nakamura, Kazufumi
AU - Miyaji, Katsumasa
AU - Akagi, Satoshi
AU - Mizoguchi, Hiroki
AU - Ogawa, Aiko
AU - Fuke, Soichiro
AU - Fujio, Hideki
AU - Kiyooka, Takahiko
AU - Nagase, Satoshi
AU - Kohno, Kunihisa
AU - Morita, Hiroshi
AU - Kusano, Kengo F.
AU - Matsubara, Hiromi
AU - Ohe, Tohru
AU - Itoh, Hiroshi
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
KW - Acute vasoreactivity testing
KW - Calcium-channel blocker
KW - Pulmonary arterial hypertension
UR - http://www.scopus.com/inward/record.url?scp=84869390636&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84869390636&partnerID=8YFLogxK
U2 - 10.1254/jphs.12114FP
DO - 10.1254/jphs.12114FP
M3 - Article
C2 - 23117888
AN - SCOPUS:84869390636
VL - 120
SP - 206
EP - 212
JO - Journal of Pharmacological Sciences
JF - Journal of Pharmacological Sciences
SN - 1347-8648
IS - 3
ER -