Epoprostenol infusion therapy changes angiographic findings of pulmonary arteries in patients with idiopathic pulmonary arterial hypertension

Masahito Sakuma, Jun Demachi, Jun Nawata, Jun Suzuki, Tohru Takahashi, Hiromi Matsubara, Satoshi Akagi, Kunio Shirato

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9 Citations (Scopus)


Background The pulmonary vascular changes induced by epoprostenol in patients with idiopathic pulmonary artery hypertension (IPAH) have not been reported by a clinical study. Methods and Results Analysis 1 compared the wedged pulmonary angiography (PAG) findings prior to initiation of epoprostenol therapy (n = 24) with those after initiation (n = 16). Analysis 2 compared the PAG findings prior to and after initiation of epoprostenol therapy (n = 9) in the saine pulmonary arteries in the same subjects. In analysis 1, a "cotton grass-like" stain originating from the peripheral pulmonary vessels (each vessel could not be distinguished on angiography) was not observable in any of 24 cases before initiation of epoprostenol therapy, but was visible in 13 of 16 cases after (p<0.0001). In analysis 2, the diameter of subsegmental arteries changed from 3.0±0.9mm (mean±standard deviation) to 3.7±1.2mm (p = 0.004) between the 2 time periods. Cotton grass-like stain was not found in any cases before epoprostenol, but in all 9 cases after chronic use (p = 0.004), Conclusions After initialing epoprostenol therapy, cotton grass-like slain appeared in mosl patients with IPAH, The possible reason for this is release of severe vasoconstriction and/or emergence of neovascularization.

Original languageEnglish
Pages (from-to)1147-1151
Number of pages5
JournalCirculation Journal
Issue number7
Publication statusPublished - Jul 15 2008
Externally publishedYes



  • Neovascularization
  • Pulmonary arteriovenous fistula
  • Vasoconstriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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