TY - JOUR
T1 - Marked hemodynamic improvements by high-dose epoprostenol therapy in patients with idiopathic pulmonary arterial hypertension
AU - Akagi, Satoshi
AU - Nakamura, Kazufumi
AU - Miyaji, Katsumasa
AU - Ogawa, Aiko
AU - Kusano, Kengo Fukushima
AU - Ito, Hiroshi
AU - Matsubara, Hiromi
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2010
Y1 - 2010
N2 - Background: The appropriate dose range of epoprostenol is thought to be 25-40 ng · kg-1 · min-1 based on the results of previous studies showing that epoprostenol therapy reduced mean pulmonary artery pressure (mPAP) by 12-22% and pulmonary vascular resistance (PVR) by 32-53% compared with baseline values in patients with idiopathic pulmonary arterial hypertension (IPAH). However, the efficacy of treatment of IPAH patients with epoprostenol >40 ng · kg-1 · min-1 has not been determined and this was the aim of the present study. Methods and Results: The study group comprised 16 consecutive patients, none of whom died; 2 dropped out because they could not be titrated up as needed to the highest effective epoprostenol dose. Hemodynamics were evaluated in 14 IPAH patients who received high-dose epoprostenol monotherapy. The mean epoprostenol dosage was 107±40 ng · kg-1 · min-1 (range, 54-190 ng · kg-1 · min-1) and the mean duration of high-dose epoprostenol therapy was 1,355±627 days (range, 582-2,410 days). Significant decreases from baseline values were seen in mPAP (from 66±16 to 47±12 mmHg, P<0.001) and PVR (from 21.6±8.3 to 6.9±2.9 Wood units, P<0.001). Compared with the baseline state, high-dose epoprostenol therapy reduced mPAP by 30% and PVR by 68%. Conclusions: The present study suggests high-dose epoprostenol therapy is a new treatment strategy for IPAH.
AB - Background: The appropriate dose range of epoprostenol is thought to be 25-40 ng · kg-1 · min-1 based on the results of previous studies showing that epoprostenol therapy reduced mean pulmonary artery pressure (mPAP) by 12-22% and pulmonary vascular resistance (PVR) by 32-53% compared with baseline values in patients with idiopathic pulmonary arterial hypertension (IPAH). However, the efficacy of treatment of IPAH patients with epoprostenol >40 ng · kg-1 · min-1 has not been determined and this was the aim of the present study. Methods and Results: The study group comprised 16 consecutive patients, none of whom died; 2 dropped out because they could not be titrated up as needed to the highest effective epoprostenol dose. Hemodynamics were evaluated in 14 IPAH patients who received high-dose epoprostenol monotherapy. The mean epoprostenol dosage was 107±40 ng · kg-1 · min-1 (range, 54-190 ng · kg-1 · min-1) and the mean duration of high-dose epoprostenol therapy was 1,355±627 days (range, 582-2,410 days). Significant decreases from baseline values were seen in mPAP (from 66±16 to 47±12 mmHg, P<0.001) and PVR (from 21.6±8.3 to 6.9±2.9 Wood units, P<0.001). Compared with the baseline state, high-dose epoprostenol therapy reduced mPAP by 30% and PVR by 68%. Conclusions: The present study suggests high-dose epoprostenol therapy is a new treatment strategy for IPAH.
KW - Epoprostenol
KW - Idiopathic pulmonary arterial hypertension
KW - Prostacyclin
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U2 - 10.1253/circj.CJ-10-0190
DO - 10.1253/circj.CJ-10-0190
M3 - Article
C2 - 20697180
AN - SCOPUS:77958036618
VL - 74
SP - 2200
EP - 2205
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 10
ER -