Usefulness of acute pulmonary vasoreactivity test of sildenafil in treatment of portopulmonary hypertension. A case report

Satoshi Akagi, Kazufumi Nakamura, Soichiro Fuke, Kengo Fukushima Kusano, Hiroshi Ito

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A 50-year-old man diagnosed with liver cirrhosis type C was referred to our hospital because of right heart failure with pulmonary hypertension. Echocardiography revealed enlargement of the right atrium and ventricle with severe tricuspid regurgitation. The peak flow velocity of tricuspid regurgitation by continuous wave Doppler echocardiography was 452cm/s. Right heart catheterization demonstrated severe pulmonary hypertension [pulmonary arterial pressure (PAP) systolic/diastolic/mean=73/20/41mmHg and pulmonary vascular resistance (PVR)=509dynscm-5] with portal hypertension. We diagnosed the patient as having portopulmonary hypertension (PoPH). Although we treated the patient with a prostacyclin analog, tricuspid regurgitation velocity was increased to 480cm/s four years after the start of the therapy. To select drugs for the treatment of PoPH, we performed an acute vasoreactivity test of sildenafil during right heart catheterization. Since single administration of sildenafil (20mg) decreased PAP (93/30/55-77/27/44mmHg) and PVR (908-833dynscm-5), we added sildenafil (20mg, t.i.d.) to the prostacyclin analog. Tricuspid regurgitation velocity decreased to 403cm/s one year after the addition of sildenafil. An acute vasoreactivity test of sildenafil during right heart catheterization was useful for the decision of the drug to be used in the treatment of PoPH.

Original languageEnglish
Pages (from-to)e31-e33
JournalJournal of Cardiology Cases
Volume4
Issue number1
DOIs
Publication statusPublished - Aug 1 2011

    Fingerprint

Keywords

  • Acute pulmonary vasoreactivity test
  • Portopulmonary hypertension
  • Sildenafil

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this