Inhaled Iloprost for Patients With Precapillary Pulmonary Hypertension and Right-Side Heart Failure
| Autor: | Gottfried Heinz, Amadea M. Martischnig, Mariam Nikfardjam, Diana Bonderman, Alexander Tichy, Irene M. Lang |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Hypertension Pulmonary Vasodilator Agents Ventricular Dysfunction Right Pulmonary hypertension Right side heart failure Internal medicine Administration Inhalation Natriuretic Peptide Brain medicine Humans Precapillary pulmonary hypertension In patient Iloprost Clinical Investigation Aged Heart Failure business.industry Blood Pressure Determination Middle Aged medicine.disease Treatment Outcome Vasodilator agents Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business Inhaled iloprost medicine.drug |
| Zdroj: | Journal of Cardiac Failure |
| ISSN: | 1071-9164 |
| Popis: | Background Pulmonary hypertension (PH) can lead to right-side heart failure (RHF) and death. There are no therapeutic recommendations for patients experiencing acute RHF in the course of PH. This study aimed to examine the safety and efficacy of inhaled iloprost in patients with precapillary PH and RHF. Methods and Results Between October 2007 and December 2008, 7 patients with precapillary PH and RHF were enrolled. Per protocol, iloprost was inhaled hourly for a minimum of 12 hours during a 24-hour period. The starting dose of 2.5 μg was increased hourly by 2.5 μg as long as the increases were tolerated. Safety and efficacy were determined by continuous invasive monitoring of systemic and pulmonary hemodynamic parameters. Systemic pressures remained stable during inhalation (66.1 ± 6.9 mm Hg at baseline and 69.1 ± 6.4 mm Hg immediately after inhalation therapy, P = 0.48). Cardiac index increased from 2.4 ± 0.7 L/min/m2 to 2.9 ± 0.9 L/min/m2 (P = .008). Pulmonary vascular resistance decreased from 634.6 ± 218.3 dyn·s·cm−5 to 489.6 ± 173.8 dyn·s·cm−5 (P = .044), and N-terminal B-type natriuretic peptide levels decreased from 13,591 ± 10,939 pg/mL to 9,944 ± 8,569 pg/mL (P = .051). Conclusion Blood pressure-guided hourly inhalation of iloprost may offer a safe and effective strategy for the treatment of PH patients with RHF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect