Influence of Inhaled Iloprost on Transpulmonary Gradient of Big Endothelin in Patients With Pulmonary Hypertension
| Autor: | H. Wilkens, Sven Schneider, Jochem König, A. Eichler, Hans-Joachim Schäfers, Michael Bauer, N. Forestier, G. W. Sybrecht |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Pulmonary Circulation medicine.medical_specialty Hypertension Pulmonary Hemodynamics Physiology (medical) Internal medicine Administration Inhalation medicine Humans Iloprost Protein Precursors Aged Endothelin-1 Inhalation business.industry Endothelins Respiratory disease Middle Aged medicine.disease Pulmonary hypertension Endothelin 1 medicine.anatomical_structure Anesthesia Cardiology Vascular resistance Female Cardiology and Cardiovascular Medicine business Endothelin receptor medicine.drug |
| Zdroj: | Circulation. 107:1509-1513 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.0000056104.49686.4b |
| Popis: | Background— The pulmonary circulation is an important site for the production and clearance of endothelin (ET)-1, a potent vasoactive and mitogenic peptide. In healthy individuals, 40% to 50% of circulating ET-1 is removed on each passage through the lungs resulting in an arteriovenous ratio of 1, indicating reduced clearance or increased release of endothelin. The influence of inhaled prostanoids on endothelin clearance is unknown. Methods and Results— In a prospective investigation, plasma concentrations of big endothelin-1 (big ET-1, Elisa) were measured in 15 patients with pulmonary hypertension undergoing right heart catheterization with iloprost inhalation (4 m, 11 f, aged 35 to 75 years, mean pulmonary arterial pressure (PAPm) 54±2.3 mm Hg, pulmonary vascular resistance (PVR) 1061±141 dyn × sec × cm −5 ). There was a significant transpulmonary gradient for big ET-1 with 31% ±11% higher concentrations in the radial artery than in the pulmonary artery ( P P P =0.013) within 15 minutes indicating a restored balance. Patients under long-term treatment with iloprost (n=7) tended to have a lower net release and AV-ratio for big ET-1 than patients without pretreatment. Conclusion— An increase in pulmonary clearance of big-ET could be a mechanism contributing to the beneficial effects of inhaled prostanoids in the treatment of PAH. |
| Databáze: | OpenAIRE |
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