Effects of Epoprostenol on Right Ventricular Hypertrophy and Dilatation in Pulmonary Hypertension

Autor: Jean G.F. Bronzwaer, Anton Vonk-Noordegraaf, Pieter E. Postmus, J. Tim Marcus, Koen M. Marques, Anco Boonstra, R.J. Roeleveld
Přispěvatelé: Pulmonary medicine, Radiology and nuclear medicine, ACS - Pulmonary hypertension & thrombosis, CCA - Imaging and biomarkers, Cardiology
Rok vydání: 2004
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Hypertension
Pulmonary
Critical Care and Intensive Care Medicine
Drug Administration Schedule
Statistics
Nonparametric
Reference Values
Right ventricular hypertrophy
Internal medicine
medicine.artery
medicine
Humans
Prospective Studies
Antihypertensive Agents
End-systolic volume
Aged
Probability
Ejection fraction
Dose-Response Relationship
Drug
Hypertrophy
Right Ventricular
Ventricular Remodeling
business.industry
Stroke volume
Middle Aged
medicine.disease
Epoprostenol
Magnetic Resonance Imaging
Pulmonary hypertension
Treatment Outcome
medicine.anatomical_structure
Case-Control Studies
Anesthesia
Heart Function Tests
Pulmonary artery
Ventricular Function
Right
Vascular resistance
Cardiology
Ventricular pressure
Female
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
Dilatation
Pathologic
Follow-Up Studies
Zdroj: Roeleveld, R J, Vonk-Noordegraaf, A, Marcus, J T, Bronzwaer, J G F, Marques, K M J, Postmus, P E & Boonstra, A 2004, ' Effects of Epoprostenol on Right Ventricular Hypertrophy and Dilatation in Pulmonary Hypertension ', Chest, vol. 125, no. 2, pp. 572-579 . https://doi.org/10.1378/chest.125.2.572
Chest, 125(2), 572-579. American College of Chest Physicians
ISSN: 0012-3692
Popis: Objectives: To gain more knowledge of changes in main pulmonary artery flow and right ventricular mass and volumes in patients with pulmonary hypertension during epoprostenol therapy. Methods: Eleven patients (9 women) were evaluated before the start of therapy and every 4 months thereafter. Right and left ventricular volumes and masses were measured by cine MRI. Flow was measured with MRI velocity quantification. At the same times, 6-min walking tests were performed. Right-heart catheterizations were performed at baseline and after 1 year. Results: Right ventricular mass in the patient group was significantly higher from that in a control group of healthy volunteers (95 ± 26 g vs 42 ± 10 g, p < 0.05 [mean ± SD]), whereas the stroke volume was lower (34 ± 11 mL vs 81 ± 11 mL, p < 0.05). The greatest improvement in right ventricular stroke volume (to 41 ± 11 mL, p < 0.05) took place in the first 4 months. During the 1-year follow-up, right ventricular end-diastolic volume and mass did not change, and mean pulmonary artery pressure remained nearly stable at 55 mm Hg at baseline and 53 mm Hg after 1 year. Pulmonary vascular resistance decreased by 12.5% (p = 0.06). Conclusions: From these data we conclude that epoprostenol lowers pulmonary vascular resistance, leading to an increase in pulmonary artery flow. This increase in pulmonary artery flow corresponds well with the increase in 6-min walking distance and can be noninvasively monitored by MRI (flow quantification). Right ventricular dilatation and hypertrophy are not reversed by epoprostenol therapy, but do not progress either.
Databáze: OpenAIRE
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