Treprostinil improves hemodynamics and symptoms in children with mild pulmonary hypertension awaiting heart transplantation

Autor:	Rachel K. Hopper, Seth A. Hollander, Esther Liu, David N. Rosenthal, Sharon Chen, Jeffrey A. Feinstein, Michelle T. Ogawa
Rok vydání:	2020
Předmět:	Male medicine.medical_specialty Heart disease Adolescent Waiting Lists medicine.medical_treatment Hypertension Pulmonary 030232 urology & nephrology Hemodynamics Prostacyclin 030230 surgery Severity of Illness Index Drug Administration Schedule 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Child Antihypertensive Agents Retrospective Studies Heart transplantation Heart Failure Transplantation business.industry Infant medicine.disease Pulmonary hypertension Epoprostenol Treatment Outcome Heart failure Child Preschool Pediatrics Perinatology and Child Health Cardiology Heart Transplantation Female Patient Safety business Treprostinil medicine.drug
Zdroj:	Pediatric transplantationREFERENCES. 24(5)
ISSN:	1399-3046
Popis:	Background Treprostinil, a prostacyclin analog, is a safe and effective therapy for children with PAH; however, the use of this agent in children with mild PVR elevations related to HF, including those with SV congenital heart disease awaiting HT, is understudied. We describe the hemodynamic and symptomatic changes in pediatric patients awaiting HT treated with treprostinil. Methods Single-center retrospective review of all patients was listed for HT who received treprostinil during the listing period. Changes in hemodynamic and functional indices between the baseline catheterization (prior to drug initiation), and prior to HT, and patient outcomes were analyzed. Results Among 16/17 (94%) who survived to HT, 8 (50%) were female, and 10 (63%) had SV physiology. The median age at drug initiation was 9 (IQR: 1, 14) years. The median duration of therapy prior to HT was 253 (IQR: 148, 504) days. Treprostinil significantly decreased PVR (3.8 vs 3.1 WU, P = .03), while mLA or mPCW pressure did not change (11 vs 13 mm Hg, P = .9). HF symptoms improved in 9/15 (60%) patients without VAD support prior to drug initiation, including 4/10 (40%) who did not receive a VAD any point while awaiting HT. Conclusions Treprostinil may be used safely in patients with mild PAH awaiting HT, including those with SV disease. PVR falls without substantial increases in mLA/mPCW pressure. HF symptoms improve in some patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ecb35cbc4568d5a3f90f774c9f636629 https://pubmed.ncbi.nlm.nih.gov/32428328 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.