Comparison of drugs for pulmonary hypertension reversibility testing: A meta-analysis
| Autor: | Shabnam Mehra, Thomas J. Mason, Maya Guglin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Sildenafil medicine.medical_treatment Hemodynamics heart failure Prostacyclin heart transplantation chemistry.chemical_compound Internal medicine pulmonary hypertension medicine Heart transplantation business.industry medicine.disease Pulmonary hypertension medicine.anatomical_structure chemistry Heart failure Anesthesia Vascular resistance Cardiology Sodium nitroprusside business medicine.drug Research Article |
| Zdroj: | Pulmonary Circulation |
| ISSN: | 2045-8940 2045-8932 |
| Popis: | Multiple drugs are used for reversibility testing of pulmonary hypertension (PH) in advanced heart failure (HF), especially in the process of heart transplant evaluation. Effects of these drugs were never systematically compared. The aim of this meta-analysis was to compare hemodynamic effects of different drugs. We identified 20 prospective studies reporting hemodynamic variables before and after acute pharmacologic testing for PH reversibility in patients with advanced HF. The data from individual studies were grouped by an outcome measure and analyzed. A mixed model meta-analysis was performed using SAS to give weighted mean effect of pre- and post-test change and inverse variance. The mean effects were weighted by the published sample size. Prostacyclin, inhaled or intravenous, and prostaglandin E1 (PGE1) had the most potent effect on pulmonary vascular resistance (PVR). Sodium nitroprusside and nitroglycerin decreased pulmonary capillary wedge pressure (PCWP), and mean pulmonary arterial pressure (MPAP) better than other drugs. Sildenafil provided overall good hemodynamic outcomes but was not the strongest drug with regard to any particular outcome. PCWP, MPAP, and systolic pulmonary arterial pressure respond better to nitroglycerin and sodium nitroprusside than to other drugs in the setting of reversibility testing. Prostacyclin and PGE1 are superior to other drugs in their acute effects on PVR. |
| Databáze: | OpenAIRE |
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