Marked Hemodynamic Improvements by High-Dose Epoprostenol Therapy in Patients With Idiopathic Pulmonary Arterial Hypertension
Marked Hemodynamic Improvements by High-Dose Epoprostenol Therapy in Patients With Idiopathic Pulmonary Arterial Hypertension
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DOI：
10.1253/circj.cj-10-0190
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发表时间：
2010-10-01
影响因子：
3.3
通讯作者：
Matsubara, Hiromi
中科院分区：
文献类型：
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作者：
Akagi, Satoshi;Nakamura, Kazufumi;Matsubara, Hiromi
背景：根据既往研究结果，认为依前列醇的适当剂量范围为25-40ng.kg（-1）.min（-1），这些研究结果显示，与特发性肺动脉高压（IPAH）患者的基线值相比，依前列醇治疗使平均肺动脉压（mPAP）降低12-22%，肺血管阻力（PVR）降低32-53%。然而，用依前列醇> 40ng.kg（-1）.min（-1）治疗IPAH患者的疗效尚未确定，这是本研究的目的。方法和结果：研究组包括16名连续患者，其中无一人死亡; 2人退出，因为他们不能根据需要滴定至最高有效的依前列醇剂量。在接受高剂量依前列醇单药治疗的14例IPAH患者中评价了血流动力学。平均依前列醇剂量为107 +/-40ng.kg（-1）.min（-1）（范围：54-190ng.kg（-1）.min（-1）），高剂量依前列醇治疗的平均持续时间为1，355 +/- 627天（范围：582- 2，410天）。mPAP较基线值显著降低（从66 +/- 16降至47 +/-12 mmHg，P
Background: The appropriate dose range of epoprostenol is thought to be 25-40ng.kg(-1).min(-1) based on the results of previous studies showing that epoprostenol therapy reduced mean pulmonary artery pressure (mPAP) by 12-22% and pulmonary vascular resistance (PVR) by 32-53% compared with baseline values in patients with idiopathic pulmonary arterial hypertension (IPAH). However, the efficacy of treatment of IPAH patients with epoprostenol >40ng.kg(-1).min(-1) has not been determined and this was the aim of the present study.Methods and Results: The study group comprised 16 consecutive patients, none of whom died; 2 dropped out because they could not be titrated up as needed to the highest effective epoprostenol dose. Hemodynamics were evaluated in 14 IPAH patients who received high-dose epoprostenol monotherapy. The mean epoprostenol dosage was 107 +/- 40ng.kg(-1).min(-1) (range, 54-190ng.kg(-1).min(-1)) and the mean duration of high-dose epoprostenol therapy was 1,355 +/- 627 days (range, 582-2,410 days). Significant decreases from baseline values were seen in mPAP (from 66 +/- 16 to 47 +/- 12mmHg, P