[Acute effects of intravenous fasudil with different dosage on patients with congenital heart defects and severe pulmonary arterial hypertension].

Objective

To compare the acute hemodynamic effects of intravenous fasudil with different dosage on patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH).

Methods

Sixty patients (37±17 years old) with CHD and PAH were consecutively enrolled. All patients underwent heart catheterization. The patients were randomly divided into two groups: the regular dosage group and the large dosage group. At initiation and 30 min after intravenous fasudil(30 mg and 60 mg respectively), the following hemodynamic parameters were measured and calculated: right atrial pressure(RAP), pulmonary arterypressure(PAP) , systemic artery pressure (SAP), pulmonary capillary wedge pressure(PCWP) , pulmonary vascular resistance(PVR) and systemic vascular resistance( SVR), cardiac index (CI) and artery oxygen saturation (SaO(2)).

Results

Compared with pre-medication, both mPAP and PVR tended to reduce significantly in the regular dosage group and the large dosage group: mPAP from (63.7±8.6)to (58.3±8.5)mmHg(P<0.01) and from (62.9±8.8) to(55.1±7.8)mmHg (P<0.01), respectively; PVR from(9.9±4.3)to (7.7±3.9) Wood(P<0. 01) and from (9.5±4.9)to(6.1±4.8)Wood(P<0.01); CI tended to increase significantly in the two groups: from (2.9±0.9) to (3.1±1.1) L·min(-1)·m(-2)( P<0.05) and from(3.0±0.8) to (3.5±1.6) L·min(-1)·m(-2)( P<0.05), respectively . Compared with the regular dosage group, both mPAP and PVR tended to reduce significantly in the large dosage group: mPAP (8.2±1.8) vs (4.2±1. 0)mmHg (P<0.05); PVR(3.7±1.1) vs (2.1±0.8 ) Wood (P<0.05) .Meanwhile , there was no significant difference in CI, SAP, SVR and SaO(2) between the two groups.

Conclusion

Fasudil could improve the acute hemodynamic effects of patients with CHD and severe PAH, especially in the large dosage group.