Zhonghua nei ke za zhi · 2003
[Clinical study on long-term treatment of primary pulmonary hypertension with continuous intravenous epoprostenol infusion].
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Cao Tie-sheng, Yuan Li-jun, Duan Yun-you, Wang Zuo-jun, Zhuang Lei, Shapiro Shelley M, Brundage Bruce H
Аннотация
OBJECTIVE: To observe the effects of treatment with long-term continuous epoprostenol (Epo) infusion on the survival and pulmonary artery pressure in patients with primary pulmonary hypertension (PPH).
METHODS: Sixty nine patients with PPH and congestive heart failure of stage III or IV (classification by New York Heart Association) treated with Epo of initial dose of 2 - 62 ng x kg(-1) x min(-1) (the dosage was enhanced by 1 - 2 ng x kg(-1) x min(-1) every 2 months according to patient's response). All patients underwent right heart catheterization and Doppler echocardiography to measure the systolic pressure gradient between the right ventricle and right atrium (DeltaP) and the cardiac output (CO). Doppler echocardiography and catheterization data were compared. Patients were followed up with echocardiography once every 4 months.
RESULTS: Of 69 patients treated with Epo 17 were followed up for > 330 days. During this period, DeltaP decreased from (84.1 +/- 24.1) mm Hg to (62.7 +/- 18.2) mm Hg (P < 0.01), CO increased from (4.00 +/- 1.22) L/min to (4.70 +/- 1.27) L/min (P < 0.02), DeltaP/CO decreased from 22.8 +/- 9.4 to 14.9 +/- 6.5 (P < 0.01). The patient survival was improved.
CONCLUSIONS: Patients with PPH treated with continuous infusion of Epo experienced a decrease in pulmonary artery pressure and an increase in cardiac output. Long-term follow-up of some patients of the group demonstrated improved survival during the period of Epo therapy.
METHODS: Sixty nine patients with PPH and congestive heart failure of stage III or IV (classification by New York Heart Association) treated with Epo of initial dose of 2 - 62 ng x kg(-1) x min(-1) (the dosage was enhanced by 1 - 2 ng x kg(-1) x min(-1) every 2 months according to patient's response). All patients underwent right heart catheterization and Doppler echocardiography to measure the systolic pressure gradient between the right ventricle and right atrium (DeltaP) and the cardiac output (CO). Doppler echocardiography and catheterization data were compared. Patients were followed up with echocardiography once every 4 months.
RESULTS: Of 69 patients treated with Epo 17 were followed up for > 330 days. During this period, DeltaP decreased from (84.1 +/- 24.1) mm Hg to (62.7 +/- 18.2) mm Hg (P < 0.01), CO increased from (4.00 +/- 1.22) L/min to (4.70 +/- 1.27) L/min (P < 0.02), DeltaP/CO decreased from 22.8 +/- 9.4 to 14.9 +/- 6.5 (P < 0.01). The patient survival was improved.
CONCLUSIONS: Patients with PPH treated with continuous infusion of Epo experienced a decrease in pulmonary artery pressure and an increase in cardiac output. Long-term follow-up of some patients of the group demonstrated improved survival during the period of Epo therapy.