Efficacy of acute inhalation of nitric oxide in patients with primary pulmonary hypertension using chronic use of continuous epoprostenol infusion

Kenya Saji, Masahito Sakuma, Jun Suzuki, Tohru Takahashi, Jun Demachi, Jun Nawata, Osamu Kitamukai, Noriko Onoue, Kouichiro Sugimura, Tomohiro Tada, Shigefumi Fukui, Yutaka Kagaya, Jun Watanabe, Kunio Shirato

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: There have only been a few reports published on combination therapy for patients with primary pulmonary hypertension (PPH). Methods and Results: Fifteen patients with PPH (4 men and 11 women, 34.5±12.1 years old) had received chronic administration of epoprostenol and the additive effects of inhaled nitric oxide (NO) and the hemodynamic changes were evaluated. In addition, the difference in the effect of acute NO loading before and after the epoprostenol therapy was compared in 6 of these patients. Under chronic use of epoprostenol, mean pulmonary arterial pressure, mean right atrial pressure and pulmonary vascular resistance were decreased with acute inhalation of NO. However, cardiac output, mean aortic pressure and systemic vascular resistance were unchanged. As a result, the pulmonary to systemic vascular resistance ratio was reduced. Moreover, after chronic use of epoprostenol, the change (delta) in cardiac output with NO inhalation was increased and the NO-induced decrease in pulmonary vascular resistance was augmented compared to those before the induction. Conclusion: Nitric oxide inhalation further improved the hemodynamics when combined with chronic use of epoprostenol in PPH patients. These results suggest the possibility that combination therapies can be used in the treatment for PPH patients.

Original languageEnglish
Pages (from-to)335-338
Number of pages4
JournalCirculation Journal
Volume69
Issue number3
DOIs
Publication statusPublished - 2005 Mar

Keywords

  • Epoprostenol
  • Fractional pulse pressure
  • Nitric oxide
  • Pulmonary angiography
  • Pulmonary arterial hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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