[Long-term treatment of pulmonary hypertension in chronic obstructive bronchopneumopathies with nifedipine. Hemodynamic study over 18 months].
The objective of this study was to evaluate the long-term results of an 18 months nifedipine treatment in patients with pulmonary hypertension (PHT) secondary to chronic obstructive broncho-pulmonary disease (COBPD). The possible alterations of the pulmonary vascular reactivity after such chronic treatment were also studied. 20 patients presenting a PHT secondary to a COBPD were randomly distributed in two equal groups: a reference group and a group treated with nifedipine. The haemodynamic work-up and blood gases measurements of patients from both groups as well as the effects of acute sublingual administration of 10 mg of nifedipine were performed at the beginning of the study, under stable conditions. After this initial test, the patients in the treated group, received 30 mg/day of nifedipine per os. The same measurements and pharmacological tests were carried out after 18 months, 24 hours after the treatment was discontinued. All patients completed the study; no adverse reaction was noted, especially no major desaturation. A significant decrease of the cardiac index (p 0.05) was noted in the reference group (-10%). No significant alteration of the pulmonary pressure and resistance, of the blood gases, was noted. The haemodynamic variations during acute testing were similar in both groups before and at the end of the observation period. Chronic administration of nifedipine may prevent the decrease of the cardiac index in patients presenting a PHT secondary to COBPD. The pulmonary vascular reactivity is not affected by this type of treatment.
Saadjian
A
A
Unité de Recherche de Pharmacologie, INSERM U 278, Faculté de Pharmacie, CHU Nord, Marseille.
Philip-Joet
F
F
Vestri
R
R
Arnaud
A
A
D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008173:Lung Diseases, Obstructive / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D013997:Time Factors
D009543:Nifedipine
Traitement au long cours de l'hypertension pulmonaire secondaire des bronchopneumopathies obstructives chroniques par la nifédipine. Etude hémodynamique sur 18 mois.