Effects of CGS-13080, a thromboxane inhibitor, on pulmonary vascular resistance in patients after mitral valve replacement surgery.
Pulmonary hypertension with an elevated pulmonary vascular resistance was observed during the immediate recovery period in patients who underwent mitral valve surgery. In eight such patients, intravenous infusion of CGS-13080, imidazo(1,5-a)pyridine-5-hexanoic acid (a thromboxane synthetase inhibitor), at a dose range of 0.08-0.1 mg/kg/hr, effectively reduced pulmonary hypertension (from a mean pulmonary arterial pressure of 36 +/- 2 to 31 +/- 2 torr) and pulmonary vascular resistance (from 339 +/- 38 to 238 +/- 37 dynes.sec.cm-5) within 30 minutes and remained reduced for the entire infusion period (48 hours in five patients and 18 hours in three patients). Mean arterial pressure or systemic vascular resistance were not significantly affected by the drug infusion. Serum thromboxane B2 levels (a stable metabolic product of thromboxane A2) were significantly reduced after administration of the compound, with the maximum effect of greater than 90% reduction. All patients tolerated the drug infusion without significant side effects.
Kim
Y D
YD
Department of Anesthesia, Georgetown University School of Medicine, Washington, DC 20007.
Foegh
M L
ML
Wallace
R B
RB
Ng
L
L
Ahmed
S W
SW
Katz
N M
NM
Siegelman
R
R
Franco
K
K
Douglas
F
F
Ku
E
E
D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood; D002315:Cardiopulmonary Bypass; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy; D011652:Pulmonary Circulation / Q000187:drug effects*; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use*; D013929:Thromboxane B2 / Q000097:blood; D013930:Thromboxane-A Synthase / Q000037:antagonists & inhibitors*; D014655:Vascular Resistance / Q000187:drug effects
D007093:Imidazoles; D011725:Pyridines; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; C037787:pirmagrel; D013930:Thromboxane-A Synthase