[Clinical study on long-term treatment of primary pulmonary hypertension with continuous intravenous epoprostenol infusion].
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.
Cao
Tie-sheng
TS
Department of Ultrasonographic Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China. caots@fmmu.edu.cn
Yuan
Li-jun
LJ
Duan
Yun-you
YY
Wang
Zuo-jun
ZJ
Zhuang
Lei
L
Shapiro
Shelley M
SM
Brundage
Bruce H
BH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D002648:Child; D011464:Epoprostenol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents; D011464:Epoprostenol