Epoprostenol in chronic thromboembolic pulmonary hypertension with distal lesions.
BACKGROUND
Although patients with primary pulmonary hypertension and patients with chronic thromboembolic pulmonary hypertension with distal lesions may share similar pathophysiological characteristics, scarce information is available on the usefulness of epoprostenol in this form of secondary pulmonary hypertension. The aim of this study was to evaluate the feasibility, safety and efficacy of epoprostenol therapy in surgically untreatable patients with chronic thromboembolic pulmonary hypertension.


METHODS
Continuous infusive therapy with epoprostenol was undertaken in 16 patients with primary pulmonary hypertension and in 11 surgically untreatable thromboembolic pulmonary hypertension patients. The median follow-up was 12.4 months (range 6-23 months). Patients underwent clinical, echocardiographic and hemodynamic evaluation at baseline and a 6-min walk test every 3 months after beginning epoprostenol; ultrasound evaluations were repeated in a subgroup of patients.


RESULTS
Epoprostenol therapy improved the clinical status, exercise tolerance and NYHA functional class. A greater left ventricular end-diastolic volume was recorded at echocardiography in both groups.


CONCLUSIONS
Epoprostenol therapy may be feasible, safe and clinically effective in patients with surgically untreatable chronic thromboembolic pulmonary hypertension.
Scelsi
Laura
L
Division of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy. l.scelsi@smatteo.pv.it
Ghio
Stefano
S
Campana
Carlo
C
D'Armini
Andrea Maria
AM
Serio
Alessandra
A
Klersy
Catherine
C
Piovella
Franco
F
Viganò
Mario
M
Tavazzi
Luigi
L
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D011464:Epoprostenol / Q000627:therapeutic use*; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012044:Regression Analysis; D013923:Thromboembolism / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D011464:Epoprostenol