title: Epoprostenol in chronic thromboembolic pulmonary hypertension with distal lesions.
abstract: 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.
authors.affiliation: Division of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy. l.scelsi@smatteo.pv.it
authors.forename: Laura
authors.initials: L
authors.lastname: Scelsi
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghio
authors.forename: Carlo
authors.initials: C
authors.lastname: Campana
authors.forename: Andrea Maria
authors.initials: AM
authors.lastname: D'Armini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Serio
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: Franco
authors.initials: F
authors.lastname: Piovella
authors.forename: Mario
authors.initials: M
authors.lastname: Viganò
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D011464:Epoprostenol