title: Marked improvement with sildenafil in a patient with primary pulmonary hypertension unresponsive to epoprostenol.
abstract: We report a 48-year-old woman with right heart failure due to primary pulmonary hypertension. Continuous infusion of epoprostenol (prostaglandin I2) for 1.5 years failed to control her condition, but she was later successfully treated with additional sildenafil for a few months. Her mean pulmonary artery pressure was originally 57 mmHg, increased to 62 mmHg with epoprostenol, and decreased to 45 mmHg with sildenafil. Additional sildenafil may be an effective and life-saving agent in patients with primary pulmonary hypertension who show a poor response to epoprostenol, which is considered to be very powerful medical treatment for the disease.
authors.affiliation: Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kataoka
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Manabe
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Mitamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogawa
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D004562:Electrocardiography; D011464:Epoprostenol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate; D011464:Epoprostenol