Comparison of the acute pulmonary vasodilating effect of beraprost sodium and nitric oxide in congenital heart disease.
BACKGROUND
Congenital heart disease patients who have pulmonary hypertension (PH) require an evaluation for pulmonary vascular reactivity before surgical repair. In the present study the acute pulmonary vasodilating effects of 100% oxygen (O2), beraprost sodium (BPS) and 40 ppm inhaled nitric oxide (iNO) during cardiac catheterization were compared.


RESULTS
There were 90 patients who underwent cardiac catheterization for evaluation of PH (mean age, 16.5+/-16 years). The baseline mean pulmonary artery (mPA) pressure was 69.6+/-14.8 mmHg and the pulmonary arteriolar resistance (Rpa) was 13.8+/-8.3 Wood unit m2. Change in pulmonary vascular reactivity was defined as a decrease in mPA or Rpa>20% from baseline. The response to 100%O2, iNO and BPS during cardiac catheterization was 84%, 72.7% and 64%, respectively. Pair comparisons among each hemodynamic parameter showed no difference between the acute vasodilating effect of BPS and iNO. In some patients BPS showed a stronger effect than iNO in lowering Rpa.


CONCLUSIONS
BPS has a similar pulmonary vasodilating effect to iNO and can be used as an acute pulmonary vasodilating agent during cardiac catheterization with potential benefits over iNO.
Durongpisitkul
Kritvikrom
K
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikdr@mahidol.ac.th
Laoprasitiporn
Duangmanee
D
Layangool
Thanarat
T
Sittiwankul
Rekwan
R
Panamonta
Mannat
M
Mokrapong
Pirapat
P
D000293:Adolescent; D006328:Cardiac Catheterization; D011464:Epoprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005215:Fasting; D006330:Heart Defects, Congenital / Q000188:drug therapy* / Q000503:physiopathology* / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D009569:Nitric Oxide / Q000627:therapeutic use*; D011652:Pulmonary Circulation / Q000502:physiology*; D013785:Thailand; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D009569:Nitric Oxide; C048081:beraprost; D011464:Epoprostenol