Pulmonary hemodynamic effects of dipyridamole infusion in patients with normal and elevated pulmonary artery systolic pressure receiving PB127.
BACKGROUND
Intravenous administration of microspheres used as ultrasound contrast agents may potentially alter pulmonary hemodynamics. PB127 (POINT Biomedical Corp., San Carlos, CA) is an investigational ultrasound perfusion-imaging agent used in conjunction with dipyridamole to diagnose coronary artery disease. The effects of PB127 alone or in combination with dipyridamole on pulmonary hemodynamics have not been described.


METHODS
We studied 20 patients, including 10 with elevated screening pulmonary artery systolic pressure (>35 mm Hg). Doppler-derived pulmonary hemodynamics were determined before and after continuous infusion of PB127 (0.175 mg/kg diluted in 5% dextrose) or 5% dextrose. Patients then received dipyridamole (0.56 mg/kg) and hemodynamics were again assessed.


RESULTS
During PB127/dextrose infusion, there were no significant changes in pulmonary hemodynamics compared with baseline. After dipyridamole, there were small increases in pulmonary artery systolic pressure and in pulmonary flow and a reduction in pulmonary vascular resistance. These changes occurred in patients with normal and elevated pulmonary artery systolic pressure.


CONCLUSIONS
PB127 infusion does not alter pulmonary hemodynamics. Mild alterations of pulmonary hemodynamics occur after dipyridamole administration.
Main
Michael L
ML
Mid America Heart Institute, Kansas City, Missouri, USA. mmain@cc-pc.com
Ehlgen
Alexander
A
Coggins
Tina R
TR
Morris
Becky A
BA
Lanza
Pam
P
Tremblay
Thomas M
TM
Schiller
Nelson B
NB
Goldman
Jonathan H
JH
D000368:Aged; D016477:Artifacts; D001794:Blood Pressure / Q000187:drug effects*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004176:Dipyridamole / Q000008:administration & dosage / Q000009:adverse effects; D004338:Drug Combinations; D004452:Echocardiography / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced / Q000000981:diagnostic imaging*; D007262:Infusions, Intravenous / Q000009:adverse effects; D008297:Male; D011651:Pulmonary Artery / Q000187:drug effects*; D011652:Pulmonary Circulation / Q000187:drug effects*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects
D003287:Contrast Media; D004338:Drug Combinations; D014665:Vasodilator Agents; D004176:Dipyridamole