title: Epoprostenol infusion therapy changes angiographic findings of pulmonary arteries in patients with idiopathic pulmonary arterial hypertension.
abstract: BACKGROUND
  The pulmonary vascular changes induced by epoprostenol in patients with idiopathic pulmonary artery hypertension (IPAH) have not been reported by a clinical study.
  
  
  RESULTS
  Analysis 1 compared the wedged pulmonary angiography (PAG) findings prior to initiation of epoprostenol therapy (n=24) with those after initiation (n=16). Analysis 2 compared the PAG findings prior to and after initiation of epoprostenol therapy (n=9) in the same pulmonary arteries in the same subjects. In analysis 1, a "cotton grass-like" stain originating from the peripheral pulmonary vessels (each vessel could not be distinguished on angiography) was not observable in any of 24 cases before initiation of epoprostenol therapy, but was visible in 13 of 16 cases after (p<0.0001). In analysis 2, the diameter of subsegmental arteries changed from 3.0+/-0.9 mm (mean +/- standard deviation) to 3.7+/-1.2 mm (p=0.004) between the 2 time periods. Cotton grass-like stain was not found in any cases before epoprostenol, but in all 9 cases after chronic use (p=0.004).
  
  
  CONCLUSIONS
  After initiating epoprostenol therapy, cotton grass-like stain appeared in most patients with IPAH. The possible reason for this is release of severe vasoconstriction and/or emergence of neovascularization.
authors.affiliation: Division of Internal Medicine, Onagawa Municipal Hospital, 51-6 Horikiriyama, Washinokamihama, Onagawa 986-2243, Japan. m-sakuma@atlas.plala.or.jp
authors.forename: Masahito
authors.initials: M
authors.lastname: Sakuma
authors.forename: Jun
authors.initials: J
authors.lastname: Demachi
authors.forename: Jun
authors.initials: J
authors.lastname: Nawata
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Tohru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Akagi
authors.forename: Kunio
authors.initials: K
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000792:Angiography; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D011464:Epoprostenol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000187:drug effects; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol