Epoprostenol infusion therapy changes angiographic findings of pulmonary arteries in patients with idiopathic pulmonary arterial hypertension.
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.
Sakuma
Masahito
M
Division of Internal Medicine, Onagawa Municipal Hospital, 51-6 Horikiriyama, Washinokamihama, Onagawa 986-2243, Japan. m-sakuma@atlas.plala.or.jp
Demachi
Jun
J
Nawata
Jun
J
Suzuki
Jun
J
Takahashi
Tohru
T
Matsubara
Hiromi
H
Akagi
Satoshi
S
Shirato
Kunio
K
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
D000959:Antihypertensive Agents; D011464:Epoprostenol