title: [A case of severe pulmonary hypertension associated with COPD treated with epoprostenol].
abstract: A rare case of chronic obstructive pulmonary disease (COPD) with severe pulmonary hypertension (PH) was found in a 68-year-old man. COPD was diagnosed in his 50s, from which time he received home oxygen therapy. In January 2007, he was admitted due to progression of dyspnea. On admission to our hospital, arterial blood gas analysis showed severe hypoxemia. Moreover, echocardiographic findings demonstrated severe deviation of the interventricular septum toward the left ventricle, with right ventricular dilatation. Cardiac catheterization data demonstrated pulmonary arterial hypertension with a low cardiac output. Because severe PH is uncommon in patients with COPD and there was no apparent etiology of PH other than COPD, we thought this case was predominantly a pulmonary vascular disease such as idiopathic pulmonary arterial hypertension. Though we first treated this patient with bosentan, it was not effective. Therefore, he was treated with continuous infusion of epoprostenol. Epoprostenol administration along with bosentan resulted in decrease of BNP and right ventricular function improvement. We report a case of severe PH due to severe COPD treated with continuous administration of epoprostenol.
authors.affiliation: Department of Pulmonary Medicine, National Hospital Organization Matsue Hospital.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yano
authors.forename: Kiryo
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Kanako
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Ikeda
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Takeyama
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D000077300:Bosentan; D011464:Epoprostenol / Q000008:administration & dosage*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D013449:Sulfonamides / Q000008:administration & dosage
chemical_list: D000959:Antihypertensive Agents; D013449:Sulfonamides; D011464:Epoprostenol; D000077300:Bosentan