title: Comparison between two drugs on the hemodynamic evaluation of pulmonary hypertension prior to heart transplantation.
abstract: BACKGROUND
  Invasive estimation of pulmonary pressure is part of the usual protocol prior to heart transplantation. The aim of this study was to compare the results of 2 different vasodilators, nitric oxide (NO) and prostacyclin, in an acute vasodilator test (AVT) for patients with pulmonary venous hypertension.
  
  
  METHODS
  From January 2000 to December 2006, 94 right-sided heart catheterizations were performed in our center within pretransplantation evaluations. AVT was performed if the mean pulmonary artery pressure (mPAP) >35 mm Hg or if the pulmonary vascular resistance (PVR) was >4 Wood units (WU). Epoprostenol was administered to 40 patients, NO to 6 patients, and both agents to 8 patients.
  
  
  RESULTS
  A significant decrease in both mPAP and PVR was shown with maximum doses of epoprostenol, with an average variation of 8.96 mm Hg in mPAP (P < .001) and 3.26 WU in PVR (P < .001). An increased cardiac output (CO) was observed with epoprostenol, with a mean difference of 1.9 L/min (P < .001) at maximum compared with baseline doses. A tendency for the mPAP and PVR to decrease was also observed with maximum NO doses, with mean decreases of mPAP and PVR of 5.62 mm Hg and 1.14 WU, respectively. A tendency for CO to decrease was observed with NO (0.75 L/min; P = .039).
  
  
  CONCLUSIONS
  In our experience, NO is the best drug for AVT due to its pulmonary tree selectivity. A study with epoprostenol was complementary; both drugs can be used in these patients prior to heart transplantation.
authors.affiliation: Cardiology Service, Virgen del Rocio Hospital, Seville, Spain. mvmogjim@hotmail.com
authors.forename: M V
authors.initials: MV
authors.lastname: Mogollón Jiménez
authors.forename: A M
authors.initials: AM
authors.lastname: Escoresca Ortega
authors.forename: R
authors.initials: R
authors.lastname: Hinojosa Pérez
authors.forename: E
authors.initials: E
authors.lastname: Lage Gallé
authors.forename: A
authors.initials: A
authors.lastname: Herruzo Avilés
authors.forename: M
authors.initials: M
authors.lastname: Sobrino Márquez
authors.forename: M
authors.initials: M
authors.lastname: Frutos López
authors.forename: N
authors.initials: N
authors.lastname: Romero Rodríguez
authors.forename: R
authors.initials: R
authors.lastname: Pérez de la Yglesia
authors.forename: A
authors.initials: A
authors.lastname: Martínez Martínez
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D016027:Heart Transplantation / Q000502:physiology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000627:therapeutic use*; D011300:Preoperative Care; D011651:Pulmonary Artery / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D012189:Retrospective Studies; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D009569:Nitric Oxide; D011464:Epoprostenol