title: No effect of epoprostenol on right ventricular diameter in patients with acute pulmonary embolism: a randomized controlled trial.
abstract: BACKGROUND
  Right ventricular dilatation in the setting of acute pulmonary embolism is associated with an adverse prognosis. Treatment with a pulmonary vasodilator has never been studied systematically. We evaluated the effect of epoprostenol on right ventricular diameter and function in patients with acute pulmonary embolism and right ventricular dilatation.
  
  
  METHODS
  In a randomized, single-blind study, 14 patients with acute pulmonary embolism received epoprostenol or placebo infusion for 24 hours on top of conventional treatment. Effects on right ventricular end-diastolic diameter, systolic pulmonary artery pressure, right ventricle fractional area change and tricuspid annular plane systolic excursion were assessed by serial echocardiography. Furthermore Troponin T and NT-proBNP were measured serially.
  
  
  RESULTS
  Compared to placebo, epoprostenol was associated with a relative change from baseline in right ventricular end-diastolic diameter of +2% after 2.5 hours and -8% after 24 hours. Epoprostenol did not have a significant effect on systolic pulmonary artery pressure, right ventricular fractional area change and tricuspid annular plane systolic excursion, nor on biochemical parameters.
  
  
  CONCLUSIONS
  In patients with acute pulmonary embolism and right ventricular overload, treatment with epoprostenol did not improve right ventricular dilatation or any other measured variables of right ventricular overload.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  URL: NCT01014156Medical ethical committee: Medisch-ethische toetsingscommissie (METc) from the VUmc (free university medical centre).
authors.affiliation: Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands. jkooter@vumc.nl
authors.forename: Albertus J
authors.initials: AJ
authors.lastname: Kooter
authors.forename: Richard G
authors.initials: RG
authors.lastname: Ijzerman
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Anco B
authors.initials: AB
authors.lastname: Boonstra
authors.forename: Yvo M
authors.initials: YM
authors.lastname: Smulders
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D015150:Echocardiography, Doppler; D011464:Epoprostenol / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D016037:Single-Blind Method; D020107:Troponin T / Q000097:blood; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D011464:Epoprostenol