title: Acute responses to inhalation of Iloprost in patients with pulmonary hypertension.
abstract: BACKGROUND
  Iloprost has been used to test acute pulmonary vasoreactivity in idiopathic pulmonary arterial hypertension (PAH). We aimed to investigate the acute hemodynamic and oxygenation responses and tolerability to 20 µg aerosolized Iloprost in Chinese patients with pulmonary hypertension.
  
  
  METHODS
  Between March 2005 and May 2010, 212 pulmonary hypertension patients inhaled a single dose of 20 µg Iloprost over 10 - 15 minutes for vasoreactivity testing. The acute hemodynamic and oxygenation responses and adverse events were recorded.
  
  
  RESULTS
  Iloprost decreased total pulmonary resistance ((1747 ± 918) dyn×s×cm(-5) vs. (1581 ± 937) dyn×s×cm(-5), P < 0.001), increased stroke volume ((45.0 ± 22.1) ml vs. (47.0 ± 24.2) ml, P = 0.002), and cardiac output ((3.7 ± 1.7) L/ml vs. (3.9 ± 1.9) L/min, P = 0.009). Heart rate and systemic vascular resistance remained stable during inhalation. However, systemic arterial blood oxygen saturation fell slightly ((91.0 ± 6.8)% vs. (90.3 ± 6.7)%, P = 0.002). Pulmonary and systemic arterial blood pressures declined within 1 - 3 minutes after inhalation initiation and reached their lowest levels within 10 - 15 minutes. Idiopathic PAH responded more favorably than pulmonary hypertension due to other causes (P £0.001) and patients with less severe pulmonary hypertension have better responses to Iloprost. No adverse events requiring medical care or leading to termination of inhalation occurred.
  
  
  CONCLUSIONS
  Inhalation of 20 µg Iloprost showed potent and selective pulmonary hemodynamic effects and was well tolerated in the Chinese pulmonary hypertension patients. Patients with idiopathic PAH and less severe pulmonary hypertension responded more favorably to inhalation of Iloprost.
authors.affiliation: Center for Pulmonary Vascular Diseases, State Key Laboratory of Cardiovascalar Disease, Fuwai Hospital, National Center for Cardiovascalar Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Hong-Liang
authors.initials: HL
authors.lastname: Zhang
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Xiong
authors.forename: Xin-Hai
authors.initials: XH
authors.lastname: Ni
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: He
authors.forename: Qin
authors.initials: Q
authors.lastname: Luo
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Zhao
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhao
authors.forename: Xing-Guo
authors.initials: XG
authors.lastname: Sun
mesh_terms: D000280:Administration, Inhalation; D002681:China; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D016285:Iloprost / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D016285:Iloprost