title: [Acute response of right ventricular function to iloprost inhalations in patients with pulmonary arterial hypertension: preliminary evaluation  with cardiac magnetic resonance imaging].
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. Without treatment, PAH progresses rapidly to right ventricular (RV) failure and even death. Cardiac magnetic resonance imaging (CMRI) has been an accurate and reproducible tool to assessment of RV morphology and function, which are important factors in the prognosis of patients with PAH. The aim of this study is to investigate acute RV response to inhalation of aerosolized iloprost in patients with PAH using CMRI.
  
  
  METHODS
  From March 2012 to March 2014, 48 patients with PAH underwent CMRI before and immediately after inhalation of iloprost with a single dose of 20 μg over 15 min-20 min. RV function parameters derived from CMRI images were analyzed before and after iloprost inhalation, including end-diastolic volume (EDV), end-diastolic area (EDA), end-systolic volume (ESV), end-systolic area (ESA), stroke volume (SV), ejection fraction (EF) and cardiac output (CO). Percentage of RV area change was also calculated [%RVAC=(EDA-ESA)/EDA×100%]. Wilcoxon's Sign Rank Test or Paired Samples t-Test was used to compare the differences of RV function parameters before and after inhalation.
  
  
  RESULTS
  After iloprost inhalation, all patients showed significant decrease in RV EDV and RV ESV (P=0.007, P<0.001 respectively). Whereas, there were significant increase in RV SV (P=0.014), RV EF (P=0.009) and %RVAC (P=0.006). RV CO had no significant difference before and after inhalation (P=0.851).
  
  
  CONCLUSIONS
  Inhalation of iloprost can immediately improve RV function in patients with PAH, and noninvasive evaluation of the acute response with CMRI is feasibility.
authors: Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Qingqing
authors: Q
authors: Lu
authors: Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Dong
authors: D
authors: Li
authors: Department of Cardiovascular Disease, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Zhenwen
authors: Z
authors: Yang
authors: Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Yan
authors: Y
authors: Han
authors: Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Qian
authors: Q
authors: Cui
authors: Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Zhang
authors: Z
authors: Zhang
authors: Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors: Tielian
authors: T
authors: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D016285:Iloprost / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000187:drug effects*; D055815:Young Adult
chemical_list: D016285:Iloprost