title: Epoprostenol Therapy for Pulmonary Arterial Hypertension.
abstract: Pulmonary arterial hypertension (PAH) is characterized by elevation of pulmonary artery pressure caused by pulmonary vasoconstriction and vascular remodeling, which leads to right heart failure and death. Epoprostenol (prostaglandin I2) has a potent short-acting vasodilator property, and intravenous continuous epoprostenol is therefore used for treatment of PAH. Here we review evidence for the usefulness of intravenous continuous epoprostenol therapy in patients with PAH. Epoprostenol therapy is effective in idiopathic PAH patients and in patients with PAH associated with connective tissue disease, portal hypertension or congenital heart diseases, but it is not effective in patients with pulmonary veno-occlusive disease or pulmonary capillary hemangiomatosis. High-dose epoprostenol therapy markedly improved hemodynamics in some patients with PAH, possibly due to reverse remodeling of pulmonary arteries. This therapy has several side effects and complications such as headache, hypotension and catheter-related infections. Intravenous continuous epoprostenol is an effective treatment, but there are still some problems to be resolved.
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.akagi-s@cc.okayama-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Akagi
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hiromi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Aiko
authors.initials: A
authors.lastname: Ogawa
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Sarashina
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ejiri
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003240:Connective Tissue Diseases / Q000150:complications; D011464:Epoprostenol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol