title: [SPECIFICS OF INHALED ILOPROST PHARMACODYNAMICS IN PATIENTS WITH SEVERE LEFT VENTRICULAR SYSTOLIC DYSFUNCTION].
abstract: OBJECTIVE
  To determine the specifics of inhaled iloprost effect on pulmonary and systemic hemodynamics in patients with pulmonary hypertension (PH) associated with left ventricular systolic dysfunction.
  
  
  METHODS
  47 vasore- activity tests (VRT) with 20 micrograms inhaled iloprost (Ventavis, Bayer) were performed in 39 candidates on heart transplantation. All patients had heart failure III-IV NYHA and PH with pulmonary vascular resistance (PVR) more than 2.5 Wood units. Hemodynamic parameters were evaluated at baseline and 15 minutes after inhalation of iloprost.
  
  
  RESULTS
  Iloprost significant decreased PAPmean: from 36.8 ± 8.5 mm Hg to 29.9 ± 9.4 mm Hg (p < 0.001). There was a significant decrease in PVR:from 4.5 1.6 Wood units to 3 ± 1 Wood units (p < 0.001). PVR dropped more than 20% in 34 cases (72.3%). Iloprost inhalation caused significant changes in systemic hemodynamic. There were decrease in sys- temic vascular resistance (SVR)from 1820 ± 527 dynes·sec·cm(-5) to 1423 ± 427 dynes·sec·cm(-5) (p < 0.001), increase in stroke volume index (SVI) from 26.1 ± 8.7 ml/m2 to 30.5 ± 9.5 ml/m2 (p < 0.001) and decrease in PCWP from 20.6 ± 5.9 mm Hg to 18.4 ± 6.6 mm Hg. (p = 0.016). We found significant negative correlation between systemic effects of iloprost and initial cardiac index (r = -0.63).
  
  
  CONCLUSIONS
  Inhaled iloprost caused significant changes in systemic hemodynamic when was used in patients with severe LV systolic dysfunction. Favorable changes in the left ventricle preload and after- load naturally increased its performance and decreased PCWP.
authors.forename: A E
authors.initials: AE
authors.lastname: Bautin
authors.forename: A S
authors.initials: AS
authors.lastname: Iakovlev
authors.forename: D M
authors.initials: DM
authors.lastname: Tashkhanov
authors.forename: S V
authors.initials: SV
authors.lastname: Datsenko
authors.forename: A O
authors.initials: AO
authors.lastname: Marichev
authors.forename: M A
authors.initials: MA
authors.lastname: Popov
authors.forename: P A
authors.initials: PA
authors.lastname: Fedotov
mesh_terms: D000280:Administration, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D016027:Heart Transplantation; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D016285:Iloprost / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation / Q000187:drug effects; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D014665:Vasodilator Agents; D016285:Iloprost