title: [Efficacy of inhaled iloprost on top of other targeted therapies for patients with pulmonary hypertension and severe right heart failure].
abstract: OBJECTIVE
  To investigate the efficacy and safety of inhaled iloprost on top of other pulmonary hypertension (PH) specific therapies for patients with PH and severe right heart failure.
  
  
  METHODS
  We consecutively enrolled WHO functional class IV patients with PH and chronic thromboembolic pulmonary hypertension (CTEPH) in Shanghai Pulmonary Hospital from January 2011 to January 2013. Inhaled iloprost was administrated to all enrolled patients, oral endothelin antagonist receptors (ERAs) and/or type 5 phosphodiasterase inhibitors (PDE5-I) were also used as basis therapies. The in-hospital outcomes and the changes of right heart functional parameters were observed.
  
  
  RESULTS
  Twenty-four patients with PH and 5 patients with CTEPH were enrolled. After a mean treatment duration of (23 ± 13) days, 3 patients dead and significant improvement was observed in the remaining 26 patients. Compared with the baseline, heart rate decreased from (99 ± 14) to (91 ± 12) bpm (P = 0.001), plasma NT-proBNP level decreased from 5 823 (3 029-13 248) to 3 220 (1 678-6 720) ng/L (P < 0.001), tricuspid annular plane systolic excursion (TAPSE) increased from (1.3 ± 0.4) to (1.4 ± 0.3) cm (P = 0.018), right ventricular diameter decreased (left-to-right diameter from (57 ± 11) to (53 ± 10) mm, P = 0.040, and superoinferior diameter from (69 ± 11) to (64 ± 16) mm, P = 0.027), Tbil also decreased from (41 ± 34) to (26 ± 17) µmol/L (P < 0.001). No severe side effects were observed.
  
  
  CONCLUSIONS
  The strategy of inhaled iloprost on top of other PAH-specific target therapy medications is effective and safe for PH patients with severe right heart failure.
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, School of Medicine, Tongji University,Shanghai 200433, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Ning
authors.forename: Lan
authors.initials: L
authors.lastname: Wang
authors.forename: Hongda
authors.initials: H
authors.lastname: Zhang
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Liu
authors.forename: Fuhua
authors.initials: F
authors.lastname: Peng
authors.forename: Qinhua
authors.initials: Q
authors.lastname: Zhao
authors.forename: Xin
authors.initials: X
authors.lastname: Jiang
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.forename: Rong
authors.initials: R
authors.lastname: Jiang
authors.affiliation: Email: jingzhicheng@vip.163.com.
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Jing
mesh_terms: D006333:Heart Failure; D006801:Humans; D006976:Hypertension, Pulmonary; D016285:Iloprost; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D014665:Vasodilator Agents; D018497:Ventricular Dysfunction, Right
chemical_list: D010446:Peptide Fragments; D014665:Vasodilator Agents; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D016285:Iloprost