Residual pulmonary vasodilative reserve predicts outcome in idiopathic pulmonary hypertension

Objective Idiopathic pulmonary arterial hypertension (IPAH) remains a devastating and incurable, albeit treatable condition. Treatment response is not uniform and parameters that help to anticipate a rather benign or a malignant course of the disease are warranted. Acute pulmonary vasoreactivity tes...

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Veröffentlicht in:Heart (British Cardiac Society) 2015-06, Vol.101 (12), p.972-976
Hauptverfasser: Leuchte, Hanno H, Baezner, Carlos, Baumgartner, Rainer A, Muehling, Olaf, Neurohr, Claus, Behr, Juergen
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Sprache:eng
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Zusammenfassung:Objective Idiopathic pulmonary arterial hypertension (IPAH) remains a devastating and incurable, albeit treatable condition. Treatment response is not uniform and parameters that help to anticipate a rather benign or a malignant course of the disease are warranted. Acute pulmonary vasoreactivity testing during right heart catheterisation is recommended to identify a minority of patients with IPAH with sustained response to calcium channel blocker therapy. This study aimed to evaluate the prognostic significance of a residual pulmonary vasodilative reserve in patients with IPAH not meeting current vasoresponder criteria. Design Observational right heart catheter study in 66 (n=66) patients with IPAH not meeting current vasoresponse criteria. Pulmonary vasodilative reserve was assessed by inhalation of 5 µg iloprost-aerosol. Results Sixty-six (n=66) of 72 (n=72) patients with IPAH did not meet current definition criteria assessed during vasodilator testing to assess pulmonary vasodilatory reserve. In those, iloprost-aerosol caused a reduction of mean pulmonary artery pressure (Δ pulmonary artery pressure—11.4%; p
ISSN:1355-6037
1468-201X
DOI:10.1136/heartjnl-2015-307529