 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
4 May 1999 | Volume 130 Issue 9 | Pages 740-743
Background: Treatment of patients with secondary pulmonary hypertension has been unsatisfactory.
Objective: To describe exercise capacity, functional class, and hemodynamic variables after long-term intravenous infusion of prostacyclin in patients with secondary pulmonary hypertension.
Design: Case series.
Setting: Academic referral center.
Patients: 33 patients with secondary, precapillary pulmonary hypertension (New York Heart Association class III or IV).
Intervention: Continuous intravenous prostacyclin administered by portable infusion pump on a compassionate-use basis.
Measurements: Functional class, treadmill time, and hemodynamic variables.
Results: Patients were followed for an average of 12.7 ± 5.6 months. Exercise tolerance and New York Heart Association class improved in each patient. The duration of treadmill exercise increased from 186 seconds to 491 seconds, an increase of 305 seconds (95% CI, 194 to 417 seconds; P < 0.001). Mean pulmonary artery pressure decreased from 60 mm Hg to 46 mm Hg, a decrease of 14 mm Hg (CI, 9 to 19 mm Hg; P < 0.001). Cardiac output increased from 3.90 L/min to 6.30 L/min, an increase of 2.40 L/min (CI, 1.56 to 3.25 L/min; P < 0.001). The pulmonary vascular resistance decreased from 1143 dynes
Conclusion: Intravenous prostacyclin may be effective in the treatment of patients with certain types of secondary pulmonary hypertension.
Author and Article Information
From Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Acknowledgment: The authors thank Trude Cummens for secretarial assistance.
Requests for Reprints: Vallerie McLaughlin, MD, Rush Heart Institute, Center for Pulmonary Heart Disease, 1725 West Harrison Street, Suite 020, Chicago, IL 60612.
Current Author Addresses: Dr. McLaughlin, Ms. Genthner, Ms. Panella, Ms. Hess, and Mr. Rich: Rush Heart Institute, Center for Pulmonary Heart Disease, 1725 West Harrison Street, Suite 020, Chicago, IL 60612. BRIEF COMMUNICATION
Compassionate Use of Continuous Prostacyclin in the Management of Secondary Pulmonary Hypertension: A Case Series
s/cm5 to 575 dynes s/cm5, a decrease of 567 dynes s/cm5 (CI, 407 to 727 dynes s/cm5; P < 0.001). Patients with collagen vascular disease, congenital heart disease, and portopulmonary hypertension were analyzed with other patients and separately. All groups had a statistically significant reduction in mean pulmonary artery pressure and a statistically significant increase in cardiac output.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., December 2, 2008; 52(23): e143 - e263. [Full Text] [PDF]
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., December 2, 2008; 52(23): 1890 - 1947. [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): e714 - e833. [Full Text] [PDF]
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): 2395 - 2451. [Full Text] [PDF]
|
|
|
|
|
|
S. Rich and M. Rabinovitch Diagnosis and Treatment of Secondary (Non-Category 1) Pulmonary Hypertension Circulation, November 18, 2008; 118(21): 2190 - 2199. [Full Text] [PDF]
|
|
|
|
 |
|
 National Pulmonary Hypertension Centres of the UK Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland Heart, March 1, 2008; 94(Suppl_1): i1 - i41. [Full Text] [PDF]
|
|
|
|
 |
|
 National Pulmonary Hypertension Centres of the UK Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland Thorax, March 1, 2008; 63(Suppl_2): ii1 - ii41. [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Hoeper, H. J. Seyfarth, G. Hoeffken, H. Wirtz, E. Spiekerkoetter, M. W. Pletz, T. Welte, and M. Halank Experience with inhaled iloprost and bosentan in portopulmonary hypertension Eur. Respir. J., December 1, 2007; 30(6): 1096 - 1102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Reichenberger, R. Voswinckel, B. Enke, M. Rutsch, E. El Fechtali, T. Schmehl, H. Olschewski, R. Schermuly, N. Weissmann, H. A. Ghofrani, et al. Long-term treatment with sildenafil in chronic thromboembolic pulmonary hypertension Eur. Respir. J., November 1, 2007; 30(5): 922 - 927. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Fisher, D. M. Serlin, K. C. Wilson, R. E. Walter, J. S. Berman, and H. W. Farber Sarcoidosis-Associated Pulmonary Hypertension: Outcome With Long-term Epoprostenol Treatment. Chest, November 1, 2006; 130(5): 1481 - 1488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. V. McLaughlin and M. D. McGoon Pulmonary Arterial Hypertension Circulation, September 26, 2006; 114(13): 1417 - 1431. [Full Text] [PDF]
|
|
|
|
|
|
I. Lang, M. Gomez-Sanchez, M. Kneussl, R. Naeije, P. Escribano, N. Skoro-Sajer, and J.-L. Vachiery Efficacy of Long-term Subcutaneous Treprostinil Sodium Therapy in Pulmonary Hypertension Chest, June 1, 2006; 129(6): 1636 - 1643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. F. Tapson, M. Gomberg-Maitland, V. V. McLaughlin, R. L. Benza, A. C. Widlitz, A. Krichman, and R. J. Barst Safety and Efficacy of IV Treprostinil for Pulmonary Arterial Hypertension: A Prospective, Multicenter, Open-Label, 12-Week Trial Chest, March 1, 2006; 129(3): 683 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Tenedios, D Erkan, and M D Lockshin Cardiac involvement in the antiphospholipid syndrome Lupus, September 1, 2005; 14(9): 691 - 696. [Abstract] [PDF]
|
|
|
|
|
|
M. M. Hoeper, M. Halank, C. Marx, G. Hoeffken, H. J. Seyfarth, J. Schauer, J. Niedermeyer, and J. Winkler Bosentan therapy for portopulmonary hypertension Eur. Respir. J., March 1, 2005; 25(3): 502 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Task Force members, N. Galie, A. Torbicki, R. Barst, P. Dartevelle, S. Haworth, T. Higenbottam, H. Olschewski, A. Peacock, G. Pietra, et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension: The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology Eur. Heart J., December 2, 2004; 25(24): 2243 - 2278. [Full Text] [PDF]
|
|
|
|
|
|
M.C. Post, S. Janssens, F. Van de Werf, and W. Budts Responsiveness to inhaled nitric oxide is a predictor for mid-term survival in adult patients with congenital heart defects and pulmonary arterial hypertension Eur. Heart J., September 2, 2004; 25(18): 1651 - 1656. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Buller, G. Agnelli, R. D. Hull, T. M. Hyers, M. H. Prins, and G. E. Raskob Antithrombotic Therapy for Venous Thromboembolic Disease: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest, September 1, 2004; 126(3_suppl): 401S - 428S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Badesch, S. H. Abman, G. S. Ahearn, R. J. Barst, D. C. McCrory, G. Simonneau, and V. V. McLaughlin Medical Therapy For Pulmonary Arterial Hypertension: ACCP Evidence-Based Clinical Practice Guidelines Chest, July 1, 2004; 126(1_suppl): 35S - 62S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Wade, F. J. Baker, R. Roscigno, W. DellaMaestra, C. P. Arneson, T. L. Hunt, and A. A. Lai Pharmacokinetics of Treprostinil Sodium Administered by 28-Day Chronic Continuous Subcutaneous Infusion J. Clin. Pharmacol., May 1, 2004; 44(5): 503 - 509. [Abstract] [Full Text]
|
|
|
|
|
|
P. Bresser, P.F. Fedullo, W.R. Auger, R.N. Channick, I.M. Robbins, K.M. Kerr, S.W. Jamieson, and L.J. Rubin Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension Eur. Respir. J., April 1, 2004; 23(4): 595 - 600. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. H.S. Kim, P. Fesler, R. N. Channick, K. U. Knowlton, O. Ben-Yehuda, S. H. Lee, R. Naeije, and L. J. Rubin Preoperative Partitioning of Pulmonary Vascular Resistance Correlates With Early Outcome After Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension Circulation, January 6, 2004; 109(1): 18 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Wade, F. J. Baker, R. Roscigno, W. DellaMaestra, T. L. Hunt, and A. A. Lai Absolute Bioavailability and Pharmacokinetics of Treprostinil Sodium Administered by Acute Subcutaneous Infusion J. Clin. Pharmacol., January 1, 2004; 44(1): 83 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Olschewski, B. Rohde, J. Behr, R. Ewert, T. Gessler, H. A. Ghofrani, and T. Schmehl Pharmacodynamics and Pharmacokinetics of Inhaled Iloprost, Aerosolized by Three Different Devices, in Severe Pulmonary Hypertension Chest, October 1, 2003; 124(4): 1294 - 1304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Barst, M. McGoon, V. McLaughlin, V. Tapson, R. Oudiz, S. Shapiro, I. M. Robbins, R. Channick, D. Badesch, B. K. Rayburn, et al. Beraprost therapy for pulmonary arterial hypertension J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2119 - 2125. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Ono, N. Nagaya, H. Okumura, Y. Shimizu, S. Kyotani, N. Nakanishi, and K. Miyatake Effect of Orally Active Prostacyclin Analogue on Survival in Patients With Chronic Thromboembolic Pulmonary Hypertension Without Major Vessel Obstruction Chest, May 1, 2003; 123(5): 1583 - 1588. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. P. Kuhn, D. W. Byrne, P. G. Arbogast, T. P. Doyle, J. E. Loyd, and I. M. Robbins Outcome in 91 Consecutive Patients with Pulmonary Arterial Hypertension Receiving Epoprostenol Am. J. Respir. Crit. Care Med., February 15, 2003; 167(4): 580 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Castro, M. Hoque, and B. D. Brown Pulmonary hypertension in sickle cell disease: cardiac catheterization results and survival Blood, February 15, 2003; 101(4): 1257 - 1261. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Kerr and L. J. Rubin Epoprostenol Therapy as a Bridge to Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension Chest, February 1, 2003; 123(2): 319 - 320. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Kawut, D. B. Taichman, C. L. Archer-Chicko, H. I. Palevsky, and S. E. Kimmel Hemodynamics and Survival in Patients With Pulmonary Arterial Hypertension Related to Systemic Sclerosis Chest, February 1, 2003; 123(2): 344 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Budhiraja and P. M. Hassoun Portopulmonary Hypertension: A Tale of Two Circulations Chest, February 1, 2003; 123(2): 562 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Galie, A. Manes, and A. Branzi The new clinical trials on pharmacological treatment in pulmonary arterial hypertension Eur. Respir. J., October 1, 2002; 20(4): 1037 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Galie, M. Humbert, J.-L. Vachiery, C. Vizza, M. Kneussl, A. Manes, O. Sitbon, A. Torbicki, M. Delcroix, R. Naeije, et al. Effects of beraprost sodium, an oral prostacyclin analogue, in patients with pulmonary arterial hypertension: a randomized, double-blind, placebo-controlled trial J. Am. Coll. Cardiol., May 1, 2002; 39(9): 1496 - 1502. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer Hemodynamic Effects of Aerosolized Iloprost in Pulmonary Hypertension at Rest and During Exercise* Chest, May 1, 2002; 121(5): 1566 - 1571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Hoeper, N. Galie, G. Simonneau, and L. J. Rubin New Treatments for Pulmonary Arterial Hypertension Am. J. Respir. Crit. Care Med., May 1, 2002; 165(9): 1209 - 1216. [Full Text] [PDF]
|
|
|
|
|
|
G. SIMONNEAU, R. J. BARST, N. GALIE, R. NAEIJE, S. RICH, R. C. BOURGE, A. KEOGH, R. OUDIZ, A. FROST, S. D. BLACKBURN, et al. Continuous Subcutaneous Infusion of Treprostinil, a Prostacyclin Analogue, in Patients with Pulmonary Arterial Hypertension . A Double-blind, Randomized, Placebo-controlled Trial Am. J. Respir. Crit. Care Med., March 15, 2002; 165(6): 800 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.M. Hoeper Pulmonary hypertension in collagen vascular disease Eur. Respir. J., March 1, 2002; 19(3): 571 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C D Vizza, S Sciomer, S Morelli, C Lavalle, P Di Marzio, D Padovani, R Badagliacca, A R Vestri, R Naeije, and F Fedele Long term treatment of pulmonary arterial hypertension with beraprost, an oral prostacyclin analogue Heart, December 1, 2001; 86(6): 661 - 665. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. F. Fedullo, W. R. Auger, K. M. Kerr, and L. J. Rubin Chronic Thromboembolic Pulmonary Hypertension N. Engl. J. Med., November 15, 2001; 345(20): 1465 - 1472. [Full Text] [PDF]
|
|
|
|
|
|
L. S. Efferen The Challenge of Sarcoidosis Chest, September 1, 2001; 120(3): 697 - 699. [Full Text] [PDF]
|
|
|
|
|
|
British Cardiac Society Guidelines and Medical Pra Recommendations on the management of pulmonary hypertension in clinical practice Heart, September 1, 2001; 86(90001): i1 - 13. [Full Text] [PDF]
|
|
|
|
|
|
T. Saba and A.J. Peacock Long-term treatment of pulmonary hypertension with aerosolized iloprost Eur. Respir. J., July 1, 2001; 18(1): 247 - 247. [Full Text] [PDF]
|
|
|
|
|
|
S. Machherndl, M. Kneussl, H. Baumgartner, B. Schneider, V. Petkov, P. Schenk, and I.M. Lang Long-term treatment of pulmonary hypertension with aerosolized iloprost Eur. Respir. J., January 1, 2001; 17(1): 8 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Gessler, T. Schmehl, M.M. Hoeper, F. Rose, H.A. Ghofrani, H. Olschewski, F. Grimminger, and W. Seeger Ultrasonic versus jet nebulization of iloprost in severe pulmonary hypertension Eur. Respir. J., January 1, 2001; 17(1): 14 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Krasuski, J. J. Warner, A. Wang, J. K. Harrison, V. F. Tapson, and T. M. Bashore Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2204 - 2211. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. V. AGUILAR and H. W. FARBER Epoprostenol (Prostacyclin) Therapy in HIV-associated Pulmonary Hypertension Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1846 - 1850. [Abstract] [Full Text]
|
|
|
|
|
|
C. Strange, M. Bolster, J. Mazur, M. Taylor, J. R. Gossage, and R. Silver Hemodynamic Effects of Epoprostenol in Patients With Systemic Sclerosis and Pulmonary Hypertension Chest, October 1, 2000; 118(4): 1077 - 1082. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kaur, B. Brown, and F. Lombardo Prostacyclin for Secondary Pulmonary Hypertension Ann Intern Med, January 18, 2000; 132(2): 165 - 165. [Full Text] [PDF]
|
|
|
|
|
|
I. M. Robbins, S. P. Gaine, R. Schilz, V. F. Tapson, L. J. Rubin, and J. E. Loyd Epoprostenol for Treatment of Pulmonary Hypertension in Patients With Systemic Lupus Erythematosus* Chest, January 1, 2000; 117(1): 14 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Prostacyclin for Secondary Pulmonary Hypertension Journal Watch Cardiology, June 11, 1999; 1999(611): 12 - 12. [Full Text]
|
|
Article
