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The effects of pulmonary vasodilating agents on right ventricular parameters in severe group 3 pulmonary hypertension : a pilot study

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Title: The effects of pulmonary vasodilating agents on right ventricular parameters in severe group 3 pulmonary hypertension : a pilot study
Authors: Sato, Takahiro Browse this author
Tsujino, Ichizo Browse this author →KAKEN DB
Sugimoto, Ayako Browse this author
Nakaya, Toshitaka Browse this author
Watanabe, Taku Browse this author
Ohira, Hiroshi Browse this author
Suzuki, Masaru Browse this author →KAKEN DB
Konno, Satoshi Browse this author →KAKEN DB
Oyama-Manabe, Noriko Browse this author →KAKEN DB
Nishimura, Masaharu Browse this author →KAKEN DB
Keywords: arterial pressure
hypertension
magnetic resonance imaging
vasodilating agents
ventricular function
Issue Date: 1-Dec-2016
Publisher: University of Chicago Press
Journal Title: Pulmonary circulation
Volume: 6
Issue: 4
Start Page: 524
End Page: 531
Publisher DOI: 10.1086/688712
Abstract: Pulmonary arterial hypertension (PAH)-approved vasodilators improve right ventricular (RV) function in patients with PAH. However, whether PAH-approved drugs ameliorate RV morphology and function in lung disease-associated pulmonary hypertension (lung-PH) remains unclear. We aimed to prospectively evaluate the changes in RV volume and ejection fraction (RVEF) in 14 consecutive severe lung-PH patients treated with PAH-approved vasodilators. Severe lung-PH was defined as a mean pulmonary arterial pressure (MPAP) of ≥35 mmHg or an MPAP of ≥25 mmHg with a cardiac index (L/min/m2) of <2. Right heart catheterization and cardiac magnetic resonance (CMR) imaging were performed at baseline and at 3 months after starting sildenafil with or without other PAH-approved drugs. Follow-up was conducted at 3 months in 11 participants; compared with baseline values, MPAP and pulmonary vascular resistance (PVR) decreased by 18% and 37%, respectively. Baseline CMR imaging revealed an elevated RV end-diastolic volume index (RVEDVI; mL/m2) of 117.5 ± 35.9 and a below-average RVEF of 25.2% ± 7.2%; after 3 months, RVEDVI decreased by 23.7% (P = 0.0061) and RVEF increased by 32.9% (P = 0.0165). Among the 11 patients, 3 were thought to be a stable and homogenous subset in terms of background lung disease and medical management administered. These 3 patients exhibited similar ameliorations in PVR and RVEF, compared with the other 8 patients. PAH-approved drug treatment may improve RV dilatation and systolic function among patients with severe lung-PH. This study was approved by University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on September 1, 2013 (UMIN000011541).
Type: article
URI: http://hdl.handle.net/2115/67743
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 辻野 一三

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