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The effects of pulmonary vasodilating agents on right ventricular parameters in severe group 3 pulmonary hypertension : a pilot study
| 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)
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Submitter: 辻野 一三
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