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Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study

Background: Right ventricle (RV) function is among the most important prognostic factors for pulmonary arterial hypertension (PAH) patients. Inhaled iloprost, an inhaled member of the prostacyclin family, is effective for the treatment of severe PAH and acute RV failure. However, the acute effects o...

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Autores principales: Li, Jing-Hui, Zhang, Hong-Da, Wang, Zhen-Zhen, Lu, Qing-Qing, Li, Dong, Lian, Tian-Yu, Lv, Zi-Chao, Jiang, Xin, Wu, Yan, Ye, Jue, Zhao, Shihua, Yang, Zhenwen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348276/
https://www.ncbi.nlm.nih.gov/pubmed/30719004
http://dx.doi.org/10.3389/fphar.2018.01550
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author Li, Jing-Hui
Zhang, Hong-Da
Wang, Zhen-Zhen
Lu, Qing-Qing
Li, Dong
Lian, Tian-Yu
Lv, Zi-Chao
Jiang, Xin
Wu, Yan
Ye, Jue
Zhao, Shihua
Yang, Zhenwen
author_facet Li, Jing-Hui
Zhang, Hong-Da
Wang, Zhen-Zhen
Lu, Qing-Qing
Li, Dong
Lian, Tian-Yu
Lv, Zi-Chao
Jiang, Xin
Wu, Yan
Ye, Jue
Zhao, Shihua
Yang, Zhenwen
author_sort Li, Jing-Hui
collection PubMed
description Background: Right ventricle (RV) function is among the most important prognostic factors for pulmonary arterial hypertension (PAH) patients. Inhaled iloprost, an inhaled member of the prostacyclin family, is effective for the treatment of severe PAH and acute RV failure. However, the acute effects of iloprost on RV physiology have not been thoroughly explored in the past. Materials and Methods: This prospective study involved 69 incident PAH patients, including 23 idiopathic PAH (IPAH) patients, 26 patients with PAH associated with connective tissue disease (CTD-PAH) and 20 with PAH associated with congenital heart disease (CHD-PAH). All patients underwent both right heart catheterization and cardiac magnetic resonance imaging at baseline and 20 min after 5 μg iloprost inhalation. Results: Acute iloprost inhalation reduced PVR from 13 ± 7 to 10 ± 6 Wood U (P < 0.001), increased RV ejection fraction (RVEF) from 31 ± 11 to 35 ± 12 % (P < 0.001), increased RV stroke volume from 53 ± 21 to 57 ± 22 ml (P < 0.001) and decreased RV end-diastolic volume from 179 ± 67 to 172 ± 69 ml (P < 0.001). Acute iloprost inhalation-induced RVEF improvement was correlated with the degree of PVR reduction (P < 0.001) in IPAH patients, but not in CTD-PAH or CHD-PAH patients. Conclusion: Acute iloprost inhalation improved RVEF, RV stroke volume and decreased RV volume in IPAH and CTD-PAH patients. Iloprost-induced RVEF increase was proportional to PVR reduction in IPAH patients, but not in CTD-PAH or CHD-PAH patients.
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spelling pubmed-63482762019-02-04 Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study Li, Jing-Hui Zhang, Hong-Da Wang, Zhen-Zhen Lu, Qing-Qing Li, Dong Lian, Tian-Yu Lv, Zi-Chao Jiang, Xin Wu, Yan Ye, Jue Zhao, Shihua Yang, Zhenwen Front Pharmacol Pharmacology Background: Right ventricle (RV) function is among the most important prognostic factors for pulmonary arterial hypertension (PAH) patients. Inhaled iloprost, an inhaled member of the prostacyclin family, is effective for the treatment of severe PAH and acute RV failure. However, the acute effects of iloprost on RV physiology have not been thoroughly explored in the past. Materials and Methods: This prospective study involved 69 incident PAH patients, including 23 idiopathic PAH (IPAH) patients, 26 patients with PAH associated with connective tissue disease (CTD-PAH) and 20 with PAH associated with congenital heart disease (CHD-PAH). All patients underwent both right heart catheterization and cardiac magnetic resonance imaging at baseline and 20 min after 5 μg iloprost inhalation. Results: Acute iloprost inhalation reduced PVR from 13 ± 7 to 10 ± 6 Wood U (P < 0.001), increased RV ejection fraction (RVEF) from 31 ± 11 to 35 ± 12 % (P < 0.001), increased RV stroke volume from 53 ± 21 to 57 ± 22 ml (P < 0.001) and decreased RV end-diastolic volume from 179 ± 67 to 172 ± 69 ml (P < 0.001). Acute iloprost inhalation-induced RVEF improvement was correlated with the degree of PVR reduction (P < 0.001) in IPAH patients, but not in CTD-PAH or CHD-PAH patients. Conclusion: Acute iloprost inhalation improved RVEF, RV stroke volume and decreased RV volume in IPAH and CTD-PAH patients. Iloprost-induced RVEF increase was proportional to PVR reduction in IPAH patients, but not in CTD-PAH or CHD-PAH patients. Frontiers Media S.A. 2019-01-21 /pmc/articles/PMC6348276/ /pubmed/30719004 http://dx.doi.org/10.3389/fphar.2018.01550 Text en Copyright © 2019 Li, Zhang, Wang, Lu, Li, Lian, Lv, Jiang, Wu, Ye, Zhao and Yang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Li, Jing-Hui
Zhang, Hong-Da
Wang, Zhen-Zhen
Lu, Qing-Qing
Li, Dong
Lian, Tian-Yu
Lv, Zi-Chao
Jiang, Xin
Wu, Yan
Ye, Jue
Zhao, Shihua
Yang, Zhenwen
Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study
title Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study
title_full Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study
title_fullStr Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study
title_full_unstemmed Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study
title_short Acute Iloprost Inhalation Improves Right Ventricle Function in Pulmonary Artery Hypertension: A Cardiac Magnetic Resonance Study
title_sort acute iloprost inhalation improves right ventricle function in pulmonary artery hypertension: a cardiac magnetic resonance study
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348276/
https://www.ncbi.nlm.nih.gov/pubmed/30719004
http://dx.doi.org/10.3389/fphar.2018.01550
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