Pulmonary hypertension (PH) is a rare disease of the pulmonary vasculature with diverse pathogenetic mechanisms. Vasoactive substances such as endothelin A receptor (ETA) antagonists and prostanoids have been used to improve haemodynamics and clinical outcome. We compared the hemodynamic response to BQ-123 (an ETA receptor antagonist) and prostacyclin or its analogue iloprost in ten patients (four men) with a mean age of 35.9±15.6 years. Seven patients had primary PH and three had PH owing to connective tissue disease. Patients underwent haemodynamic evaluation before and after administration of intra-atrial BQ-123 (200mmol/min for 60min), intravenous prostacyclin (3ng·kg-1·min-1 for 4h) or iloprost as an aerosol (100µg over 24h). Response to vasodilator administration was defined as >15% decrease in pulmonary vascular resistance index (PVRI). Of the ten patients, five showed a response to BQ-123 and eight responded to prostanoids. Four patients were responders and one patient was a non-responder to both agents. PVRI decreased by 16.6±13.4% with BQ-123, and 24.4±15.7% with prostanoids (not statistically significant). The aetiology of PH did not affect the response to either drug. In conclusion, response to ETA antagonist or prostanoid administration can be achieved in a large group of patients with severe PH, however few patients respond identically to both agents. These findings are consistent with a multifactorial mechanism involved in this disease.
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September 2002
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Conference Article|
September 01 2002
Differential vasoactive response to endothelin receptor antagonists and prostacyclin in patients with severe pulmonary hypertension
Sotiria C. APOSTOLOPOULOU;
*Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
Dr Sotiria C. Apostolopoulou (e-mail [email protected]).
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Georgios KOURGIANNIDIS;
Georgios KOURGIANNIDIS
†1st Cardiology Department, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
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Athanassios MANGINAS;
Athanassios MANGINAS
†1st Cardiology Department, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
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Zenon S. KYRIAKIDES;
Zenon S. KYRIAKIDES
‡2nd Cardiology Department, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
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David WEBB;
David WEBB
§Department of Medical Sciences, University of Edinburgh, Western General Hospital, Edinburgh, U.K.
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Spyridon RAMMOS;
Spyridon RAMMOS
*Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
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Dimitrios T. KREMASTINOS;
Dimitrios T. KREMASTINOS
‡2nd Cardiology Department, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
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Dennis V. COKKINOS
Dennis V. COKKINOS
*Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens GR 17674, Greece
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Publisher: Portland Press Ltd
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2002 The Biochemical Society and the Medical Research Society
2002
Clin Sci (Lond) (2002) 103 (s2002): 298S–301S.
Citation
Sotiria C. APOSTOLOPOULOU, Georgios KOURGIANNIDIS, Athanassios MANGINAS, Zenon S. KYRIAKIDES, David WEBB, Spyridon RAMMOS, Dimitrios T. KREMASTINOS, Dennis V. COKKINOS; Differential vasoactive response to endothelin receptor antagonists and prostacyclin in patients with severe pulmonary hypertension. Clin Sci (Lond) 1 September 2002; 103 (s2002): 298S–301S. doi: https://doi.org/10.1042/CS103S298S
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