PH (pulmonary hypertension) often complicates the disease course of patients with COPD (chronic obstructive pulmonary disease) and is an indication of a worse prognosis. In the present study, we assessed whether pravastatin administration was effective in improving PH and exercise capacity in COPD patients with PH, and whether the pulmonary protection was mediated by inhibiting ET-1 (endothelin-1) production. In a double-blind parallel design, 53 COPD patients with PH were randomly assigned to receive either placebo or pravastatin (40 mg/day) over a period of 6 months at a medical centre. Baseline characteristics were similar in both groups. The exercise time remained stable throughout the study in the placebo group. After 6 months, the exercise time significantly increased 52% from 660±352 to 1006±316 s (P<0.0001) in pravastatin-treated patients. With pravastatin, echocardiographically derived systolic PAP (pulmonary artery pressure) decreased significantly from 47±8 to 40±6 mmHg. There was significant improvement in the Borg dyspnoea score after administering pravastatin. Despite unchanged plasma ET-1 levels throughout the study, urinary excretion of the peptide was decreased and significantly correlated with an improvement in exercise time in pravastatin-treated patients (r=−0.47, P=0.01). In conclusion, pravastatin significantly improved exercise tolerance, and decreased PH and dyspnoea during exercise in COPD patients with PH, probably by inhibiting ET-1 synthesis.
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March 2009
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Research Article|
February 12 2009
Effects of pravastatin on functional capacity in patients with chronic obstructive pulmonary disease and pulmonary hypertension
Tsung-Ming Lee;
Tsung-Ming Lee
*Cardiology Section, Department of Medicine, Taipei Medical University and Chi-Mei Medical Center, Tainan, Taiwan
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Chien-Chang Chen;
†Cardiology Section, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
Correspondence: Professor Nen-Chung Chang (email [email protected]).
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Hsiu-Nien Shen;
Hsiu-Nien Shen
‡Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan
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Nen-Chung Chang
Nen-Chung Chang
§Department of Medicine, Cardiology Section, Taipei Medical University and Hospital, Taipei, Taiwan
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Publisher: Portland Press Ltd
Received:
June 18 2008
Revision Received:
October 02 2008
Accepted:
October 03 2008
Accepted Manuscript online:
October 03 2008
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2009 Biochemical Society
2009
Clin Sci (Lond) (2009) 116 (6): 497–505.
Article history
Received:
June 18 2008
Revision Received:
October 02 2008
Accepted:
October 03 2008
Accepted Manuscript online:
October 03 2008
Connected Content
This is a commentary on:
Role of pravastatin in pulmonary hypertension in chronic obstructive pulmonary disease
Citation
Tsung-Ming Lee, Chien-Chang Chen, Hsiu-Nien Shen, Nen-Chung Chang; Effects of pravastatin on functional capacity in patients with chronic obstructive pulmonary disease and pulmonary hypertension. Clin Sci (Lond) 1 March 2009; 116 (6): 497–505. doi: https://doi.org/10.1042/CS20080241
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