Authors: Ralf Ewert Christian F Opitz Roland Wensel Jörg Winkler Michael Halank Stephan B Felix
Publish Date: 2007/02/15
Volume: 96, Issue: 4, Pages: 211-
Abstract
To describe the clinical and haemodynamic effects during the first 6 months of continuous intravenous iloprost treatment in patients with idiopathic pulmonary arterial hypertension IPAH and relevant disease progression despite continued mono therapy with aerosolized iloprostTwentyfour IPAH patients with clinical decompensation to NYHA class IV despite therapy with aerosolized iloprost and optimized conservative treatment were assessed clinically haemodynamically and by cardiopulmonary exercise testing for at least 6 months Upon switching from inhaled to intravenous iloprost all patients improved clinically NYHA III while pulmonary vascular resistance PVR and right atrial pressure decreased from 2386 ± 243 to 1381 ± 124 dyne ·s ·cm−5 and 12 ± 1 to 85 ± 1 mmHg respectively both p 005 Despite this acute improvement haemodynamic PVR increased from 1462±223 to 1978 ± 327 dyne ·s ·cm−5 and clinical 4 deaths 4 transplantations deterioration occurred with continued intravenous treatment during the following 6 monthsIn the group of patients described in this report the clinical and haemodynamic deterioration occurring while on mono therapy with inhaled iloprost could be stopped by switching to continuous application of intravenous iloprost However with continued intravenous therapy only a subgroup of patients could clinically be stabilized and transplanted successfully
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