Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension
In: Circulation (New York, N.Y.), Jg. 111 (2005), Heft 23, S. 3105-3111
Online
academicJournal
- print, 22 ref
Zugriff:
Background-Characteristics of patients with idiopathic pulmonary arterial hypertension (IPAH) who benefit from long-term calcium channel blockers (CCB) are unknown. Methods and Results-Acute pulmonary vasodilator testing with epoprostenol or nitric oxide was performed in 557 IPAH patients. Acute responders, defined by a fall in both mean pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) >20%, received long-term oral CCB. Patients who benefit from long-term CCB were defined as those being in New York Heart Association (NYHA) functional class I or II after at least 1 year on CCB monotherapy. Among the 70 patients who displayed acute pulmonary vasoreactivity (12.6%; 95% CI, 9.8% to 15.3%) and received CCB therapy, only 38 showed long-term improvement (6.8%; 95% CI, 4.7% to 8.9%). Long-term CCB responders had less severe disease at baseline than patients who failed. During acute vasodilator testing, long-term CCB responders displayed a more pronounced fall in mean PAP (-39±11% versus -26±7%; P<0.0001), reaching an absolute value of mean PAP lower than that measured in patients who failed (33±8 versus 46±10 mm Hg; P<0.0001). After 7.0±4.1 years, all but 1 long-term CCB responders were alive in NYHA class I or II, with a sustained hemodynamic improvement. In the group of patients who failed on CCB, the 5-year survival rate was 48%. Conclusions-Long-term CCB responders represent <10% of IPAH patients evaluated in a pulmonary vascular referral center. During acute vasodilator testing, these patients showed significantly lower levels of both mean PAP and PVR, which reached near-normal values.
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Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension
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Autor/in / Beteiligte Person: | SITBON, Olivier ; HUMBERT, Marc ; JAÏS, Xavier ; LOOS, Vincent ; HAMID, Abdul M ; PROVENCHER, Steeve ; GARCIA, Gilles ; PARENT, Florence ; HERVE, Philippe ; SIMONNEAU, Gérald |
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Zeitschrift: | Circulation (New York, N.Y.), Jg. 111 (2005), Heft 23, S. 3105-3111 |
Veröffentlichung: | Hagerstown, MD: Lippincott Williams & Wilkins, 2005 |
Medientyp: | academicJournal |
Umfang: | print, 22 ref |
ISSN: | 0009-7322 (print) |
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