Clinical Analysis in Patients of Idiopathic Pulmonary Hypertension With Acute Pulmonary Vasodilator Test
10.3969/j.issn.1000-3614.2014.07.009
- VernacularTitle:特发性肺动脉高压患者急性肺血管反应试验的临床分析
- Author:
Enci HU
;
Zhihong LIU
;
Jianguo HE
;
Xinhai NI
;
Qing GU
;
Zhihui ZHAO
;
Tao YANG
;
Yaguo ZHENG
;
Changming XIONG
- Publication Type:Journal Article
- Keywords:
Idiopathic pulmonary arterial hypertension;
Acute pulmonary vasodilator test;
Hemodynamic parameters
- From:
Chinese Circulation Journal
2014;(7):513-516
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the effect of calcium channel blocker (CCB) treatment in patients of idiopathic pulmonary arterial hypertension (IPAH) with positive acute pulmonary vasodilator test, and to compare the hemodynamic differences between the positive and negative patients.
Methods: A total of 156 consecutive IPAH patients with acute pulmonary vasodilator test were studied. The patients were divided into 2 groups according to the testing result. Positive group, n=23 and Negative group, n=133. The positive patients were followed up by clinical or telephone visit to investigate their CCB dose, WHO PAH cardiac classiifcation and the survival conditions. Kaplan-meier curve was conducted to analyze the living condition and t test was used to compare the hemodynamic differences between the positive and negative patients.
Results: There were 43 male and 113 female patients at the male/female ratio of 1: 2.6, and 14.7% (23/156) positive patients. The average follow-up period for Positive group was (50.9 ± 3.8) months. There were 13 patients using diltiazem with the mean dose of (277 ± 108) mg/d at the range of (90-450) mg/d; 3 patients using amlodipine, 1 with the dose of 15mg/d and 2 with the dose of 7.5mg/d. The 1, 2 and 3 years survival rate for the positive patients were for 91.3%, 86.6% and 79.7% respectively. The mean pulmonary arterial pressure and pulmonary vascular resistance were lower, P=0.000, while the mixed venous oxygen saturation was higher in Positive group than Negative group, P=0.009.The NT-pro BNP level was lower in Positive group, P=0.001.
Conclusion: IPAH patients has lower ratio of positive acute pulmonary vasodilator test. The positive patients has the higher 1, 3 and 5 years survival rate and better hemodynamic parameters as the mean pulmonary arterial pressure, pulmonary vascular resistance and better level of NT-pro BNP.
