Immediately effects of inhaled aerosolised iloprost in adult patients with severe pulmonary hypertension secondary to congenital heart diseases
10.3760/cma.j.issn.0253-3758.2011.01.014
- VernacularTitle:先天性心脏病并重度肺动脉高压患者雾化吸入伊诺前列素的即刻效应
- Author:
Cao-Jin ZHANG
1
;
Yi-Gao HUANG
;
Jun-Jun SHEN
;
Tao HUANG
;
Wen-Hui HUANG
;
Ya-Ling CUI
;
Xin-Sheng HUANG
Author Information
1. 广东省人民医院广东省心血管病研究所
- Keywords:
Congenital heart disease;
Pulmonary arterial hypertension;
Pulmonary vascular resistance;
Iloprost;
Hemodynamics
- From:
Chinese Journal of Cardiology
2011;39(1):65-68
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the immediately effects of inhaled aerosolized iloprost in adult patients with severe pulmonary arterial hypertension(PAH)secondary to congenital heart diseases(CHD).Methods Adult patients with severe PAH secondary to CHD(n = 165)were included in this study. Right heart catheterization was performed, Pulmonary and systemic blood flow, the oxygen consumption VO2(ml/min)were calculated using Fick's principle. Pulmonary vascular resistances(PVR)were calculated with standard formulas and indexed to body surface area. Hemodynamic parameters were measured before and after iloprost inhalation(20 μg). Results Post iloprost inhalation, heart rate, mean aortic pressure, pulmonary systolic pressure to aortic systolic pressure ratio all remained unchanged(P ＞ 0. 05), while pulmonary artery pressure(PAP)were significantly reduced and Qp significantly increased from(7. 2 ±4. 8)L/min to(9. 9 ±7.2)L/min(P＜0.01), PVR was also significantly reduced from(13.4 ±8.7)Wood units to(9.5 ±6. 6)Wood units(P ＜0. 01),and left-to-right shunt volume increased from(3.2 ±4. 4)L/min to(5. 5 ±7.0)L/min(P ＜ 0. 01)and right -to-left shunt volume decreased from(1.0 ± 1.0)L/min to(0. 7 ± 0. 7)L/min(P ＜ 0. 01). Subgroup analysis showed that adult patients with patent ductus arteriosus and/or ventricular septal defects are more likely to develop severe pulmonary arterial hypertension or Eisenmenger syndrome than patients with atrial septal defects. Conclusions Inhaled Aerosolised iloprost use is effective and safe for adult patients with severe pulmonary arterial hypertension secondary to congenital heart diseases.
