BACKGROUND: The continuous infusion of prostacyclin has been shown to improve exercise capacity and survival in patients with primary pulmonary hypertension (PPH). Inhalation of iloprost, a stable analog of prostacyclin, might be an alternative therapy for PPH, selectively acting on the pulmonary vascular bed through ventilation-matched alveolar deposition of the drug. We investigated the short-term effects of iloprost inhalation on exercise capacity and gas exchange in patients with PPH. METHODS AND RESULTS: In 11 patients with PPH, we performed 2 consecutive cardiopulmonary exercise tests before and after the inhalation of 17 microgram of iloprost. Patients had marked pulmonary hypertension (mean pulmonary artery pressure 65 mm Hg), and inhalation resulted in a decrease in pulmonary vascular resistance (1509 versus 1175 dyne. s(-1). cm(-5), P<0.05). Arterial blood gases remained unchanged (PaO(2) 69.3 versus 66.8 mm Hg; PaCO(2) 29.6 versus 28.8 mm Hg). Iloprost significantly (P<0.05) improved exercise duration (379 versus 438 seconds), peak oxygen uptake (12.8 versus 14.2 mL. kg(-1). min(-1)), VE-versus-V CO(2) slope (58 versus 51.4). CONCLUSIONS: The present data show that iloprost inhalation exerts pulmonary vasodilatation and improves symptoms and exercise capacity in patients with PPH. The data also suggest that iloprost inhalation is a suitable treatment for PPH. Whether these effects are maintained during long-term treatment and are paralleled by improvement in prognosis remains to be determined.
BACKGROUND: The continuous infusion of prostacyclin has been shown to improve exercise capacity and survival in patients with primary pulmonary hypertension (PPH). Inhalation of iloprost, a stable analog of prostacyclin, might be an alternative therapy for PPH, selectively acting on the pulmonary vascular bed through ventilation-matched alveolar deposition of the drug. We investigated the short-term effects of iloprost inhalation on exercise capacity and gas exchange in patients with PPH. METHODS AND RESULTS: In 11 patients with PPH, we performed 2 consecutive cardiopulmonary exercise tests before and after the inhalation of 17 microgram of iloprost. Patients had marked pulmonary hypertension (mean pulmonary artery pressure 65 mm Hg), and inhalation resulted in a decrease in pulmonary vascular resistance (1509 versus 1175 dyne. s(-1). cm(-5), P<0.05). Arterial blood gases remained unchanged (PaO(2) 69.3 versus 66.8 mm Hg; PaCO(2) 29.6 versus 28.8 mm Hg). Iloprost significantly (P<0.05) improved exercise duration (379 versus 438 seconds), peak oxygen uptake (12.8 versus 14.2 mL. kg(-1). min(-1)), VE-versus-V CO(2) slope (58 versus 51.4). CONCLUSIONS: The present data show that iloprost inhalation exerts pulmonary vasodilatation and improves symptoms and exercise capacity in patients with PPH. The data also suggest that iloprost inhalation is a suitable treatment for PPH. Whether these effects are maintained during long-term treatment and are paralleled by improvement in prognosis remains to be determined.
Authors: Manuel J Richter; Hossein A Ghofrani; Robert Voswinckel; Werner Seeger; Richard Schulz; Frank Reichenberger; Henning Gall Journal: Pulm Circ Date: 2015-03 Impact factor: 3.017
Authors: N Nagaya; Y Shimizu; T Satoh; H Oya; M Uematsu; S Kyotani; F Sakamaki; N Sato; N Nakanishi; K Miyatake Journal: Heart Date: 2002-04 Impact factor: 5.994
Authors: Jonathan Rhodes; Ana Ubeda-Tikkanen; Mathieu Clair; Susan M Fernandes; Dionne A Graham; Carly E Milliren; Kevin P Daly; Mary P Mullen; Michael J Landzberg Journal: Int J Cardiol Date: 2013-03-29 Impact factor: 4.164
Authors: T Iwase; N Nagaya; M Ando; T Satoh; F Sakamaki; S Kyotani; H Takaki; Y Goto; Y Ohkita; M Uematsu; N Nakanishi; K Miyatake Journal: Heart Date: 2001-08 Impact factor: 5.994
Authors: M Wojewoda; K Przyborowski; B Sitek; A Zakrzewska; L Mateuszuk; J A Zoladz; S Chlopicki Journal: Naunyn Schmiedebergs Arch Pharmacol Date: 2016-12-03 Impact factor: 3.000