Chest, Vol 96, 784-789, Copyright © 1989 by American College of Chest Physicians

ARTICLES

Pulmonary vasodilation with prostacyclin in primary and secondary pulmonary hypertension

K Jones, T Higenbottam and J Wallwork
Department of Respiratory Physiology, Papworth Hospital, Cambridge, England.

Twenty-three patients with pulmonary hypertension underwent right cardiac catheterization and measurement of their response to a short- term infusion of prostacyclin. Pulmonary vasodilation with a greater than 20 percent fall in PVR occurred in all five patients with primary pulmonary hypertension where the predominant lesions were plexogenic; in three out of five patients where the predominant lesions were thrombotic; in three out of five patients with pulmonary hypertension and obstruction of proximal vessels; in three out of five patients with COPD; in both patients with pulmonary fibrosis due to sarcoidosis; and in the one patient with pulmonary veno-occlusive disease, where the pulmonary vasodilation was offset by a fall in arterial oxygen content. Prostacyclin is a safe and effective drug to use for testing the response of the pulmonary circulation to a vasodilator in pulmonary hypertension due to different causes. Short-term testing for a vasodilator response, with a view to instituting long-term therapy, should not be restricted to those patients with primary pulmonary hypertension due to plexogenic pulmonary arteriopathy.

This article has been cited by other articles:

				K. A. Fisher, D. M. Serlin, K. C. Wilson, R. E. Walter, J. S. Berman, and H. W. Farber Sarcoidosis-Associated Pulmonary Hypertension: Outcome With Long-term Epoprostenol Treatment. Chest, November 1, 2006; 130(5): 1481 - 1488. [Abstract] [Full Text] [PDF]

				C. Strange Treatment for Secondary Pulmonary Hypertension Chest, October 1, 2005; 128(4): 1897 - 1898. [Full Text] [PDF]

				H. A. Faraz, Y. Selektor, M. A. Ehtesham, M. Harbut, and K. K. Mubarak CASE REPORT: BOSENTAN-RESISTANT SARCOIDOSIS-ASSOCIATED PULMONARY HYPERTENSION RESPONSIVE TO SILDENAFIL Chest Meeting Abstracts, October 1, 2005; 128(4): 436S - 436S. [Abstract] [PDF]

				A. F. Shorr, D. L. Helman, D. B. Davies, and S. D. Nathan Pulmonary hypertension in advanced sarcoidosis: epidemiology and clinical characteristics Eur. Respir. J., May 1, 2005; 25(5): 783 - 788. [Abstract] [Full Text] [PDF]

				L. S. Efferen The Challenge of Sarcoidosis Chest, September 1, 2001; 120(3): 697 - 699. [Full Text] [PDF]

				I. R. Preston, J. R. Klinger, M. J. Landzberg, J. Houtchens, D. Nelson, and N. S. Hill Vasoresponsiveness of Sarcoidosis-Associated Pulmonary Hypertension Chest, September 1, 2001; 120(3): 866 - 872. [Abstract] [Full Text] [PDF]

				B. A. Banks, I. Seri, H. Ischiropoulos, J. Merrill, J. Rychik, and R. A. Ballard Changes in Oxygenation With Inhaled Nitric Oxide in Severe Bronchopulmonary Dysplasia Pediatrics, March 1, 1999; 103(3): 610 - 618. [Abstract] [Full Text]

				I. M. Robbins, L. L. Cuiper, C. M. Stein, A. J. J. Wood, H. B. He, R. Parker, and B. W. Christman Angiotensin II mediates systemic rebound hypertension after cessation of prostacyclin infusion in sheep J Appl Physiol, August 1, 1998; 85(2): 731 - 737. [Abstract] [Full Text] [PDF]