Chest
Selected ReportsLong-term Treatment With Oral Sildenafil in Addition to Continuous IV Epoprostenol in Patients With Pulmonary Arterial Hypertension
Section snippets
Materials and Methods
For measurements of hemodynamic and gas exchange parameters, a thermodilution pulmonary artery catheter was inserted before and after 5 months treatment with sildenafil. A 6-min walking test (6MWT) was performed before and after the sildenafil trial. The dose of epoprostenol and iloprost was not changed in the 3 months before and during the sildenafil trial. The 6MWT distance and the hemodynamic measurements were made before the administration of sildenafil and iloprost. The study was approved
Discussion
Addition of sildenafil to the long-term therapy with IV epoprostenol improved pulmonary arterial pressures and the 6MWT distance in all three patients without significant adverse effects at the reported doses. IV epoprostenol is now established as a treatment to be considered for all patients with PPH, and hundreds of patients worldwide experienced the beneficial effect of this treatment. Introduced initially as a bridge to transplantation, it is now considered superior to lung transplantation
References (11)
- et al.
Treatment of primary pulmonary hypertension with intravenous epoprostenol (prostacyclin)
Br Heart J
(1987) - et al.
A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension
N Engl J Med
(1996) - et al.
Reduction in pulmonary vascular resistance with long-term epoprostenol (prostacyclin) therapy in primary pulmonary hypertension
N Engl J Med
(1998) - et al.
Long-term prostacyclin for pulmonary hypertension with associated congenital heart defects
Circulation
(1999)