Epoprostenol Infusion Therapy Changes Angiographic Findings of Pulmonary Arteries in Patients With Idiopathic Pulmonary Arterial Hypertension

  • Sakuma Masahito
    Division of Internal Medicine, Onagawa Municipal Hospital
  • Demachi Jun
    Department of Cardiology, Ishinomaki Municipal Hospital
  • Nawata Jun
    Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Suzuki Jun
    Department of Internal Medicine, Kurihara Central Hospital
  • Takahashi Tohru
    Department of Cardiology, Iwate Prefectural Central Hospital
  • Matsubara Hiromi
    Division of Cardiology, National Hospital Organization Okayama Medical Center
  • Akagi Satoshi
    Division of Cardiology, National Hospital Organization Okayama Medical Center
  • Shirato Kunio
    Division of Internal Medicine, Saito Hospital

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Background The pulmonary vascular changes induced by epoprostenol in patients with idiopathic pulmonary artery hypertension (IPAH) have not been reported by a clinical study. Methods and Results Analysis 1 compared the wedged pulmonary angiography (PAG) findings prior to initiation of epoprostenol therapy (n=24) with those after initiation (n=16). Analysis 2 compared the PAG findings prior to and after initiation of epoprostenol therapy (n=9) in the same pulmonary arteries in the same subjects. In analysis 1, a "cotton grass-like" stain originating from the peripheral pulmonary vessels (each vessel could not be distinguished on angiography) was not observable in any of 24 cases before initiation of epoprostenol therapy, but was visible in 13 of 16 cases after (p<0.0001). In analysis 2, the diameter of subsegmental arteries changed from 3.0±0.9 mm (mean ± standard deviation) to 3.7±1.2 mm (p=0.004) between the 2 time periods. Cotton grass-like stain was not found in any cases before epoprostenol, but in all 9 cases after chronic use (p=0.004). Conclusions After initiating epoprostenol therapy, cotton grass-like stain appeared in most patients with IPAH. The possible reason for this is release of severe vasoconstriction and/or emergence of neovascularization. (Circ J 2008; 72: 1147 - 1151)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 72 (7), 1147-1151, 2008

    一般社団法人 日本循環器学会

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