Chest
Comparison of Inhaled Nitric Oxide and Inhaled Aerosolized Prostacyclin in the Evaluation of Heart Transplant Candidates With Elevated Pulmonary Vascular Resistance
Section snippets
MATERIALS AND METHODS
The study was performed at Sahlgrenska University Hospital, Göteborg, Sweden, and approved by the Human Ethics Committee of the Medical Faculty, University of Göteborg. Ten patients, 4 female and 6 male (24 to 59 years of age, mean 49 years) with elevated PVR (PVR >200 dyne o s o cm−5 and/or TPG >10 mm Hg) were included after informed consent. The patients were scheduled for diagnostic right heart catheterization. The diagnoses were ischemic (n=5) or dilated (n=5) cardiomyopathy (Table 1).
RESULTS
Patient characteristics prior to inclusion are shown in Table 1. Mean values for central hemodynamic variables during control and during PGI2 and NO inhalation are given in Table 2. No CO values were obtained for patient 7 due to a severe tricuspid valve insufficiency. Individual data on the effects of inhalation on MPAP, PCWP, TPG, and PVR are shown in Figure 2.
DISCUSSION
In the present study, we have compared the effects of inhaled aerosolized PGI2 (concentration in solution 10 μg/mL) with those of inhaled NO (40 ppm) on central hemodynamics in heart transplant candidates with congestive heart failure and elevated PVR. The main findings were that inhaled PGI2 induced a pulmonary vasodilation, with a decrease in PVR, MPAP, and TPG, comparable to that induced by inhaled NO. Furthermore, inhaled PGI2 caused no significant effect on SVR. It is not immediately
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Manuscript received November 19, 1997; revision accepted March 2, 1998.
Supported by the Swedish Medical Research Council (No. 8682 and 4341), The Medical Faculty of Göteborg (LUA), Göteborg Medical Association, and Sahlgrenska University Hospital Foundations.
Presented in part at the International Society for Heart and Lung Transplantations 17th annual meeting and scientific sessions, April 2-5, 1997, London, England.