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首页> 外文期刊>Circulation journal >Long-Term Epoprostenol Therapy in Pulmonary Artery Hypertension Sequence of Changes in Hemodynamic Effects
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Long-Term Epoprostenol Therapy in Pulmonary Artery Hypertension Sequence of Changes in Hemodynamic Effects

机译:长期依普列汀治疗肺动脉高压患者血流动力学改变的序列

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Background: Sequential changes in the hemodynamic effect of chronic epoprostenol therapy raise the following questions. Does an increase in cardiac output (CO) precede lowering of the pulmonary artery pressure (PAP) over the time course of improvement? What are the characteristics of good responders to chronic epoprostenol treatment?Methods and Results: Hemodynamics were evaluated by catheter examination. Most patients still alive after >1 year showed an increase in CO either with no change in mean PAP or accompanied by a decrease in mean PAP during increased dosing of epoprostenol. Immediately before cessation of the increase in epoprostenol dose in good responders, the ratio of total pulmonary resistance to total systemic resistance was low, and the pulmonary artery wedge pressure minus right atrial pressure was high compared with the newest data in poor responders. One year after fixing at the best dose of epoprostenol, the mean PAP further decreased.Conclusions: In good responders, pulmonary selectivity to epoprostenol is high, and the blood returning to the left-sided heart through the pulmonary circulation increases. Hemodynamics further improve, even after fixing at the best dose of epoprostenol. The present data did not show that an increase in CO precedes lowering of the PAP over the course of improvement.
机译:背景:慢性依泊汀治疗的血液动力学效应的顺序变化引起以下问题。在改善过程中,心输出量(CO)的增加是否会先于肺动脉压力(PAP)的降低?方法和结果:通过导管检查评估血流动力学,对慢性依泊汀治疗有良好反应者的特征是什么? ≥1年后仍存活的大多数患者在增加依泊汀的剂量期间,CO升高或平均PAP无变化或伴有平均PAP降低。与不良反应者的最新数据相比,在良好反应者中停止增加依前列烯醇剂量之前,总肺阻力与总全身阻力之比较低,肺动脉楔压减去右心房压较高。固定最佳剂量的依普西汀后一年,平均PAP进一步降低。结论:在良好的应答者中,对依普西汀的肺部选择性高,并且血液通过肺循环返回左侧心脏的数量增加。即使固定了最佳剂量的依泊烯醇,血流动力学也进一步改善。目前的数据并未显示在改善过程中,CO的增加先于PAP的降低。

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