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Clinical Investigations: PULMONARY HYPERTENSION |

Effects of Lipo-Prostaglandin E1 on Pulmonary Hemodynamics and Clinical Outcomes in Patients With Pulmonary Arterial Hypertension*

Jieyan Shen, MD; Ben He, PhD; Binyao Wang, MD
Author and Funding Information

*From the Department of Cardiology, Shanghai Second Medical University-Affiliated Renji Hospital, Shanghai, Republic of China.

Correspondence to: Jieyan Shen, MD, Department of Cardiology, Renji Hospital, 1630 Dong Fang Rd, Shanghai 200127, ROC; e-mail: Shenjieyan_66@hotmail.com



Chest. 2005;128(2):714-719. doi:10.1378/chest.128.2.714
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Objective: To determine whether lipid microspheres containing prostaglandin E1 (lipo-PGE1) improve pulmonary hemodynamics and clinical outcomes in patients with pulmonary arterial hypertension (PAH).

Methods: Forty-nine patients with PAH (8 patients with primary pulmonary hypertension, 21 patients with collagen vascular disease, 20 patients with congenital systemic-to-pulmonary shunts) were randomly classified into a conventional therapy group (n = 22) or a group receiving lipo-PGE1 plus conventional drugs (lipo-PGE1 group; n = 27). Echocardiographic pulmonary parameters, New York Heart Association (NYHA) functional class, and Bruce treadmill test results for exercise capacity were recorded before and after treatment.

Results: After 2 weeks of treatment with lipo-PGE1 (10 μg bid for 14 days), there were significant improvements in the values (± SD) for systolic pulmonary arterial pressure (SPAP) [76.9 ± 27.9 mm Hg vs 66.5 ± 22.8 mm Hg, p < 0.001]; total pulmonary resistance (27.2 ± 13.3 dyne·s·cm5 vs 20.2 ± 10.7 dyne·s·cm5, p < 0.001); left ventricular ejection fraction (58.7 ± 9.6% vs 64.4 ± 6.8%, p < 0.001); and cardiac output (3.1 ± 0.8 L/min vs 3.7 ± 1.1 L/min, p < 0.01). The NYHA functional class decreased from 3.0 ± 0.6 to 2.5 ± 0.6 (p < 0.001), and the exercise capacity increased from 2.8 ± 1.0 to 4.3 ± 1.3 metabolic equivalents (MET) [p < 0.001]. Compared with the conventional therapy group, the lipo-PGE1 group achieved significant reduction of SPAP (10.4 ± 10.3 mm Hg vs 2.2 ± 5.6 mm Hg, p = 0.002) and a significant elevation of exercise capacity (1.5 ± 0.9 MET vs 0.6 ± 1.1 MET, p = 0.018).

Conclusion: Lipo-PGE1 can decrease pulmonary artery pressure and increase exercise capacity in patients with PAH.

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