Abstract: Poster Presentations |

Improvement in 6 Minute Walk Distance During Long-Term Intravenous Epoprostenol (Prostacyclin) Therapy in Patients With Portopulmonary Hypertension FREE TO VIEW

Marie M. Budev, DO, MPH; Omar A. Minai, MD FCCP; Mohammed Alam, MD; Kay D. Stelmach, RN RRT; Kevin McCarthy, RCPT; Alejandro C. Arroliga, MD FCCP
Author and Funding Information

The Cleveland Clinic Foundation, Cleveland, OH


Chest. 2003;124(4_MeetingAbstracts):223S-c-224S. doi:10.1378/chest.124.4_MeetingAbstracts.223S-c
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PURPOSE:  Epoprostenol has been reported to improve hemodynamics and functional capacity in primary pulmonary hypertension. The effect of long-term epoprostenol on exercise capacity in portopulmonary hypertension (PoPHTN) has not been previously reported.

METHODS:  Charts of PoPHTN patients who were placed on therapy with epoprostenol were reviewed for demographics, epoprostenol dose, 6 minute walk distance at baseline, 1st follow up visit, and 3rd follow up visit, duration of epoprostenol therapy, and survival.

RESULTS:  A total of 12 patients [age(yrs±SD) 51.4 ± 6.3, 6 males] with a history of PoPHTN and long-term epoprostenol therapy were identified. The median duration of therapy with epoprostenol was 97.5 weeks (interquartile range, 26 to 236 weeks). The dose of epoprostenol ranged from 6 ng/kg/min to 46 ng/kg/min during various followup periods. Eight out of 12 patients died (67%) over the follow-up period and the most common cause of death was hepatic failure (63%). In the 8 patients who died, the average duration of epoprostenol therapy to the time of death was 128± 71.79 weeks [duration(months±SD)]. The average 6 minute walk distance for all patients increased from a baseline of 1079.6±395.4 (ft±SD) to 1245.5±300.02 [(ft±SD) p=NS] at the first follow up visit and 1247.9 ± 375.19 [(ft±SD) p=NS] at the third follow up visit.CONCLUSIONS: Long-term infusion of eposprostenol may improve exercise capacity in PoPHTN as demonstrated by improved 6 minute walk distances. Patients with PoPHTN may be safely and effectively maintained on long-term epoprostenol therapy.

CLINICAL IMPLICATIONS:  Continuous infusion of epoprostenol may be useful to increasing exercise capacity in PoPHTN and possibly severing as a bridge to transplantation.

DISCLOSURE:  M.M. Budev, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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