Why the study?
Using PAH-targeted therapy in severe pulmonary hypertension with chronic lung disease is controversial because pulmonary vasodilation could worsen hypoxemia.
Does PAH-targeted therapy improve laboratory indicators, hemodynamics, and survival in patients with severe pulmonary hypertension in chronic lung disease?
Does PAH-targeted therapy improve laboratory indicators, hemodynamics, and survival in patients with severe pulmonary hypertension in chronic lung disease?
In patients with severe pulmonary hypertension associated with chronic lung disease, PAH-targeted therapy improved oxygenation and NT-proBNP without worsening hypoxemia, though it did not demonstrate a statistically significant survival benefit.
May reduce concern over hypoxemia worsening with PAH therapy in severe PH-CLD; leaves open survival benefit and should not yet change practice.
Background Using PAH-targeted therapy in severe pulmonary hypertension (PH) patients with chronic lung disease (CLD) is controversial as the pulmonary vasodilation could worsen hypoxemia. Objective To investigate the efficacy of patients with severe PH-CLD to PAH targeted therapy. Methods We retrospectively enrolled patients with severe PH-CLD in our study. Each patient underwent laboratory indicators and transthoracic echocardiography at baseline and after the therapy, and survival after therapy were also evaluated. Results After PAH targeted therapy, NT - proBNP significantly decreased (1043.10(236.75-2697.50) pg/ml vs 287.10(21.00-555.90) pg/ml, p =0.035), whereas PaO 2 and the oxygenation index in blood gas analysis significantly increased(59.18± 30.12 mmHg vs 74.35(61.63-163.95)mmHg, p =0.010 and 177.21± 84.38 mmHg vs 286.22± 165.13 mmHg, p =0.035, respectively). But the difference at 1-,3- years survival rates between the two groups was not statistically significant (82.82% and 66.26% vs 75.87% and 20.23%, respectively, p =0.094). Multivariate regression analysis identified baseline mean right atrial pressure values and cardiac index as significant predictors of survival of patients with severe PH-CLD. Conclusions PAH targeted therapy may have benefit in patients with severe PH-CLD and didn’t worsen their hypoxemia. Right ventricular function might have an important impact on the survival of patients.
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Li et al. (2020) studied this question.
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