Key result
Oral beraprost matches inhaled nitric oxide for acute pulmonary vasodilation in congenital heart disease.
Why the study?
Congenital heart disease patients with pulmonary hypertension require evaluation of pulmonary vascular reactivity before surgical repair, but comparative data on acute vasodilating effects of agents are limited.
Does beraprost sodium have a similar acute pulmonary vasodilating effect compared to inhaled nitric oxide in patients with congenital heart disease and pulmonary hypertension?
Observational (n=90)
Yes
Does beraprost sodium have a similar acute pulmonary vasodilating effect compared to inhaled nitric oxide in patients with congenital heart disease and pulmonary hypertension?
Absolute Event Rate: 9.5% vs 9.2%
p-value: p=0.973
Beraprost sodium demonstrates a similar acute pulmonary vasodilating effect to inhaled nitric oxide during cardiac catheterization in patients with congenital heart disease and pulmonary hypertension.
BPS offers a practical oral alternative to iNO for acute vasoreactivity testing in CHD-PH; leaves open effects on surgical eligibility or outcomes.
BACKGROUND: Congenital heart disease patients who have pulmonary hypertension (PH) require an evaluation for pulmonary vascular reactivity before surgical repair. In the present study the acute pulmonary vasodilating effects of 100% oxygen (O2), beraprost sodium (BPS) and 40 ppm inhaled nitric oxide (iNO) during cardiac catheterization were compared. METHODS AND RESULTS: There were 90 patients who underwent cardiac catheterization for evaluation of PH (mean age, 16.5+/-16 years). The baseline mean pulmonary artery (mPA) pressure was 69.6+/-14.8 mmHg and the pulmonary arteriolar resistance (Rpa) was 13.8+/-8.3 Wood unit m2. Change in pulmonary vascular reactivity was defined as a decrease in mPA or Rpa>20% from baseline. The response to 100%O2, iNO and BPS during cardiac catheterization was 84%, 72.7% and 64%, respectively. Pair comparisons among each hemodynamic parameter showed no difference between the acute vasodilating effect of BPS and iNO. In some patients BPS showed a stronger effect than iNO in lowering Rpa. CONCLUSIONS: BPS has a similar pulmonary vasodilating effect to iNO and can be used as an acute pulmonary vasodilating agent during cardiac catheterization with potential benefits over iNO.
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Durongpisitkul et al. (2004) conducted an observational in Congenital heart disease with pulmonary hypertension (n=90). Beraprost sodium vs. 40 ppm inhaled nitric oxide was evaluated on Pulmonary arteriolar resistance (Rpa) in Wood unit m2 (p=0.973). Oral beraprost sodium produced a similar acute pulmonary vasodilating effect to inhaled nitric oxide in patients with congenital heart disease and pulmonary hypertension, with no significant difference in pulmonary arteriolar resistance (p=0.973).
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