Open AccessInhaled Low‐Dose Iloprost for Pulmonary Hypertension: A Prospective, Multicenter, Open‐Label Study
Author(s) -
Sun YunJuan,
Xiong ChangMing,
Shan GuangLiang,
Gu Qing,
Zeng WeiJie,
Lu XianLing,
Zhu Feng,
Liu ZhiHong,
Ni XinHai,
He JianGuo
Publication year - 2012
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.21987
Subject(s) - iloprost , medicine , inhalation , hemodynamics , anesthesia , pulmonary hypertension , cardiac index , cardiology , cardiac output , prostacyclin
Background: Inhaled iloprost (average >30 µg/d) has been considered an effective treatment for severe pulmonary hypertension (PH). Further evidence also showed that low‐dose iloprost given intravenously was equally effective as high‐dose iloprost in the therapy of systemic sclerosis. Hypothesis: Patients with pulmonary hypertension will benefit from inhalation of low‐dose iloprost. Methods: Sixty‐two patients with PH were enrolled and initiated with neubulizedlow‐dose iloprost (2.5 µg per inhalation, 6× daily) for 24 weeks in 13 medical centers in China. Efficacy endpoints included changes in 6‐minute walk distance (6MWD), World Health Organization functional class (WHO‐FC), and hemodynamic parameters. Results: Fourteen patients (22.6%) prematurely discontinued the study: 8 due to clinical worsening (6 in WHO‐FCIII–IV at baseline), 4 because of protocol change, and 2 patients lost during follow‐up. In the remaining 48 patients, 6MWD was increased from 356 ± 98 meters to 414 ± 99 meters ( P < 0.001) and WHO‐FC improved significantly ( P = 0.006) after 24‐week inhalation therapy. Cardiac output, cardiac index, and mixed venous oxygen saturation improved significantly compared with baseline (n = 34, P < 0.05). Most of the hemodynamic parameters improved significantly in patients in WHO‐FC II ( P < 0.05) but not in patients in WHO‐FCIII–IV. Conclusions: Low‐dose iloprost inhalation significantly improved exercise capacity and functional status in patients with PH. It was well tolerated. The improvement of hemodynamics was confirmed in patients with WHO‐FCI–II but not in patients with WHO‐FCIII–IV, suggesting the importance of early treatment in patients with advanced disease stages. Clin. Cardiol. 2012 DOI: 10.1002/clc.21987 This study was supported by National Grant from the Ministry of Science and Technology (Beijing, China, project number 2006BAI01A07) and the Capital Development Scientific Fund (Beijing, China, project number 2005‐1018). The authors have no other funding, financial relationships, or conflicts of interest to disclose.