on June 6, 2005
Circulation. 2005
Published online before print June 6, 2005, doi: 10.1161/CIRCULATIONAHA.104.488486
Published online before print June 6, 2005, doi: 10.1161/CIRCULATIONAHA.104.488486
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Submitted on July 23, 2004
From the Centre des Maladies Vasculaires Pulmonaires, UPRES EA 2705, Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine Béclère, AP-HP, Université Paris-Sud, Clamart, France. * To whom correspondence should be addressed. E-mail: olivier.sitbon{at}abc.aphp.fr.
Background--Characteristics of patients with idiopathic pulmonary arterial hypertension (IPAH) who benefit from long-term calcium channel blockers (CCB) are unknown. Methods and Results--Acute pulmonary vasodilator testing with epoprostenol or nitric oxide was performed in 557 IPAH patients. Acute responders, defined by a fall in both mean pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) >20%, received long-term oral CCB. Patients who benefit from long-term CCB were defined as those being in New York Heart Association (NYHA) functional class I or II after at least 1 year on CCB monotherapy. Among the 70 patients who displayed acute pulmonary vasoreactivity (12.6%; 95% CI, 9.8% to 15.3%) and received CCB therapy, only 38 showed long-term improvement (6.8%; 95% CI, 4.7% to 8.9%). Long-term CCB responders had less severe disease at baseline than patients who failed. During acute vasodilator testing, long-term CCB responders displayed a more pronounced fall in mean PAP (-39±11% versus -26±7%; P<0.0001), reaching an absolute value of mean PAP lower than that measured in patients who failed (33±8 versus 46±10 mm Hg; P<0.0001). After 7.0±4.1 years, all but 1 long-term CCB responders were alive in NYHA class I or II, with a sustained hemodynamic improvement. In the group of patients who failed on CCB, the 5-year survival rate was 48%. Conclusions--Long-term CCB responders represent <10% of IPAH patients evaluated in a pulmonary vascular referral center. During acute vasodilator testing, these patients showed significantly lower levels of both mean PAP and PVR, which reached near-normal values.
Revised on February 21, 2005
Accepted on March 2, 2005
Long-Term Response to Calcium Channel Blockers in Idiopathic Pulmonary Arterial Hypertension
Olivier Sitbon MD*,
Key words: calcium channel blockers • follow-up studies • hypertension, pulmonary • nitric oxide • pulmonary circulation
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Circulation 2005 111: 3015.
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|
|
|
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|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
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|
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|
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|
|
|
|
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|
|
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|
|
|
|
 |
|
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|
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|
|
|
|
|
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|
|
|
|
|
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|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
S Mehta and G J Shoemaker Improving survival in idiopathic pulmonary arterial hypertension: revisiting the "kingdom of the near-dead" Thorax, December 1, 2005; 60(12): 981 - 983. [Full Text] [PDF]
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|
|