Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Voswinckel, R; Reichenberger, F; Enke, B; Kreckel, A; Krick, S; Gall, H; Schermuly, RT; Grimminger, F; Rubin, LJ; Olschewski, H; Seeger, W; Ghofrani, HA.
Acute effects of the combination of sildenafil and inhaled treprostinil on haemodynamics and gas exchange in pulmonary hypertension.
Pulm Pharmacol Ther. 2008; 21(5): 824-832.
Doi: 10.1016/j.pupt.2008.07.003
Web of Science
PubMed
FullText
FullText_MUG
Google Scholar
- Co-Autor*innen der Med Uni Graz
- Olschewski Horst
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Background: Inhaled treprostinil was recently developed for the treatment of pulmonary arterial hypertension (PAN). We investigated the safety and acute haemodynamic effects of the combination oral sildenafil and inhaled treprostinil in an open label study in patients with precapillary pulmonary hypertension. Methods and patients: Inhaled nitric oxide (20 ppm; n = 50), sildenafil (50 mg; n = 50) and inhaled treprostinil (15 mu g; n = 25 or 30 mu g; n = 25) were applied in subsequent order during right heart catheter investigation to consecutive patients with pulmonary arterial hypertension (PAH; n = 28), non-operable chronic thromboembolic pulmonary hypertension (CTEPH; n = 17) and pulmonary fibrosis associated pulmonary hypertension (n = 5). Results: Inhaled nitric oxide reduced pulmonary vascular resistance (PVR) to 87.3 +/- 5.1% of baseline values, reduced mean pulmonary arterial pressure (PAP) to 89.7 +/- 3.5% and increased cardiac output (CO) to 102.4 +/- 2.9%. Sildenafil reduced PVR to 80.1 +/- 5.0%, mPAP to 86.5 +/- 2.9% and increased CO to 103.8 +/- 3.2%. Treprostinil, inhaled 1 h after sildenafil, reduced PVR to 66.3 +/- 3.8%, mPAP to 77.8 +/- 3.3%, and increased CO to 107.1 +/- 3.3% (mean 95% confidence interval). Subgroup analysis showed similar acute haemodynamic effects in PAH and CTEPH patients. Ventilation/perfusion distribution measurement in six patients with pre-existing gas exchange limitations was not changed by sildenafil and treprostinil. Relevant side effects were not observed. Conclusion: The combination of sildenafil and inhaled treprostinil was well tolerated and induced additive, pulmonary selective vasodilatation in pulmonary hypertension patients. This could be of relevance also for long-term treatment of PAH and CTEPH patients. (c) 2008 Elsevier Ltd. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Administration, Inhalation -
- Administration, Oral -
- Antihypertensive Agents - administration and dosage
- Area Under Curve -
- Blood Pressure - drug effects
- Cough - chemically induced
- Drug Synergism -
- Drug Therapy, Combination -
- Epoprostenol - adverse effects
- Female -
- Hemodynamics - drug effects
- Humans -
- Hypertension, Pulmonary - complications
- Male -
- Middle Aged -
- Phosphodiesterase 5 Inhibitors -
- Phosphodiesterase Inhibitors - administration and dosage
- Piperazines - adverse effects
- Pulmonary Fibrosis - complications
- Pulmonary Gas Exchange - drug effects
- Purines - adverse effects
- Sulfones - adverse effects
- Treatment Outcome -
- Vascular Resistance - drug effects
- Find related publications in this database (Keywords)
- Prostaglandins
- Pulmonary arterial hypertension
- Phosphodiesterase inhibitors
- Pulmonary heart disease
- Treprostinil