دورية أكاديمية
أعرض في EDS

Calcium channel blockers in patients with pulmonary arterial hypertension receiving PAH-specific treatment.

التفاصيل البيبلوغرافية
العنوان: Calcium channel blockers in patients with pulmonary arterial hypertension receiving PAH-specific treatment.
المؤلفون: Hirakawa K; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Asano R; Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Ueda J; Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Aoki T; Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Tsuji A; Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Ogo T; Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: Tak@ncvc.go.jp.
المصدر: International journal of cardiology [Int J Cardiol] 2024 Jul 01; Vol. 406, pp. 132043. Date of Electronic Publication: 2024 Apr 15.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Elsevier
Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981-
مواضيع طبية MeSH: Calcium Channel Blockers*/therapeutic use , Calcium Channel Blockers*/administration & dosage, Humans ; Female ; Male ; Retrospective Studies ; Middle Aged ; Adult ; Pulmonary Arterial Hypertension/drug therapy ; Pulmonary Arterial Hypertension/physiopathology ; Treatment Outcome ; Follow-Up Studies
مستخلص: Background: Calcium channel blockers (CCB) are the first effective therapy for vasoreactive patients with idiopathic pulmonary arterial hypertension (IPAH). However, the advent of modern PAH-specific drugs may undermine the role of vasoreactivity tests and CCB treatment. We aimed to clarify the effect of acute vasoreactivity testing and CCB on patients with IPAH receiving PAH-specific treatment.
Methods: We retrospectively investigated consecutive patients with IPAH (n = 136) diagnosed between 2000 and 2020 and collected data from patients who underwent acute vasoreactivity testing using inhaled nitric oxide (NO). The effects of vasoreactivity testing and CCB therapy were reviewed. Long-term survival was analysed using the Kaplan-Meier method.
Results: Acute vasoreactivity testing was performed in 49% of patients with IPAH (n = 67), including 23 patients (34%) receiving PAH-specific therapy without vasoreactivity testing. Eight patients (12%), including three patients (4.4%) receiving PAH-specific therapy, presented acute responses at vasoreactivity testing. They received high-dose CCB therapy (CCB monotherapy for five patients [7.5%] and CCB therapy and PAH-specific therapy for three patients [4.4%]). They presented a significant improvement in clinical parameters and near-normalisation of haemodynamics (mean pulmonary arterial pressure decreased from 46 [interquartile range: 40-49] to 19.5 [interquartile range: 18-23] mmHg [P < .001] at 1-year follow-up). All eight vasoreactive responders receiving CCB therapy showed better long-term survival than non-responders treated with PAH-specific therapy (P < .001).
Conclusions: CCB therapy benefited patients with IPAH who showed acute response to vasoreactivity testing using inhaled NO, even when receiving modern PAH-specific therapy. Acute vasoreactive responders may benefit more from CCB than from PAH-specific therapy.
Competing Interests: Declaration of competing interest T. Ogo has received lecture fees from Janssen Pharmaceutical K.K., Bayer Yakuhin, Ltd., Nippon Shinyaku Co., Ltd., and Mochida Pharmaceutical Co., Ltd.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
فهرسة مساهمة: Keywords: Acute vasoreactivity testing; Calcium channel blockers; Nitric oxide; Pulmonary arterial hypertension
المشرفين على المادة: 0 (Calcium Channel Blockers)
تواريخ الأحداث: Date Created: 20240413 Date Completed: 20240506 Latest Revision: 20240506
رمز التحديث: 20240507
DOI: 10.1016/j.ijcard.2024.132043
PMID: 38614366
قاعدة البيانات: MEDLINE
الوصف
تدمد:1874-1754
DOI:10.1016/j.ijcard.2024.132043