Abstract
Background: Pulmonary arterial hypertension (PAH) has a poor prognosis despite the available therapeutic options. Normalization of hemodynamics would be needed to obtain the good prognosis.
Aims and Objectives: We aimed to investigate the determinants in PAH patients for normalization of hemodynamics only with oral drugs.
Methods: We retrospectively reviewed 190 patients with PAH treated at a single referral center. Hemodynamic parameters were investigated before and after treatments. All the patients were divided into a good control group with mean pulmonary arterial pressure (mPAP)<30mmHg and a poor control group with mPAP≧30mmHg at follow-up.
Results: Eighty-two patients were idiopathic/heritable, 65 patients were connective tissue disease, 22 patients congenital heart disease and 21 patients were portal hypertension. mPAP decreased significantly from baseline to follow-up (51±18.7 mmHg to 34.1±15.2 mmHg, p<0.001). The decrease of mPAP had no differences between the cause of PAH. The decrease of mPAP in combination treatments with parenteral prostanoid was significantly greater than that in patients treated with only oral drugs (22.5±2.0 mmHg vs.11.6±1.4 mmHg, p<0.001). Among the 76 patients treated with only oral drugs, mPAP before treatment in the poor control group was higher than that in another group (47.2 mmHg vs. 38.1 mmHg, p<0.001). The best cutoff value of mPAP before treatment for detecting mean PAP≦30mmHg after treatment was 39.5mmHg according to the receiver operating analysis (p=0.001).
Conclusions: To achieve normalization of hemodynamics in PAH, parenteral prostanoid should be used in cases with baseline mPAP exceeding 40mmHg.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5467.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019