Effect of cyclic intravenous Iloprost therapy in patients with Idiopathic Pulmonary Artery Hypertension

MalekMohammad, Majid; Sharif-Kashani , Babak; Monjazebi, Fatemeh; Khosravi , Katayon

[Home ] [Archive]

[ فارسی ]

Main Menu

Home

Journal Information

Indexing Sources

Guide for Authors

Online Submission

Ethics

Articles archive

For Reviewers

Contact us

Basic and Clinical Biochemistry and Nutrition

DOAJ

CINAHL

EBSCO

IMEMR

ISC

Search in website

Receive site information

enamad

Volume 20, Issue 6 (Bimonthly 2017)

Feyz Med Sci J 2017, 20(6): 509-517

Back to browse issues page

Effect of cyclic intravenous Iloprost therapy in patients with Idiopathic Pulmonary Artery Hypertension

Majid MalekMohammad

, Babak Sharif-Kashani ^*

, Fatemeh Monjazebi

, Katayon Khosravi

Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran. , babaksharifkashani@yahoo.com

Abstract: (5739 Views)

Background: Prostacyclin have positive effects in improving the cardiopulmonary variables, signs and the hemodynamics of cases with a idiopathic pulmonary artery hypertension (IPAH).The objective of this study was to determine the benefits of intermittent intravenous Iloprost infusion on IPAH cases.

Material and Methods: This longitudinal study was conducted on IPAH cases (no=20) at Massih Daneshvari Hospital (2011-2013), treated with cyclic intravenous Iloprost. The treatment consisted of a 6 hours/day Iloprost infusion for three consecutive days. Every 6 weeks the infusion was repeated again with a velocity of 0.5-2.0 ng/kg/min. Before, during and after the completion of functional class, six-minute walk test (6MWD), pulmonary artery pressure (PAP), right ventricular pressure (RVP), and plasma NT-ProBNP level were measured.

Result: At follow-up, NYHA score, PAP, RVP, NT-ProBNP and PASP were significantly decreased (P<0.001), while the distance walked in 6MWD was significantly increased.

Conclusion: Our results suggest that cyclic intravenous Iloprost might improve the NYHA score, PAP, RVP and can provide a protection against the development or worsening of PAH in patients with IPAH.

Keywords: Iloprost, Idiopathic Pulmonary Artery Hypertension

Full-Text [PDF 261 kb] (1783 Downloads)

Type of Study: Research | Subject: General
Received: 2017/01/1 | Revised: 2017/07/24 | Accepted: 2017/01/1 | Published: 2017/01/1

References

1. Hoeper MM, Bogaard HJ, Condliffe R, Frantz R, Khanna D, Kurzyna M, et al. Definitions and diagnosis of pulmonary hypertension. J Am College Cardiol 2013; 62(25 Suppl): D42-50.

2. D'Alonzo GE, Barst RJ, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, et al. Survival in patients with primary pulmonary hypertensionResults from a national prospective registry. Annals Intern Med 1991; 115(5): 343-9.

3. Galiè N, Rubin LJ. Introduction: new insights into a challenging disease: A review of the third world symposium on pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43(12s1): S1-S.

4. Simonneau G, Galie N, Rubin LJ, Langleben D, Seeger W, Domenighetti G, et al. Clinical classification of pulmonary hypertension. J Am Coll Cardiol 2004; 43(12 Suppl S): S5-S12.

5. Humbert M, Sitbon O, Simonneau G. Treatment of pulmonary arterial hypertension. N Engl J Med 2004; 351(14): 1425-36.

6. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2015: ehv317.

7. Peacock A, Murphy N, McMurray J, Caballero L, Stewart S. An epidemiological study of pulmonary arterial hypertension. Eur Respir J 2007; 30(1): 104-9.

8. Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2009; 30(20): 2493-537.

9. Humbert M, Sitbon O, Chaouat A, Bertocchi M, Habib G, Gressin V, et al. Pulmonary arterial hypertension in France: results from a national registry. Am J Respir Crit Care Med 2006; 173(9): 1023-30.

10. Caravita S, Wu SC, Secchi MB, Dadone V, Bencini C, Pierini S. Long-term effects of intermittent Iloprost infusion on pulmonary arterial pressure in connective tissue disease. Eur J Intern Med 2011; 22(5): 518-21.

11. Humbert M, Morrell NW, Archer SL, Stenmark KR, MacLean MR, Lang IM, et al. Cellular and molecular pathobiology of pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43(12 Suppl S): 13S-24S.

12. Galiè N, Corris PA, Frost A, Girgis RE, Granton J, Jing ZC, et al. Updated treatment algorithm of pulmonary arterial hypertension. Turk Kardiyol Dern Ars 2014; 42 Suppl 1: 78-94.

13. Caramaschi P, Volpe A, Tinazzi I, Bambara LM, Carletto A, Biasi D. Does cyclically iloprost infusion prevent severe isolated pulmonary hypertension in systemic sclerosis? Preliminary results. Rheumatol Int 2006; 27(2): 203-5.

14. Paramothayan NS, Lasserson TJ, Wells A, Walters EH. Prostacyclin for pulmonary hypertension in adults. The Cochrane Library. 2005.

15. Gryglewski R, Stock G. Prostacyclin and its stable analogue iloprost: Springer; 1987.

16. Krause W, Krais T. Pharmacokinetics and pharmacodynamics of the prostacyclin analogue iloprost in man. Eur J Clin Pharmacol 1986; 30(1): 61-8.

17. Grant SM, Goa KL. Iloprost. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in peripheral vascular disease, myocardial ischaemia and extracorporeal circulation procedures. Drugs 1992; 43(6): 889-924.

18. Olschewski H, Simonneau G, Galiè N, Higenbottam T, Naeije R, Rubin LJ, et al. Inhaled iloprost for severe pulmonary hypertension. N Engl J Med 2002; 347(5): 322-9.

19. Janssena M, Wollersheim H, Kraus C, Hildebrand M, Watson H, Thien T. Pharmacokinetics of oral iloprost in patients with Raynaud’s phenomenon secondary to systemic sclerosis. Prostaglandins Other Lipid Mediat 2000; 60(4-6): 153-60.

20. Higenbottam T, Butt AY, McMahon A, Westerbeck R, Sharples L. Long term intravenous prostaglandin (epoprostenol or iloprost) for treatment of severe pulmonary hypertension. Heart 1998; 80(2): 151-5.

21. Magnani B, Galie N. Prostacyclin in primary pulmonary hypertension. Eur Heart J 1996; 17(1): 18-24.

22. Hildebrand M, Pfeffer M, Mahler M, Staks T, Windt-Hanke F, Schütt A. Oral iloprost in healthy volunteers. Eicosanoids 1991; 4(3): 149-54.

23. McLaughlin VV, Shillington A, Rich S. Survival in primary pulmonary hypertension the impact of epoprostenol therapy. Circulation 2002; 106(12): 1477-82.

24. Rich S, Rubin L, Abenhail L. Rich S. Executive summary from the World Symposium on Primary Pulmonary Hypertension (Evian, France, September 610, 1998). The World Health Organization publication via the Internet:Available at: http://www who int/ncd/cvd/pph html.

25. McLaughlin VV, Presberg KW, Doyle RL, Abman SH, McCrory DC, Fortin T, et al. Prognosis of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest J 2004; 126(1_suppl): 78S-92S.

26. Laboratories ACoPSfCPF. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166(1): 111.

27. Bendayan D, Shitrit D, Ygla M, Huerta M, Fink G, Kramer M. Hyperuricemia as a prognostic factor in pulmonary arterial hypertension. Respir Med 2003; 97(2): 130-3.

28. Voelkel MA, Wynne KM, Badesch DB, Groves BM, Voelkel NF. Hyperuricemia in severe pulmonary hypertension. Chest 2000; 117(1): 19-24.

29. Higenbottam T, Spiegelhalter D, Scott JP, Fuster V, Dinh-Xuan A, Caine N, et al. Prostacyclin (epoprostenol) and heart-lung transplantation as treatments for severe pulmonary hypertension. Br Heart J 1993; 70(4): 366-70.

30. Leuchte HH, Holzapfel M, Baumgartner RA, Ding I, Neurohr C, Vogeser M, et al. Clinical significance of brain natriuretic peptide in primary pulmonary hypertension. J Am Coll Cardiol 2004; 43(5): 764-70.

31. Badesch DB, Abman SH, Ahearn GS, Barst RJ, McCrory DC, Simonneau G, et al. Medical therapy for pulmonary arterial hypertensionACCP evidence-based clinical practice guidelines. Chest 2004; 126(1Suppl): 35S-62S.

32. Barst RJ, Gibbs JS, Ghofrani HA, Hoeper MM, McLaughlin VV, Rubin LJ, et al. Updated evidence-based treatment algorithm in pulmonary arterial hypertension. J Am Coll Cardiol 2009; 54(1 Suppl): S78-84.

33. McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association Developed in Collaboration With the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol 2009; 53(17): 1573-619.

34. Palange P, Ward S, Carlsen K, Casaburi R, Gallagher C, Gosselink R, et al. Recommendations on the use of exercise testing in clinical practice. Eur Respir J 2007; 29(1): 185-209.

35. American Thoracic Society; American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003; 167(2): 211.

36. Hoeper MM, Oudiz RJ, Peacock A, Tapson VF, Haworth SG, Frost AE, et al. End points and clinical trial designs in pulmonary arterial hypertensionClinical and regulatory perspectives. J Am Coll Cardiol 2004; 43(12 Suppl S): S48-S55.

37. Nagaya N, Nishikimi T, Uematsu M, Satoh T, Kyotani S, Sakamaki F, et al. Plasma brain natriuretic peptide as a prognostic indicator in patients with primary pulmonary hypertension. Circulation 2000; 102(8): 865-70.

38. Souza R, Bogossian HB, Humbert M, Jardim C, Rabelo R, Amato M, et al. N-terminal-pro-brain natriuretic peptide as a haemodynamic marker in idiopathic pulmonary arterial hypertension. Eur Respir J 2005; 25(3): 509-13.

39. Nagaya N, Nishikimi T, Okano Y, Uematsu M, Satoh T, Kyotani S, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. J Am Coll Cardiol 1998; 31(1): 202-8.

40. Bartram S, Denton C, du Bois R, Black C. Use of intravenous prostacyclin to treat pulmonary hypertension associated with systemic sclerosis. Br J Rheumatol 1994; 33(S1): 30.

41. Niewierowicz I, Eskilsson J, Scheja A, Akesson A. Intermittent iloprost infusion therapy for pulmonary hypertension in scleroderma-a pilot study. Scand J Rheumatol1995; 24: 123-7.

42. Bartosik I, Eskilsson J, Scheja A, Akesson A. Intermittent iloprost infusion therapy of pulmonary hypertension in scleroderma-a pilot study. Br J Rheumatol 1996; 35(11): 1187–8.

43. D'Alonzo GE, Barst RJ, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, et al. Survival in patients with primary pulmonary hypertension: results from a national prospective registry. Ann Intern Med 1991; 115(5): 343-49.

44. Fuster V, Steele P, Edwards W, Gersh B, McGoon MD, Frye RL. Primary pulmonary hypertension: natural history and the importance of thrombosis. Circulation 1984; 70(4): 580-7.

Send email to the article author

Add your comments about this article

Mendeley

Zotero

RefWorks

MalekMohammad M, Sharif-Kashani B, Monjazebi F, Khosravi K. Effect of cyclic intravenous Iloprost therapy in patients with Idiopathic Pulmonary Artery Hypertension. Feyz Med Sci J 2017; 20 (6) :509-517
URL: http://feyz.kaums.ac.ir/article-1-3224-en.html

This open access journal is licensed under a Creative Commons Attribution-NonCommercial ۴.۰ International License. CC BY-NC ۴. Design and publishing by Kashan University of Medical Sciences.
Copyright ۲۰۲۳© Feyz Medical Sciences Journal. All rights reserved.

Volume 20, Issue 6 (Bimonthly 2017)

Back to browse issues page

Persian site map - English site map - Created in 0.05 seconds with 46 queries by YEKTAWEB 4660