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Acute Vasoreactivity Testing With Nicardipine in Patients With Pulmonary Arterial Hypertension

Acute Vasoreactivity Testing With Nicardipine in Patients With Pulmonary Arterial Hypertension

Authors :
Yukihiro Saito
Kazufumi Nakamura
Katsumasa Miyaji
Satoshi Akagi
Hiroki Mizoguchi
Aiko Ogawa
Soichiro Fuke
Hideki Fujio
Takahiko Kiyooka
Satoshi Nagase
Kunihisa Kohno
Hiroshi Morita
Kengo F Kusano
Hiromi Matsubara
Tohru Ohe
Hiroshi Ito
Source :
Journal of Pharmacological Sciences, Vol 120, Iss 3, Pp 206-212 (2012)
Publication Year :
2012
Publisher :
Elsevier, 2012.

Abstract

Acute vasoreactivity testing for patients with pulmonary arterial hypertension (PAH) has been reported to be useful to identify patients with sustained beneficial response to oral calcium-channel blockers (CCBs), but there is a risk of exacerbation during the testing with oral CCBs. Therefore, we developed a testing method utilizing intravenous nicardipine, a short-acting CCB, and examined the safety and usefulness of acute vasoreactivity testing with nicardipine in PAH patients. Acute vasoreactivity testing with nicardipine was performed in 65 PAH patients. Nicardipine was administered by short-time continuous infusion (1 μg·kg−1·min−1 for 5 min and 2 μg·kg−1·min−1 for 5 min) followed by bolus injection (5 μg/kg). Hemodynamic responses were continuously measured using a right heart catheter. Acute responders were defined as patients who showed a decrease in mean pulmonary artery pressure of at least 10 mmHg to an absolute level below 40 mmHg with preserved or increased cardiac output. Two acute responders and sixty-three non-acute responders were identified. There was no hemodynamic instability requiring additional inotropic agents or death during the testing. Acute responders had good responses to long-term oral CCBs. The acute vasoreactivity testing with nicardipine might be safe and useful for identifying CCB responders in PAH patients. Keywords:: calcium-channel blocker, acute vasoreactivity testing, pulmonary arterial hypertension

Subjects

Subjects :
Therapeutics. Pharmacology
RM1-950

Details

Language :
English
ISSN :
13478613
Volume :
120
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Journal of Pharmacological Sciences
Publication Type :
Academic Journal
Accession number :
edsdoj.4c17fc767a7540f295229ea59242ddef
Document Type :
article
Full Text :
https://doi.org/10.1254/jphs.12114FP