STRUCTURE OF PULMONARY HYPERTENSION IN PATIENTS AWAITING HEART TRANSPLANTATION

Abstract

The selection of recipients for the orthotopic heart transplantation is of great importance. In 2006–2009 we examined 25 tests on reversibility of pulmonary hypertension, i.e. in 14 patients with dilated cardiomyopathy (DCM) (11 males and 3 females aged 41,1 ± 9,3) and in 11 patients with coronary artery disease (CAD) (all males aged 50 ± 4.9). Initial pulmonary vascular resistance (PVR) was 3,61 ± 1,02 and 3,59 ± 0,98 respectively. Alprostadil was infused to all the patients. Pulmonary hypertension was irreversible in 4 (28,5%) DCM patients and in 2 (18%) CAD patients. Initial PVR in those patients was 6,27 ± 3,2 and 5,7 ± 2,4 respectively. The average alprostadil dose necessary for the reverse of pulmonary hypertension was 0,054 ± 0,027 μg/kg/min in DCM patients, and 0,047 ± 0,022 μg/kg/min in CAD patients. Thus, the application of alprostadil for the pharmacological correction of pulmonary vascular resistance is most effective in patients with moderate pulmonary hypertension according to Rich classification.

Keywords

• orthotopic heart transplantation
• coronary artery disease
• dilated cardiomyopathy
• reversibility of pulmonary hypertension
• alprostadil.