EFFECT OF INHALED ILOPROST ON PULMONARY AND SYSTEMIC HEMODYNAMICS IN PATIENTS WITH PULMONARY HYPERTENSION ASSOCIATED WITH LEFT VENTRICULAR SYSTOLIC DYSFUNCTION

Our purpose was to determine the effect of inhaled iloprost on pulmonary and systemic hemodynamics in patients with pulmonary hypertension associated with left ventricular systolic dysfunction. 29 vasoreactivity tests (VRT) with 20 micrograms inhaled iloprost (Ventavis, Bayer) were performed in candidates on heart transplantation. All patients had heart failure of IIINIV NYHA class and PH with pulmonary vascular resistance (PVR) more than 2.5 Wood units. Hemodynamic parameters were evaluated at baseline and 15 minutes after inhalation of iloprost. A prospective study was consistent. Iloprost significantly decreased PAPmean x from 34.6 ± 9.1 mm Hg. to 29.2 ± 9.1 mm. Hg (p < 0,0001), while reducing PAPmean more than 20 % was achieved in 16 cases (55.2 %).There was a significant decrease in PVR from 4.5 ± 1.6 Wood units to 2.9 ± 1 Wood units (p <0,0001). PVR dropped more than 20 % in 24 cases (82.8 %). Iloprost inhalation increased stroke volume index (SVI) from 24.9 ± 7.9 ml/m² to 30.1 ± 10.2 ml/m² (p-0,0003). Reduction of systemic vascular resistance (SVR) was the main cause of LV output augmentation. SVR decreased from 1905 ± 477 dynes∙sec∙cm^{- 5} to 1505 ± 460 dynes∙sec∙cm^{- 5} (p-0,0001). Conclusions. In patients with LV systolic dysfunction inhaled iloprost caused reduction of PAPmean and PVR. Moreover, inhaled iloprost improve LV output due to afterload decline.

трансплантация сердца, легочная гипертензия, илопрост, heart transplantation, pulmonary hypertension, iloprost

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