The Observation Of Tadalafil Monotherapy And Combined With Beraprost In The Treatment Of Moderate-Severe Pulmonary Arterial Hypertension Associated With Congenital Heart Disease

Objective:To compare the efficacy of tadalafil monotherapy and tadalafil combined with beraprost therapy in treatment of moderate-severe pulmonary arterial hypertension associated with congenital heart disease（PAH-CHD）patients.Methods:33 patients were included from the department of Cardiology,The People’s Hospital of Guangxi Zhuang Autonomous Region during October 2015to October 2017.All patients were treated with tadalafil or tadalafil combined with beraprost.Analysis of the differeces of the transthoracic echocardiography,WHO functional class（WHO-FC）,6-min walk distance（6MWD）,borg dyspnea index,evaluation of targeted drugs the curative effect of monotherapy and tadalafil combined beraprost treatment of moderate-severe PAH-CHD.And we also observed the occurrence of drug-related adverse reactions.Results:20 with tadalafil monotherapy,13 combined with beraprost therapy.Compared with baseline,s PAP and tricuspid regurgitation velocity were decreased whereas PO₂ and SpO₂ were increased（P<0.05）in both groups after6 months of treatment;borg dyspnea index decreased in combination therapy group after 6 months of treatment（P<0.05）;the 6MWD and pro-BNP decreased in both groups after 3 months of treatment（P<0.05）;Compared with the Tadalafil monotherapy,the 6MWD of the combination therapy was increased at3 months（P<0.05）.There was no changes in WHO-FC（P>0.05）.No serious drug relevant complication and the patient was well tolerated.Conclusions:Tadalafil combined with beraprost was showed no difference in the treatment of moderate-severe PAH-CHD in reducing sPAP and pro-BNP,and hypoxemia and WHO-FC were confirmed no difference either compared with tadalafil monotherapy.Long term follow-up was needed at 6MWD in the treatment of tadalafil combined with beraprost.The dyspnea score index was clearly better in the combination therapy group at 6 months of treatment.No serious adverse reactions occurred during the treatment of moderate-severe PAH-CHD with tadalafil and tadalafil combined beraprost.