Acute Impact Of Iloprost Solution For Inhalation On Pulmonary Hemodynamics And Right Ventricular Function In Patients With Pulmonary Hypertension

Objective To compare the acute impact of Iloprost Solution for Inhalation on pulmonary hemodynamics and right ventricular function in patients with pulmonary hypertension(PH).Methods A total of60consecutive patients admitted in General Hospital of Tianjin medical university were included in the study,who were given the diagnosis of PH after right heart catheterization and acute pulmonary vasodilator testing using Iloprost Solution for Inhalation. Impact of Iloprost Solution for Inhalation on pulmonary hemodynamics could be derived from the right heart catheterization and be compared.60of the study individuals underwent cardiac magnetic resonance imaging.Parameters of right ventricular function,such as right ventricular end diastolic volume, right ventricular end systolic volume,right ventricular ejection fraction,could be measured and be compared.Resultes Hemodynamic parameters before and after the use of Iloprost Solution for Inhalation were as follows.The mean right atrial pressure(mRAP) decreased from7.69±4.65mmHg to6.29±4.25mmHg (P＜0.001). The mean pulmonary arterial pressure(mPAP) changed from55.37±16.82mmHg to48.49±15.92mmHg (P＜0.001). The pulmonary vascular resistance(PVR) decreased from1390.44±981.61dyne·s·cm5to1022.41±626.42dyne·s·cm5(P＜0.001). The right ventricular cardiac index(RVCI) increased from2.54±1.36to3.02±1.87(P<0.001). The mixed venous oxygen saturation increased from63.22±8.90%to67.88±9.11%(P＜0.001).The impact of Iloprost Solution for Inhalation on right ventricular measured by cardiac magnetic resonance imaging were as follows. The right ventricular end diastolic volume index(right ventricular end diastolic volume corrected by body surface area)(RV-EDVI) decreased froml28.58±54.11ml/m2to124.30±54.08ml/m2(P＜0.001). The right ventricular end systolic volume index (RV-ESVI) changed from88.22±46.97ml/m2to79.68±44.96ml/m2(P＜0.001). The right ventricular stroke volume index (RV-SVI) increased from40.37±14.01ml/m2to44.61±14.81ml/m2(P＜0.001). The right ventricular ejection fraction (RVEF) increased from34.63±12.51%to39.33±12.67%(P=0.01).Adverse reactions were mild, including7cases of cough,5cases of blushing, and3cases of headache,1case of feeling nauseated.Conclusion1. Iloprost Solution for Inhalation can significantly improve the hemodynamics and right ventricular function in patients with pulmonary hypertension.2.Right heart catheterization is a gold standard for the diagnosis and right ventricular function evaluation.3. Cardiac magnetic resonance imaging can be applied for the measurement of RV volumes, systolic function, and mass,and make an significance on the assession of the right ventricular function.