Use of pulmonary arterial hypertension-specific therapy in non-WHO group I pulmonary hypertension

South Med J. 2015 Jan;108(1):51-7. doi: 10.14423/SMJ.0000000000000217.

Abstract

Objectives: The development of pulmonary hypertension (PH) in non-World Health Organization group I PH adversely affects exercise capacity. It is unclear whether pulmonary artery hypertension (PAH)-specific drugs improve pulmonary hemodynamics and exercise capacity in such patients.

Methods: We performed a retrospective chart review of consecutive patients with non-World Health Organization group I PH treated with PAH-specific therapy.

Results: We identified 24 patients. The mean (standard deviation) age was 48 (14.8) years. Seventeen (71%) patients were women. The 6-minute walk distance improved significantly for the whole group in an initial follow-up period of 4.6 (2.3) months; however, the improvement was seen only in patients with obstructive sleep apnea (OSA) or severe PH and it was not sustained during a longer follow-up period of 11.5 (4.1) months, except in patients with OSA. PH was treated with a variety of PAH-specific drugs, including combination therapy in five patients.

Conclusions: The use of PAH-specific therapy in selected patients with PH secondary to lung diseases, OSA, or sarcoidosis may result in significant improvement in 6-minute walk distance, particularly in patients with OSA or severe PH.

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use*
  • Cohort Studies
  • Endothelin Receptor Antagonists / therapeutic use*
  • Epoprostenol / analogs & derivatives
  • Epoprostenol / therapeutic use
  • Exercise Test
  • Exercise Tolerance / physiology*
  • Female
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / physiopathology
  • Lung Diseases, Interstitial / complications
  • Male
  • Middle Aged
  • Phosphodiesterase 5 Inhibitors / therapeutic use*
  • Prostaglandins / therapeutic use
  • Pulmonary Disease, Chronic Obstructive / complications
  • Respiratory Function Tests
  • Retrospective Studies
  • Sarcoidosis / complications
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / complications
  • Treatment Outcome
  • World Health Organization

Substances

  • Antihypertensive Agents
  • Endothelin Receptor Antagonists
  • Phosphodiesterase 5 Inhibitors
  • Prostaglandins
  • Epoprostenol
  • treprostinil