|Wojciech Jacheć1*, Celina Wojciechowska2, Andrzej Tomasik2, Damian Kawecki2, Ewa Nowalany-Kozielska2and Jan Wodniecki2|
|1II Katedra i Oddział Kliniczny Kardiologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach, ul. Skłodowskiej 10, 41-800 Zabrze, Polska|
|2Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Poland|
|Corresponding Author :||Wojciech Jacheć
II Katedra i Oddział Kliniczny
Kardiologii w Zabrzu Śląskiego
Uniwersytetu Medycznego w Katowicach
ul. Skłodowskiej 10
41-800 Zabrze, Polska
Tel: +48 32 373 23 72
Fax: +48 32 271 10 10
E-mail: [email protected]
|Received May 26, 2015; Accepted June 25, 2015; Published June 29, 2015|
|Citation: Jachec W, Wojciechowska C, Tomasik A, Kawecki D, Nowalany-Kozielska E et al. (2015) Response to Inhaled Nitric Oxide, But neither Sodium Nitroprusside nor Sildenafil, Predicts Survival in Patients with Dilated Cardiomyopathy Complicated with Pulmonary Hypertension. J Clin Exp Cardiolog 6:376. doi:10.4172/2155-9880.1000376|
|Copyright: ©2015 Jacheć W. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
|Related article at
Pubmed Scholar Google
Visit for more related articles at Journal of Clinical & Experimental Cardiology
Introduction: Pulmonary hypertension in patients with dilated cardiomyopathy is associated with higher mortality.
Objectives: The aim of the study was to assess the predictive value of the vasodilator response to three different drugs, sodium nitroprusside, inhaled nitric oxide, and oral sildenafil, in patients with dilated cardiomyopathy complicated with pulmonary hypertension.
Patients and methods: Twenty-nine patients with dilated cardiomyopathy complicated with postcapillary pulmonary hypertension (left ventricle ejection fraction (LVEF) 20.6 ± 8.2%, mean pulmonary artery pressure (mPAP) 42.49 ± 7.27 mmHg, transpulmonary gradient (TPG)>12 mmHg or pulmonary vascular resistance index (PVRI)>5 WU/m2) underwent single-session vaso reactivity testing with sodium nitroprusside, inhaled nitric oxide (120 ppm), oral sildenafil (50 mg), and a combination of sildenafil and inhaled nitric oxide. The vasodilator responders were defined as those participants who achieved a reduction of PVRI<5 WU/m2 and TPG<12 mmHg.
The primary study endpoint was death in the 30-month-long follow-up. Kaplan-Meier analysis and Cox proportional hazard modelling were used to identify the predictors of survival.
Results: In the follow-up, eight patients died (six patients with irreversible pulmonary hypertension). Six patients underwent successful heart transplantation. Multivariate Cox proportional hazard analysis disclosed a response to nitric oxide as the only predictor of longer survival (HR=11.77, 95% CI=1.12-123.9 at P=0.04).
Conclusions: Vasodilator response to inhaled nitric oxide predicts longer survival in patients with dilated cardiomyopathy complicated with pulmonary hypertension.
|Table 1||Table 2||Table 3||Table 4||Table 5|
|Figure 1||Figure 2|
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals