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Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology.

Publication ,  Journal Article
Krasuski, RA; Warner, JJ; Wang, A; Harrison, JK; Tapson, VF; Bashore, TM
Published in: J Am Coll Cardiol
December 2000

OBJECTIVES: We sought to compare the responses of patients with pulmonary hypertension from primary and secondary causes (PPH and SPH, respectively) to inhaled nitric oxide (iNO) in the cardiac catheterization laboratory. BACKGROUND: Pulmonary hypertension can lead to right ventricular pressure overload and failure. Although vasodilators are effective as therapy in patients with PPH, less is known about their role in adults with SPH. Inhaled nitric oxide can accurately predict the response to other vasodilators in PPH and could be similarly utilized in SPH. METHODS: Forty-two patients (26 to 77 years old) with pulmonary hypertension during cardiac catheterization received iNO. Demographic and hemodynamic data were collected. Their response to iNO was defined by a decrease of > or =20% in mean pulmonary artery (PA) pressure or pulmonary vascular resistance (PVR). RESULTS: Mean PA pressures and PVR were lower during nitric oxide (NO) inhalation in all patients with pulmonary hypertension. Seventy-eight percent of patients with PPH and 83% of patients with SPH were responders to iNO. A trend was seen toward a greater response with larger doses of NO in patients with SPH. Nitric oxide was a more sensitive predictor of response (79%), compared with inhaled oxygen (64%), and was well tolerated, with no evidence of systemic effects. Elevation in right ventricular end-diastolic pressure appeared to predict poor vasodilatory response to iNO. CONCLUSIONS: Nitric oxide is a safe and effective screening agent for pulmonary vasoreactivity. Regardless of etiology of pulmonary hypertension, pulmonary vasoreactivity is frequently demonstrated with the use of NO. Right ventricular diastolic dysfunction may predict a poor vasodilator response.

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Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

December 2000

Volume

36

Issue

7

Start / End Page

2204 / 2211

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Vasodilation
  • Pulmonary Artery
  • Nitric Oxide
  • Middle Aged
  • Male
  • Hypertension, Pulmonary
  • Humans
  • Hemodynamics
  • Female
 

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Krasuski, R. A., Warner, J. J., Wang, A., Harrison, J. K., Tapson, V. F., & Bashore, T. M. (2000). Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology. J Am Coll Cardiol, 36(7), 2204–2211. https://doi.org/10.1016/s0735-1097(00)00994-3
Krasuski, R. A., J. J. Warner, A. Wang, J. K. Harrison, V. F. Tapson, and T. M. Bashore. “Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology.J Am Coll Cardiol 36, no. 7 (December 2000): 2204–11. https://doi.org/10.1016/s0735-1097(00)00994-3.
Krasuski RA, Warner JJ, Wang A, Harrison JK, Tapson VF, Bashore TM. Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology. J Am Coll Cardiol. 2000 Dec;36(7):2204–11.
Krasuski, R. A., et al. “Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology.J Am Coll Cardiol, vol. 36, no. 7, Dec. 2000, pp. 2204–11. Pubmed, doi:10.1016/s0735-1097(00)00994-3.
Krasuski RA, Warner JJ, Wang A, Harrison JK, Tapson VF, Bashore TM. Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology. J Am Coll Cardiol. 2000 Dec;36(7):2204–2211.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

December 2000

Volume

36

Issue

7

Start / End Page

2204 / 2211

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Vasodilation
  • Pulmonary Artery
  • Nitric Oxide
  • Middle Aged
  • Male
  • Hypertension, Pulmonary
  • Humans
  • Hemodynamics
  • Female