Journal article
The effects of oxygenation on acute vasodilator challenge in pulmonary arterial hypertension
Pulmonary circulation, Vol.14(2), pp.e12375-n/a
04/2024
DOI: 10.1002/pul2.12375
PMCID: PMC11088807
PMID: 38736893
Abstract
Identification of long-term calcium channel blocker (CCB) responders with acute vasodilator challenge is critical in the evaluation of patients with pulmonary arterial hypertension. Currently there is no standardized approach for use of supplemental oxygen during acute vasodilator challenge. In this retrospective analysis of patients identified as acute vasoresponders, treated with CCBs, all patients had hemodynamic measurements in three steps: (1) at baseline; (2) with 100% fractional inspired oxygen; and (3) with 100% fractional inspired oxygen plus inhaled nitric oxide (iNO). Those meeting the definition of acute vasoresponsiveness only after first normalizing for the effects of oxygen in step 2 were labeled "iNO Responders." Those who met the definition of acute vasoresponsiveness from a combination of the effects of 100% FiO
and iNO were labeled "oxygen responders." Survival, hospitalization for decompensated right heart failure, duration of CCB monotherapy, and functional data were collected. iNO responders, when compared to oxygen responders, had superior survival (100% vs. 50.1% 5-year survival, respectively), fewer hospitalizations for acute decompensated right heart failure (0% vs. 30.4% at 1 year, respectively), longer duration of CCB monotherapy (80% vs. 52% at 1 year, respectively), and superior 6-min walk distance. Current guidelines for acute vasodilator testing do not standardize oxygen coadministration with iNO. This study demonstrates that adjusting for the effects of supplemental oxygen before assessing for acute vasoresponsiveness identifies a cohort with superior functional status, tolerance of CCB monotherapy, and survival while on long-term CCB therapy.
Details
- Title: Subtitle
- The effects of oxygenation on acute vasodilator challenge in pulmonary arterial hypertension
- Creators
- Matthew D Rockstrom - University of Colorado Anschutz Medical CampusYing Jin - Colorado School of Public HealthRyan A Peterson - University of Colorado Anschutz Medical CampusPeter Hountras - University of Colorado Anschutz Medical CampusDavid Badesch - University of Colorado Anschutz Medical CampusSue Gu - University of Colorado Anschutz Medical CampusBryan Park - University of Colorado Anschutz Medical CampusJohn Messenger - University of Colorado Anschutz Medical CampusLindsay M Forbes - University of Colorado Anschutz Medical CampusWilliam K Cornwell III - University of Colorado Anschutz Medical CampusTodd M Bull - University of Colorado Anschutz Medical Campus
- Resource Type
- Journal article
- Publication Details
- Pulmonary circulation, Vol.14(2), pp.e12375-n/a
- DOI
- 10.1002/pul2.12375
- PMID
- 38736893
- PMCID
- PMC11088807
- NLM abbreviation
- Pulm Circ
- ISSN
- 2045-8932
- eISSN
- 2045-8940
- Language
- English
- Date published
- 04/2024
- Academic Unit
- Biostatistics; Internal Medicine
- Record Identifier
- 9984914146602771
Metrics
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