Acute absolute vasodilatation is associated with a lower vascular wall stiffness in pulmonary arterial hypertension

Abstract: Background: Acute vasoreactivity testing (VT) is considered mandatory in the diagnostic work-up of patients with pulmonary arterial hypertension (PAH). We studied the relation between the acute absolute arterial vasodilatation and the severity of vascular remodeling estimated by intravascular ultrasound (IVUS) in patients with idiopathic PAH.Methods: Simultaneous right heart catheterization and IVUS of the pulmonary artery (PA) were performed both in basal conditions and during short-term intravenous epoprostenol infusion in nineteen idiopathic PAH patients. Pulmonary vascular resistance (PVRi) and capacitance indexes (stroke volume/pulse pressure, Cp), were calculated. Local pulsatility was estimated by IVUS (IVUSp) (systolic–diastolic lumen area/diastolic lumen area×100; sA–dA/dA) and PA stiffness was assessed by the elastic modulus (E: pulse pressure/IVUSp).Results: Epoprostenol infusion (11±2ng/kg/min) determined a real vasodilatation (increment of dA>10%) in six patients. This vasodilation group presented on average significantly higher cardiac index, stroke volume index and Cp, and lower PVRi and IVUSp (P
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Original Articles Source Type: research