acute vasoreactivity study

Indications

• pulmonary hypertension

Procedure

Acute administration of adenosine, epopprostenol or other vasodilator reduces pulmonary artery pressure by > 20% in 25-35% of patients. Cardiac output is generally increased or unchanged, systemic blood pressure is minimally reduced or unchanged.

Epeprostanol is infused at 1-2 ng/kg/min & increased by 2 ng/kg/min every 5-10 minutes until a clinically significant fall in blood pressure, increase in heart rate of averse symptoms (nausea. vomiting, headache) occur.

Adenosine IV 5- ug/kg/mion is titrated upward every 2 min until uncomfortable symtpoms of 200 ug/kg/min is reached

Inhaled nitric oxied is investgational. A fall in pulmonary artery pressure in response to inhaled nitric oxide is a good indicator patient will respond to Ca+ channel blocker.

A positive response to vasodilates indicates that patients with pulmonary hypertension may be treated with oral vasodilators i.e. Ca+2 channel blockers). {No reference to Revatio}

More general terms

• fluoroscopy

Additional terms

• pulmonary hypertension