PMID- 11899690
OWN - NLM
STAT- MEDLINE
DCOM- 20020402
LR  - 20161209
IS  - 0755-4982 (Print)
IS  - 0755-4982 (Linking)
VI  - 31
IP  - 7
DP  - 2002 Feb 23
TI  - [Therapeutic management of primary pulmonary hypertension].
PG  - 320-8
AB  - SEVERITY AND TREATMENT: The management of primitive pulmonary hypertension starts 
      by the evaluation of its severity, based on the New York Heart Association's 
      (NYHA) functional classification and right cardiac catheterization data. 
      Hemodynamic criteria of poor prognosis are: an increase in right atrial pressure 
      > 10 mm Hg, a decrease in cardiac output (cardiac index < 2.2 l/min/m2), an 
      increase in pulmonary vascular resistance > to 20 mm Hg/l/min/m2, and saturation 
      of the oxygen content in venous blood < 63%. These prognostic data will condition 
      treatment. CALCIUM CHANNEL BLOCKERS: Are the only vasodilators that have 
      demonstrated efficacy in primitive pulmonary hypertension (PPH). However, only 
      20% of patients respond to calcium blockers. To determine a positive response to 
      these agents, a carbon monoxide inhalation test is required during right cardiac 
      catheterization. Prescription of calcium channel blockers to non-responders is 
      often responsible for adverse events, from enhanced dyspnoea to sudden death. 
      Continuous intravenous infusion of epoprostenol has considerably improved the 
      prognosis of PPH and related pulmonary hypertension (PH). Despite the 
      constraints, such treatment should be proposed to NYHA functional class III and 
      IV patients not responding to carbon monoxide tests, until new, equally efficient 
      products have been launched on the market. If epoprostenol fails or provokes 
      severe side effects, pulmonary or cardio-pulmonary transplantation should be 
      envisaged.
FAU - Chaouat, A
AU  - Chaouat A
AD  - Service de Pneumologie, Hopital de Hautepierre, 1 Avenue Moliere, F67098 
      Strasbourg. ari.chaouat@chru-strasbourg.fr
FAU - Weitzenblum, E
AU  - Weitzenblum E
LA  - fre
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Prise en charge therapeutique des hypertensions arterielles pulmonaires 
      primitives.
PL  - France
TA  - Presse Med
JT  - Presse medicale (Paris, France : 1983)
JID - 8302490
RN  - 0 (Anticoagulants)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Diuretics)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Vasodilator Agents)
RN  - 35E3NJJ4O6 (beraprost)
RN  - DCR9Z582X0 (Epoprostenol)
RN  - JED5K35YGL (Iloprost)
SB  - IM
MH  - Administration, Oral
MH  - Adult
MH  - Algorithms
MH  - Anticoagulants/therapeutic use
MH  - Antihypertensive Agents/administration & dosage/therapeutic use
MH  - Calcium Channel Blockers/therapeutic use
MH  - Cardiac Catheterization
MH  - Clinical Trials as Topic
MH  - Diuretics/therapeutic use
MH  - Epoprostenol/administration & dosage/*analogs & derivatives/therapeutic use
MH  - Female
MH  - Heart Atria/surgery
MH  - Heart Septum/surgery
MH  - Humans
MH  - Hypertension, Pulmonary/classification/diagnosis/drug 
      therapy/mortality/surgery/*therapy
MH  - Iloprost/administration & dosage/therapeutic use
MH  - Infusions, Intravenous
MH  - Lung Transplantation
MH  - Male
MH  - Platelet Aggregation Inhibitors/administration & dosage/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Risk Factors
MH  - Survival Analysis
MH  - Vasodilator Agents/administration & dosage/therapeutic use
RF  - 45
EDAT- 2002/03/20 10:00
MHDA- 2002/04/03 10:01
CRDT- 2002/03/20 10:00
PHST- 2002/03/20 10:00 [pubmed]
PHST- 2002/04/03 10:01 [medline]
PHST- 2002/03/20 10:00 [entrez]
PST - ppublish
SO  - Presse Med. 2002 Feb 23;31(7):320-8.