Comparison of the acute pulmonary vasodilating effect of beraprost sodium and nitric oxide in congenital heart disease - Thailand multicenter study

Background: Congenital heart disease patients who have pulmonary hypertension (PH) require an evaluation for pulmonary vascular reactivity before surgical repair. In the present study the acute pulmonary vasodilating effects of 100% oxygen (O2), beraprost sodium (BPS) and 40 ppm inhaled nitric oxide (iNO) during cardiac catheterization were compared. Methods and Results: There were 90 patients who underwent cardiac catheterization for evaluation of PH (mean age, 16.5±16 years). The baseline mean pulmonary artery (mPA) pressure was 69.6±14.8 mmHg and the pulmonary arteriolar resistance (Rpa) was 13.8±8.3 Wood unit m². Change in pulmonary vascular reactivity was defined as a decrease in mPA or Rpa >20% from baseline. The response to 100%O2, iNO and BPS during cardiac catheterization was 84%, 72.7% and 64%, respectively. Pair comparisons among each hemodynamic parameter showed no difference between the acute vasodilating effect of BPS and iNO. In some patients BPS showed a stronger effect than iNO in lowering Rpa. Conclusions: BPS has a similar pulmonary vasodilating effect to iNO and can be used as an acute pulmonary vasodilating agent during cardiac catheterization with potential benefits over iNO.