The Hemodynamic Effects of Prostaglandin E1 in Patients with Pulmonary Hypertension due to Mitral Stenosis: A Dose-compared Study

The aim of this study was to evaluate the hemodynamic effects of prostaglandin E1 (PGE1) in patients with pulmonary hypertension due to mitral stenosis. 30 patients with pulmonary artery systolic pressures above 30 mmHg, were divided into two groups. In group I (n: 15) and in group II (n: 15) PGE1 was administered with a dose of 20 ng/kg/min and 40 ng/kg/min, respectively. Hemodynamic measurements were recorded before and after PGE1 infusion. Statistically significant changes (p<0.05) were observed by PGE1 infusion in mean values with respect to following parameters: mean arterial pressure (MAP) 85.7 to 80 mmHg in group II, mean pulmonary artery pressure 43 to 37 mmHg in group I and 45 to 33 mmHg in group II, central venous pressure 7.5 to 6.7 mmHg in group II, pulmonary vascular resistance 507 to 422 dyn. sec.cm-5 in group I and 467 to 268 dyn.sec.cm-5 in in group II, pulmonary capillary wedge pressure 23 to 20 mmHg in group I and 24 to 19 mmHg in group II, systemic vascular resistance 2049 to 1967 dyn. sec.cm-5 in group I and 1778 to 1452 dyn.sec.cm-5 in group II, right ventricle stroke work index 10.6 to 9.2 gm/m2 in group I and 11.3 to 8.7 gm/m2 in group II, cardiac output 3.3 to 3.4 1/min in group I and 3.6 to 4.1 1/min in group II, cardiac index 2.19 to 2.25 1/min/m2 in group I and 2.39 to 2.69 1/min/m2 in group II, stroke volume 31.7 to 32.2 ml in group 1 and 33.8 to 37.1 1/ml in group II. These findings were more apparent in group II patients. We concluded that PGE1 is a potent pulmonary vasodilatator improving the right ventricular functions by decreasing the right ventricular afterload in patients with mitral stenosis. It has a dose-related effect; the appropriate dose differs in patients and should be adapted by the decrease in MAP.