Author/Authors :
Zhang, Xiang Shanghai Zhoupu Hospital, Shanghai, China , Zhang, Xueming Renji Hospital - Shanghai Jiaotong University School of Medicine, Shanghai, China , Wang, Saihua Shanghai Zhoupu Hospital, Shanghai, China , Luo, Jun Shanghai Zhoupu Hospital, Shanghai, China , Zhao, Zhihong Shanghai Zhoupu Hospital, Shanghai, China , Zheng, Changzhu Shanghai Zhoupu Hospital, Shanghai, China , Shen, Jieyan Renji Hospital - Shanghai Jiaotong University School of Medicine, Shanghai, China
Abstract :
Background. Pulmonary hypertension due to left ventricular heart failure with preserved ejection fraction (PH-HFpEF) is an
increasingly medical problem. ,e aim of the study was to evaluate the clinical efficacy of fasudil on PH-HFpEF elderly
patients and to figure out the subtype of PH-HFpEF which may be the therapeutic object of fasudil. Method. 58 PH-HFpEF
elderly patients were enrolled. Patients were diagnosed with passive pulmonary hypertension (PPH) or reactive pulmonary
hypertension (RPH) by right heart catheterization and all receiving Rho kinase inhibitor fasudil for 2 weeks. ,e endpoint
includes changes in SpO2, NT-pro BNP, cardiac functional classification, and echocardiography measurements after 2 weeks
treatment. Results. The course of disease in the RPH group was longer than the PPH group (p < 0.05). Cardiac output was
found to be worse in the RPH group than the PPH group (p < 0.01). Besides, the RPH group demonstrated a greater
transpulmonary pressure gradient (TPG) and pulmonary vascular resistance (PVR) than the PPH group (p < 0.01 for both) as
well as pulmonary arterial systolic pressure (PASP) and mean pulmonary arterial pressure (mPAP) (p < 0.01 for both), which
fits the feature of RPH. After treatment of fasudil, in RPH group, PASP significantly decreased (p < 0.01) with decreased E/E′
and increased E/A (p < 0.05 for both), indicating that pulmonary haemodynamics and cardiac diastolic function were
ameliorated, but the measurements in the PPH group had no significant changes. NT-pro BNP and 6 MWD of both groups
were improved (p < 0.05). The total effective rate of the RPH group was 74.29%, which was higher than 47.83% of the PPH
group (p < 0.05). Conclusion. The Rho kinase inhibitor fasudil can improve pulmonary and left ventricular haemodynamics
in patients with PH-HFpEF. The total effective rate was higher in the RPH group. Fasudil may be a promising targeted drug
for the RPH in PH-HFpEF patients. This trial is registered with ChiCTR-INR-16009511.
