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The acute effects of 30 mg vs 60 mg of intravenous Fasudil on patients with congenital heart defects and severe pulmonary arterial hypertension

Hongyun Ruan1, Yigang Zhang2, Ru Liu3, Xiangjun Yang1
1 Department of Cardiology, The First Affiliated Hospital, Soochow University, Suzhou, China
2 Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
3 Department of Ultrasonography, Xuzhou Central Hospital, Xuzhou, China
* Corresponding Author: Xiangjun Yang, MD, Department of Cardiology, The First Affiliated Hospital, Soochow University, Suzhou 215006, China. Email:

Congenital Heart Disease 2019, 14(4), 645-650. https://doi.org/10.1111/chd.12764

Abstract

Objective: The optimal dose of Fasudil is still controversial in congenital heart disease accompanied with severe pulmonary hypertension (CHD‐PAH). This study aimed to compare acute hemodynamic changes after different doses of Fasudil in 60 consecu‐ tive adult patients with CHD‐PAH.
Design: Prospective randomized controlled trial.
Setting: Tertiary cardiology center.
Patients: Adult patients with CHD‐PAH.
Interventions: Patients were randomized to Fasudil 30 or 60 mg.
Outcome Measures: The hemodynamic parameters were measured at baseline and after 30 minutes of Fasudil through right cardiac catheterization. Blood gas results were obtained from the pulmonary artery, right ventricle, right atrium, superior and inferior vena cava, and femoral artery. Pulmonary vascular resistance (PVR) and sys‐ temic arterial resistance (SVR) were calculated.
Results: The changes in systolic pulmonary artery pressure (sPAP) (−13.1% vs −9.3%, P < .05), diastolic PAP (dPAP) (−17.6% vs −14.5%, P < .05), mean PAP (mPAP) (−12.4% vs −8.5%, P < .05), and PVR (−35.8% vs −22.2%, P < .05) were more pronounced in the 60‐mg group than in the 30‐mg group. All patients had no obvious adverse reac‐ tions related to peripheral blood pressure.
Conclusions: Fasudil could improve the hemodynamics of patients with CHD‐PAH, especially with the 60‐mg dose. There were no serious adverse reactions.

Keywords

congenital heart defects, pulmonary arterial hypertension, Rho kinase inhibitor

Cite This Article

Ruan, H., Zhang, Y., Liu, R., Yang, X. (2019). The acute effects of 30 mg vs 60 mg of intravenous Fasudil on patients with congenital heart defects and severe pulmonary arterial hypertension. Congenital Heart Disease, 14(4), 645–650.



This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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