Cea-Calvo Luis, Escribano Subías Pilar, Tello de Menesses Rocío, Lázaro Salvador María, Gómez Sánchez Miguel A, Delgado Jiménez Juan F, Pindado Rodríguez Carlos, Ruiz Cano María J, Sáenz de la Calzada Carlos
Servicio de Cardiología. Unidad de Hipertensión Pulmonar, Insuficiencia Cardíaca y Trasplante Cardíaco. Hospital Universitario 12 de Octubre. Madrid. España.
Rev Esp Cardiol. 2003 Apr;56(4):421-5. doi: 10.1016/s0300-8932(03)76889-4.
The treatment of pulmonary hypertension associated with infection by human immunodeficiency virus has not been well defined. Treprostinil is a prostacyclin analogue that has recently been shown to be useful for the treatment of pulmonary hypertension, whether primary, secondary to congenital heart disease, or associated with collagen disease, in a 12-week, double-blind study. We report the results of a one-year follow-up of three patients with pulmonary hypertension associated with human immunodeficiency virus infection who are being treated with treprostinil at our center.
After secondary causes of pulmonary hypertension were excluded by a routine work-up, patients started treatment with subcutaneous prostacyclin (treprostinil) with progressive up-titration of the dose. Functional status and effort capacity were assessed every three months and an echocardiographic study was performed every six months.
All patients showed improvement in clinical status, as shown by the NYHA functional class and the results of the six-minute walking test (increase of at least 75 meters). All the patients remain alive after one year of follow-up. Echocardiographic systolic pulmonary pressure decreased in two patients. No serious adverse events were observed.
Subcutaneous prostacyclin (treprostinil) seems to be an effective and safe therapeutic option for the treatment of pulmonary hypertension associated with human immunodeficiency virus infection.
人类免疫缺陷病毒感染相关肺动脉高压的治疗尚未明确。在一项为期12周的双盲研究中，曲前列尼尔作为一种前列环素类似物，已被证明可用于治疗原发性、先天性心脏病继发或与胶原病相关的肺动脉高压。我们报告了在我们中心接受曲前列尼尔治疗的3例人类免疫缺陷病毒感染相关肺动脉高压患者的一年随访结果。
通过常规检查排除肺动脉高压的继发原因后，患者开始皮下注射前列环素（曲前列尼尔）治疗，并逐渐增加剂量。每三个月评估一次功能状态和运动能力，每六个月进行一次超声心动图检查。
所有患者的临床状态均有改善，如纽约心脏协会功能分级和六分钟步行试验结果所示（至少增加75米）。随访一年后所有患者均存活。两名患者的超声心动图收缩期肺动脉压下降。未观察到严重不良事件。
皮下注射前列环素（曲前列尼尔）似乎是治疗人类免疫缺陷病毒感染相关肺动脉高压的一种有效且安全的治疗选择。
