Acute effect of iloprost inhalation on right atrial function and ventricular dyssynchrony in patients with pulmonary artery hypertension

Abstract

Background: Right atrium function and ventricular function have significant prognos-tic value in pulmonary arterial hypertension patients. Acute changes in right ventricu-lar synchrony and right atrium function postiloprost inhalation have not been evaluated.Methods: Cross- sectional study. Consecutive pulmonary arterial hypertension pa-tients (group I from Nice classification) were included. Echocardiographic right atrium and right ventricular function pre- and postiloprost inhalation, including a right ven-tricular dyssynchrony index and right atrium function using speckle tracking, were per-formed in all patients.Results: Twenty pulmonary arterial hypertension patients, 44±7 years and 90% fe-males, were included. After iloprost inhalation, we observed a significant increment in right ventricular fractional area change and a significant decrease in right ventricular dyssynchrony index (21.4±5.6% vs 26.1±4.0 %, P=.007 and 79±44 vs 32±22 msec-onds, P<.01, respectively), also an improvement in right atrium reservoir function (8.6±3.1% vs 11.7±3.5 %, P=.002).Conclusions: Iloprost inhalation induces acute changes in right ventricular function, dyssynchrony, and right atrium performance that may add relevant clinical information in the management and risk stratification of pulmonary arterial hypertension patients.