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Failure of vasoldilator infusion to alter pulmonary diffusing capacity in systemic sclerosis
C A Thurm1, F M Wigley, W P Dole
1Department of Medicine, Johns Hopkins University School of Medicine, Francis Scott Key Medical Center, Baltimore, Maryland.
The American Journal of Medicine
|May 1, 1991
Summary
Iloprost, a vasodilator, did not improve the abnormal diffusing capacity for carbon monoxide (DLCO) response in patients with systemic sclerosis (SSc). This suggests pulmonary vascular defects in SSc are not due to reversible vasospasm.
Area of Science:
- Pulmonary Medicine
- Rheumatology
- Cardiovascular Research
Background:
- Systemic sclerosis (SSc) is associated with abnormal pulmonary function.
- Patients with SSc exhibit an impaired increase in diffusing capacity for carbon monoxide (DLCO) when moving from an upright to a supine position.
Purpose of the Study:
- To investigate if iloprost, a prostacyclin analogue and vasodilator, can reverse the abnormal postural DLCO response in SSc patients.
- To determine if pulmonary vascular defects in SSc are related to reversible pulmonary vasospasm.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving 14 SSc patients.
- Pulmonary function tests, including DLCO, were conducted in both upright and supine positions before and during a 3-day infusion of iloprost or placebo.
Main Results:
- Iloprost administration did not significantly alter baseline pulmonary function tests, including DLCO.
- Iloprost failed to reverse the abnormal DLCO response observed in the supine position in SSc patients.
Conclusions:
- The study indicates that the pulmonary vascular abnormalities in systemic sclerosis are unlikely to be caused by reversible pulmonary vasospasm.
- The findings suggest that other mechanisms contribute to the observed pulmonary dysfunction in SSc.