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Acute vasodilator testing: An opportunity to advance the precision care of pulmonary hypertension

Meghan M Cirulis1, Lynda O Jorgensen2, Ronald W Day2

  • 1Division of Pulmonary Medicine (Fellow), Department of Internal Medicine, University of Utah, 50 North Medical Drive, Salt Lake City, UT, 84132, USA.

Respiratory Medicine Case Reports
|August 7, 2019
PubMed

Insights

A child with severe pulmonary arterial hypertension showed immediate normalization of pulmonary arterial pressure with nitric oxide. This acute response to inhaled nitric oxide persisted, suggesting its value in personalized pulmonary hypertension treatment.

Area of Science:

  • Cardiology
  • Pulmonology
  • Pediatrics

Background:

  • Pulmonary arterial hypertension (PAH) is a severe condition characterized by high blood pressure in the lung arteries.
  • Accurate assessment of pulmonary vascular response is crucial for effective PAH management.

Observation:

  • An 8-year-old child with severe PAH experienced immediate normalization of pulmonary arterial pressure during inhaled nitric oxide administration.
  • This acute responsiveness to nitric oxide was maintained throughout the patient's life.

Findings:

  • The patient's acute vasodilator testing responses correlated with long-term medication efficacy.
  • Inhaled nitric oxide demonstrated a consistent and sustained effect on pulmonary arterial pressure.

Implications:

  • Acute vasodilator testing, particularly with inhaled nitric oxide, can predict long-term treatment responses in PAH.
  • This approach may enhance precision medicine strategies for pediatric and adult pulmonary hypertension patients.

Keywords:
Calcium channel blockerGuanylate cyclaseNitric oxideNitric oxide synthasePulmonary hypertensionVasodilator testingcalcium channel blocker(s), CCBinhaled nitric oxide, iNOmean pulmonary arterial pressure, mPAPparts per million, ppm

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