CARDIOVASCULAR MEDICINE

Oral beraprost sodium improves exercise capacity and ventilatory efficiency in patients with primary or thromboembolic pulmonary hypertension

N Nagaya¹, Y Shimizu¹, T Satoh¹, H Oya¹, M Uematsu², S Kyotani¹, F Sakamaki¹, N Sato¹, N Nakanishi¹, K Miyatake¹

¹ Division of Cardiology, Department of Medicine, National Cardiovascular Centre, Osaka, Japan
² Department of Internal Medicine, Osaka Seamen's Insurance Hospital, Osaka, Japan

Correspondence to:
Correspondence to:
Dr Noritoshi Nagaya, Division of Cardiology, Department of Medicine, National Cardiovascular Centre, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan;
nagayann{at}hsp.ncvc.go.jp

Objective: To investigate the effect of beraprost sodium, an orally active prostacyclin analogue, on exercise capacity and ventilatory efficiency in patients with primary pulmonary hypertension and chronic thromboembolic pulmonary hypertension.

Patients and design: Symptom limited cardiopulmonary exercise testing was performed before and 3 (1) months (mean (SEM)) after beraprost treatment in 30 patients with precapillary pulmonary hypertension (14 with primary pulmonary hypertension and 16 with chronic thromboembolic pulmonary hypertension).

Results: Long term treatment with beraprost resulted in significant increases (mean (SEM)) in peak workload (87 (4) W to 97 (5) W, p < 0.001) and peak oxygen consumption (peak O₂, 14.9 (0.7) ml/kg/min to 16.8 (0.7) ml/kg/min, p < 0.001). Beraprost decreased the ventilatory response to carbon dioxide production during exercise (E–CO₂ slope, 42 (2) to 37 (1), p < 0.001). No significant difference in the responses of these variables to beraprost treatment was observed between patients with primary pulmonary hypertension and chronic thromboembolic pulmonary hypertension.

Conclusions: Oral administration of beraprost sodium may improve exercise capacity and ventilatory efficiency in patients with both primary and chronic thromboembolic pulmonary hypertension.

Keywords: primary pulmonary hypertension; oral prostacyclin analogue; beraprost sodium; exercise capacity

Abbreviations: NYHA, New York Heart Association; E; CO2 slope, ventilatory response to carbon dioxide production; O2, oxygen consumption; O2; W, ratio of change in oxygen uptake to change in work rate

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