Pulmonary hypertension (PH) leads to an increased right ventricular workload,
cardiac failure and death. In
idiopathic pulmonary arterial hypertension (PAH) the vasodilating
vasoactive intestinal peptide (
aviptadil) is deficient. The aim of the present study was to test the acute effects on haemodynamics and blood
gases, and the safety, of a single dose of inhaled
aviptadil in chronic PH. A total of 20 patients with PH (PAH in nine, PH in
lung disease in eight and chronic thromboembolic PH in three) inhaled a single 100-microg dose of
aviptadil during right-heart catheterisation. Haemodynamics and blood
gases were measured.
Aviptadil aerosol caused a small and temporary but significant selective pulmonary vasodilation, an improved stroke volume and mixed venous oxygen saturation. Overall, six patients experienced a pulmonary vascular resistance reduction of >20%. In patients with significant
lung disease,
aviptadil tended to improve oxygenation. The pulmonary vasodilating effect of
aviptadil aerosol was modest and short-lived, did not cause any side-effects and led to a reduced workload of the right ventricle without affecting systemic blood pressure.
Aviptadil inhalation tended to improve oxygenation in patients with significant
lung disease. Further studies are needed to evaluate the full therapeutic potential of
aviptadil aerosol, including higher doses and chronic treatment.