2P-0597 Intravenous administration of a Rho-kinase inhibitor, fasudil, reduces pulmonary vascular resistance in patients with pulmonary hypertension

2003 ◽  
Vol 4 (2) ◽  
pp. 170-171
Author(s):  
Y. Fukumoto ◽  
Y. Hirakawa ◽  
K. Abe ◽  
G. Koike ◽  
M. Mohri ◽  
...  
2008 ◽  
Vol 295 (5) ◽  
pp. L828-L836 ◽  
Author(s):  
Adeleke M. Badejo ◽  
Jasdeep S. Dhaliwal ◽  
David B. Casey ◽  
Thomas B. Gallen ◽  
Anthony J. Greco ◽  
...  

The small GTP-binding protein Rho and its downstream effector, Rho-kinase, are important regulators of vasoconstrictor tone. Rho-kinase is upregulated in experimental models of pulmonary hypertension, and Rho-kinase inhibitors decrease pulmonary arterial pressure in rodents with monocrotaline and chronic hypoxia-induced pulmonary hypertension. However, less is known about responses to fasudil when pulmonary vascular resistance is elevated on an acute basis by vasoconstrictor agents and ventilatory hypoxia. In the present study, intravenous injections of fasudil reversed pulmonary hypertensive responses to intravenous infusion of the thromboxane receptor agonist, U-46619 and ventilation with a 10% O2 gas mixture and inhibited pulmonary vasoconstrictor responses to intravenous injections of angiotensin II, BAY K 8644, and U-46619 without prior exposure to agonists, which can upregulate Rho-kinase activity. The calcium channel blocker isradipine and fasudil had similar effects and in small doses had additive effects in blunting vasoconstrictor responses, suggesting parallel and series mechanisms in the lung. When pulmonary vascular resistance was increased with U-46619, fasudil produced similar decreases in pulmonary and systemic arterial pressure, whereas isradipine produced greater decreases in systemic arterial pressure. The hypoxic pressor response was enhanced by 5–10 mg/kg iv nitro-l-arginine methyl ester (l-NAME), and fasudil or isradipine reversed the pulmonary hypertensive response to hypoxia in control and in l-NAME-treated animals, suggesting that the response is mediated by Rho-kinase and L-type Ca2+ channels. These results suggest that Rho-kinase is constitutively active in regulating baseline tone and vasoconstrictor responses in the lung under physiological conditions and that Rho-kinase inhibition attenuates pulmonary vasoconstrictor responses to agents that act by different mechanisms without prior exposure to the agonist.


2016 ◽  
Vol 4 ◽  
pp. 898-905 ◽  
Author(s):  
Magdalena Jasińska-Stroschein ◽  
Jacek Owczarek ◽  
Urszula Sołtysiak ◽  
Daria Orszulak-Michalak

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Xiang Zhang ◽  
Xueming Zhang ◽  
Saihua Wang ◽  
Jun Luo ◽  
Zhihong Zhao ◽  
...  

Background. Pulmonary hypertension due to left ventricular heart failure with preserved ejection fraction (PH-HFpEF) is an increasingly medical problem. The aim of the study was to evaluate the clinical efficacy of fasudil on PH-HFpEF elderly patients and to figure out the subtype of PH-HFpEF which may be the therapeutic object of fasudil. Method. 58 PH-HFpEF elderly patients were enrolled. Patients were diagnosed with passive pulmonary hypertension (PPH) or reactive pulmonary hypertension (RPH) by right heart catheterization and all receiving Rho kinase inhibitor fasudil for 2 weeks. The endpoint includes changes in SpO2, NT-pro BNP, cardiac functional classification, and echocardiography measurements after 2 weeks treatment. Results. The course of disease in the RPH group was longer than the PPH group (p<0.05). Cardiac output was found to be worse in the RPH group than the PPH group (p<0.01). Besides, the RPH group demonstrated a greater transpulmonary pressure gradient (TPG) and pulmonary vascular resistance (PVR) than the PPH group (p<0.01 for both) as well as pulmonary arterial systolic pressure (PASP) and mean pulmonary arterial pressure (mPAP) (p<0.01 for both), which fits the feature of RPH. After treatment of fasudil, in RPH group, PASP significantly decreased (p<0.01) with decreased E/E′ and increased E/A (p<0.05 for both), indicating that pulmonary haemodynamics and cardiac diastolic function were ameliorated, but the measurements in the PPH group had no significant changes. NT-pro BNP and 6 MWD of both groups were improved (p<0.05). The total effective rate of the RPH group was 74.29%, which was higher than 47.83% of the PPH group (p<0.05). Conclusion. The Rho kinase inhibitor fasudil can improve pulmonary and left ventricular haemodynamics in patients with PH-HFpEF. The total effective rate was higher in the RPH group. Fasudil may be a promising targeted drug for the RPH in PH-HFpEF patients. This trial is registered with ChiCTR-INR-16009511.


2004 ◽  
Vol 94 (3) ◽  
pp. 385-393 ◽  
Author(s):  
Kohtaro Abe ◽  
Hiroaki Shimokawa ◽  
Keiko Morikawa ◽  
Toyokazu Uwatoku ◽  
Keiji Oi ◽  
...  

2005 ◽  
Vol 11 (9) ◽  
pp. S307
Author(s):  
Takuya Kishi ◽  
Yoshitaka Hirooka ◽  
Akihiro Masumoto ◽  
Kousuke Inokuchi ◽  
Koji Ito ◽  
...  

2015 ◽  
Vol 79 (6) ◽  
pp. 1213-1214 ◽  
Author(s):  
Keiichi Odagiri ◽  
Hiroshi Watanabe

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