The Long-Term Response To Treatment With Calcium Channel Blockers in Patients With Idiopathic Pulmonary Arterial Hypertension

Background: long-term outcomes in patients with idiopathic pulmonary arterial hypertension (ipah) treated with calcium channel blockers (ccbs) are not well documented. therefore, this study aimed to determine the long-term response to treatment with ccbs in patients with ipah. methods: this retrospective cohort study was performed on 81 patients with ipah admitted to our center. vasoreactivity testing with adenosine was performed in all patients. twenty-five patients showed a positive response to vasoreactivity testing and were included in the analysis. results: of 24 patients, 20 (83.3%) were female, and the mean age of the patients was 45.90±10.42 years. fifteen patients improved after 1 year on ccb therapy (the long-term ccb responders group), and 9 showed no improvement (the ccb failure group). the ccb responders group had a greater proportion of patients in new york heart association (nyha) functional class i or ii (93.3%), a longer distance walked, and less severe hemodynamic parameters. at the 1-year evaluation, the long-term ccb responders had more improvements in the mean 6-minute walk test result (437.43±125.32 vs 268.17±130.06; p=0.040), the mixed venous oxygen saturation level (71.84±9.87 vs 59.03±9.95; p=0.041), and the cardiac index (4.76±1.12 vs 3.15±0.90; p=0.012). additionally, mpap was lower in the long-term ccb responders group (47.35±12.70 vs 67.23±14.08; p=0.034). finally, all the ccb responders were in nyha functional class i or ii (p=0.001). conclusion: our study illustrated that long-term treatment with oral ccbs was effective in 60% of acute responders and 18.5% of the entire study population.