JACC: Basic to Translational Science
Short-Term Hemodynamic Effects of Apelin in Patients With Pulmonary Arterial Hypertension
Lauren Brash, Gareth D. Barnes, Melanie J. Brewis, A. Colin Church, Simon J. Gibbs, Luke S.G.E. Howard, Geeshath Jayasekera, Martin K. Johnson, Neil McGlinchey, Joelle Onorato, Joanne Simpson, Colin Stirrat, Stephen Thomson, Geoffrey Watson, Martin R. Wilkins, Carrie Xu, David J. Welsh, David E. Newby and Andrew J. Peacock
Table 2
Table 2
Hemodynamic Data
| Apelin, nmol/min | Saline Placebo, min | |||||||
|---|---|---|---|---|---|---|---|---|
| Baseline | 10 | 30 | 100 | Baseline | 5 | 10 | 15 | |
| All subjects (n = 19) | ||||||||
| PVR, WU | 9.1 ± 0.9 | 7.9 ± 0.7 | 8.2 ± 0.7 | 8.5 ± 0.8 | 9.2 ± 0.8 | 9.0 ± 0.9 | 9.6 ± 1.0 | 9.4 ± 1.0 |
| CO, l/min | 4.8 ± 0.3 | 5.3 ± 0.3 | 5.3 ± 0.3 | 5.2 ± 0.3 | 4.8 ± 0.2 | 4.9 ± 0.3 | 4.7 ± 0.3 | 4.8 ± 0.3 |
| HR, beats/min | 72 ± 2.9 | 73 ± 2.9 | 72 ± 3.0 | 72 ± 3.2 | 72 ± 3.1 | 73 ± 3.5 | 73 ± 3.5 | 74 ± 3.6 |
| mPAP, mm Hg | 48 ± 2.7 | 46 ± 2.9 | 47 ± 3.0 | 48 ± 2.9 | 49 ± 2.7 | 48 ± 2.7 | 49 ± 3.0 | 48 ± 3.1 |
| SV, ml | 70 ± 4.9 | 75 ± 4.8 | 77 ± 4.8 | 77 ± 5.7 | 70 ± 4.8 | 70 ± 4.8 | 69 ± 5.0 | 69 ± 5.3 |
| MAP, mm Hg | 88 ± 2.6 | 85 ± 2.0 | 88 ± 2.9 | 87 ± 2.5 | 88 ± 2.8 | 87 ± 2.5 | 87 ± 2.5 | 88 ± 2.9 |
| SVR, dyne | 1,413 ± 74 | 1,245 ± 70 | 1,303 ± 84 | 1,326 ± 95 | 1,433 ± 94 | 1,421 ± 110 | 1,447 ± 101 | 1,440 ± 99 |
| Treatment naive (n = 5) | ||||||||
| PVR, WU | 7.4 ± 1.2 | 6.6 ± 01.0 | 7.2 ± 1.3 | 7.2 ± 1.3 | 8.1 ± 1.0 | 7.4 ± 1.3 | 7.4 ± 1.4 | 7.2 ± 1.4 |
| CO, l/min | 5.1 ± 0.4 | 5.3 ± 0.5 | 5.2 ± 0.6 | 5.6 ± 0.7 | 5.0 ± 0.5 | 5.1 ± 0.6 | 5.1 ± 0.6 | 5.3 ± 0.7 |
| HR, beats/min | 64 ± 4.7 | 62 ± 5.5 | 61 ± 4.5 | 64 ± 5.6 | 64 ± 6.5 | 66 ± 6.8 | 65 ± 5.6 | 66 ± 5.8 |
| mPAP, mm Hg | 43 ± 2.7 | 41 ± 3.1 | 42 ± 4.3 | 43 ± 3.6 | 45 ± 2.4 | 42 ± 4.0 | 41 ± 3.6 | 40 ± 4.0 |
| SV, ml | 81 ± 9.3 | 88 ± 10.1 | 86 ± 9.5 | 88 ± 11.2 | 80 ± 9.0 | 79 ± 8.0 | 80 ± 9.5 | 82 ± 12.3 |
| MAP, mm Hg | 85 ± 2.7 | 81 ± 3.1 | 88 ± 2.9 | 87 ± 4.5 | 85 ± 3.2 | 84 ± 3.7 | 84 ± 5.4 | 81 ± 3.5 |
| SVR, dyne | 1,280 ± 103 | 1,201 ± 182 | 1,354 ± 226 | 1,283 ± 283 | 1,365 ± 227 | 1,329 ± 244 | 1,363 ± 294 | 1,266 ± 240 |
| On treatment (n = 14) | ||||||||
| PVR, WU | 9.7 ± 1.2 | 8.4 ± 0.8 | 8.5 ± 0.9 | 8.9 ± 0.9 | 9.6 ± 1.1 | 9.6 ± 1.1 | 10.4 ± 1.2 | 10.2 ± 1.3 |
| CO, l/min | 4.8 ± 0.3 | 5.3 ± 0.3 | 5.3 ± 0.3 | 5.1 ± 0.3 | 4.8 ± 0.3 | 4.8 ± 0.3 | 4.6 ± 0.3 | 4.7 ± 0.3 |
| HR, beats/min | 75 ± 3.3 | 77 ± 2.9 | 76 ± 3.3 | 75 ± 3.6 | 75 ± 3.4 | 75 ± 4.0 | 76 ± 4.1 | 77 ± 4.2 |
| mPAP, mm Hg | 50 ± 3.4 | 48 ± 3.6 | 49 ± 3.8 | 50 ± 3.6 | 50 ± 3.6 | 50 ± 3.3 | 51 ± 3.6 | 51 ± 3.7 |
| SV, ml | 66 ± 5.6 | 71 ± 5.1 | 73 ± 5.5 | 72 ± 6.5 | 66 ± 5.6 | 67 ± 5.8 | 65 ± 5.6 | 65 ± 5.5 |
| MAP, mm Hg | 89 ± 3.5 | 86 ± 2.5 | 88 ± 3.8 | 87 ± 3.0 | 89 ± 3.7 | 88 ± 3.1 | 88 ± 2.8 | 90 ± 3.6 |
| SVR, dyne | 1,461 ± 92 | 1,261 ± 74 | 1,285 ± 87 | 1,339 ± 99 | 1,457 ± 104 | 1,454 ± 125 | 1,477 ± 97 | 1,502 ± 104 |
| On PDE5 inhibitors (n = 11) | ||||||||
| PVR, WU | 10.9 ± 1.2 | 9.1 ± 0.9 | 9.2 ± 1.0 | 10.8 ± 1.0 | 10.6 ± 1.1 | 10.6 ± 1.2 | 11.6 ± 1.3 | 11.4 ± 1.4 |
| CO, l/min | 4.5 ± 0.3 | 5.1 ± 0.3 | 5.1 ± 0.4 | 4.9 ± 0.4 | 4.5 ± 0.3 | 4.5 ± 0.3 | 4.3 ± 0.3 | 4.4 ± 0.3 |
| HR, beats/min | 75 ± 3.8 | 78 ± 3.3 | 76 ± 3.7 | 76 ± 4.3 | 75 ± 4.0 | 75 ± 4.7 | 76 ± 4.8 | 77 ± 5.0 |
| mPAP, mm Hg | 52 ± 3.9 | 51 ± 3.9 | 52 ± 4.2 | 52 ± 4.0 | 53 ± 3.7 | 52 ± 3.5 | 54 ± 3.7 | 54 ± 3.9 |
| SV, ml | 62 ± 6.7 | 68 ± 6.2 | 71 ± 6.8 | 69. ± 8.0 | 63 ± 6.8 | 64 ± 7.0 | 61 ± 6.8 | 62 ± 6.6 |
| MAP, mm Hg | 85 ± 3.0 | 85 ± 2.3 | 85 ± 2.2 | 85 ± 2.2 | 87 ± 2.7 | 86 ± 2.1 | 86 ± 2.8 | 87 ± 2.5 |
| SVR, dyne | 1,494 ± 114 | 1,289 ± 86 | 1,290 ± 92 | 1,382 ± 108 | 1,495 ± 116 | 1,513 ± 149 | 1,543 ± 112 | 1,542 ± 120 |
| On treatment without PDE5 inhibitors (n = 3) | ||||||||
| PVR, WU | 5.3 ± 1.3 | 5.6 ± 1.4 | 5.9 ± 1.4 | 5.6 ± 1.4 | 5.6 ± 1.5 | 5.9 ± 1.4 | 6.2 ± 1.6 | 5.9 ± 1.4 |
| CO, l/min | 5.8 ± 0.6 | 6.0 ± 0.7 | 6.1 ± 0.4 | 5.9 ± 0.5 | 5.6 ± 0.2 | 5.7 ± 0.1 | 5.6 ± 0.3 | 5.7 ± 0.3 |
| HR, beats/min | 73 ± 7.7 | 72 ± 6.8 | 73 ± 7.8 | 70 ± 6.8 | 74 ± 7.9 | 74 ± 8.5 | 74 ± 8.2 | 76 ± 9.1 |
| mPAP, mm Hg | 41. ± 5.9 | 39 ± 7.4 | 40 ± 8.0 | 41 ± 8.2 | 40 ± 8.5 | 41 ± 8.1 | 42 ± 9.5 | 42 ± 8.7 |
| SV, ml | 80 ± 0.6 | 83 ± 1.7 | 84 ± 3.5 | 85 ± 3.4 | 77 ± 5.3 | 79 ± 6.9 | 77 ± 3.7 | 76 ± 5.1 |
| MAP, mm Hg | 103 ± 8.4 | 92 ± 8.2 | 101 ± 15.6 | 91 ± 12.9 | 98 ± 15.2 | 95 ± 13.8 | 93 ± 9.0 | 102 ± 14.2 |
| SVR, dyne | 1,342 ± 109 | 1,157 ± 160 | 1,267 ± 276 | 1,178 ± 257 | 1,318 ± 256 | 1,238 ± 195 | 1,238 ± 149 | 1,357 ± 233 |
| Treatment naive and treatment without PDE5 inhibitors (n = 8) | ||||||||
| PVR, WU | 6.7 ± 0.9 | 6.2 ± 0.8 | 6.7 ± 0.9 | 6.6 ± 1.0 | 7.2 ± 0.9 | 6.8 ± 0.9 | 7.0 ± 1.0 | 6.7 ± 1.0 |
| CO, l/min | 5.4 ± 0.3 | 5.6 ± 0.4 | 5.6 ± 0.4 | 5.7 ± 0.5 | 5.2 ± 0.3 | 5.3 ± 0.4 | 5.3 ± 0.4 | 5.4 ± 0.5 |
| HR, beats/min | 68 ± 4.1 | 66 ± 4.4 | 66 ± 4.3 | 66 ± 4.1 | 68 ± 4.9 | 69 ± 5.1 | 68 ± 4.6 | 70 ± 5.0 |
| mPAP, mm Hg | 42 ± 2.5 | 40 ± 3.1 | 41 ± 3.7 | 42 ± 3.5 | 43 ± 3.2 | 42 ± 3.6 | 42 ± 3.8 | 41 ± 3.7 |
| SV, ml | 81 ± 5.6 | 86 ± 6.1 | 85 ± 5.8 | 87 ± 6.8 | 79 ± 5.7 | 79 ± 5.3 | 79 ± 5.8 | 80 ± 7.6 |
| MAP, mm Hg | 92 ± 4.6 | 85 ± 3.8 | 93 ± 5.9 | 89 ± 5.5 | 90 ± 5.8 | 88 ± 5.4 | 88 ± 4.7 | 89 ± 6.3 |
| SVR, dyne | 1,303 ± 72 | 1,185 ± 121 | 1,322 ± 164 | 1,238 ± 181 | 1,348 ± 160 | 1,295 ± 160 | 1,316 ± 184 | 1,300 ± 163 |
Values are mean ± SEM.
HR = heart rate; other abbreviations as in Table 1.
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