The acute effects of 30 mg vs 60 mg of intravenous Fasudil on patients with congenital heart defects and severe pulmonary arterial hypertension

ObjectiveThe optimal dose of Fasudil is still controversial in congenital heart disease accompanied with severe pulmonary hypertension (CHD-PAH). This study aimed to compare acute hemodynamic changes after different doses of Fasudil in 60 consecutive adult patients with CHD-PAH. DesignProspective randomized controlled trial. SettingTertiary cardiology center. PatientsAdult patients with CHD-PAH. InterventionsPatients were randomized to Fasudil 30 or 60mg. Outcome MeasuresThe hemodynamic parameters were measured at baseline and after 30minutes of Fasudil through right cardiac catheterization. Blood gas results were obtained from the pulmonary artery, right ventricle, right atrium, superior and inferior vena cava, and femoral artery. Pulmonary vascular resistance (PVR) and systemic arterial resistance (SVR) were calculated. ResultsThe changes in systolic pulmonary artery pressure (sPAP) (-13.1% vs -9.3%, P<.05), diastolic PAP (dPAP) (-17.6% vs -14.5%, P<.05), mean PAP (mPAP) (-12.4% vs -8.5%, P<.05), and PVR (-35.8% vs -22.2%, P<.05) were more pronounced in the 60-mg group than in the 30-mg group. All patients had no obvious adverse reactions related to peripheral blood pressure. ConclusionsFasudil could improve the hemodynamics of patients with CHD-PAH, especially with the 60-mg dose. There were no serious adverse reactions.