Continuous infusion of intravenous epoprostenol (EPO) improves exercise capacity and survival in pulmonary arterial hypertension (PAH); however, it is associated with side effects. This study aimed to describe our experience on safe EPO withdrawal with the aid of an exercise stress test.

This retrospective review included patients with PAH who were successfully withdrawn from EPO. Haemodynamic data were obtained before EPO administration, at withdrawal, and after discontinuation. After the mean pulmonary arterial pressure (mPAP) decreased to <25 mmHg for at least 1 year, an exercise test under right heart catheterisation was performed. If exercise pulmonary hypertension was not record (mPAP - cardiac output slope < 3), EPO was withdrawn.

Of the 99 patients who received EPO, ten were identified as having undergone withdrawal or termination. mPAP decreased from 61 (54–71) mmHg before treatment to 19 (17–21) mmHg before withdrawal and remained unchanged, at 19 (14–23) mmHg, 1 year after EPO discontinuation. After a median follow-up of 32 months, all the patients survived.

Patients with PAH who recovered their normal haemodynamic function were safely withdrawn from EPO with the aid of an exercise stress test.

持续静脉注射依前列醇 (EPO) 可提高肺动脉高压 (PAH) 患者的运动能力和生存率；但是，它与副作用有关。本研究旨在描述我们在运动压力测试的帮助下安全撤除 EPO 的经验。

这项回顾性研究纳入了成功退出 EPO 的 PAH 患者。在 EPO 给药前、停药时和停药后获得血流动力学数据。在平均肺动脉压 (mPAP) 降至 <25 mmHg 至少 1 年后，在右心导管插入术下进行了运动试验。如果未记录运动性​​肺动脉高压（mPAP - 心输出量斜率 < 3），则停用 EPO。

在接受 EPO 的 99 名患者中，有 10 名被确定为已退出或终止治疗。mPAP 从治疗前的 61 (54-71) mmHg 下降到停药前的 19 (17-21) mmHg，并且在 EPO 停药 1 年后保持不变，为 19 (14-23) mmHg。中位随访 32 个月后，所有患者均存活。

在运动压力测试的帮助下，恢复正常血流动力学功能的 PAH 患者可以安全地退出 EPO。