Relationship between baseline ET-1 plasma levels and outcome in patients with idiopathic pulmonary hypertension treated with bosentan
| Autor: | Vizza, Carmine Dario, Letizia, Claudio, Badagliacca, Roberto, Poscia, Roberto, Beatrice, Pezzuto, Cristina, Gambardella, Nona, Alfred, Silvia, Papa, Serena, Marcon, Mancone, Massimo, Iacoboni, Carlo, Riccieri, Valeria, Maurzio, Volterrani, Fedele, Francesco, Pezzuto, Beatrice |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Hypertension Pulmonary Idiopathic Pulmonary Hypertension Urology pulmonary arterial hypertension medicine.artery medicine Humans Familial Primary Pulmonary Hypertension Prospective Studies Antihypertensive Agents Aged Sulfonamides bosentan clinical worsening business.industry Middle Aged Brain natriuretic peptide medicine.disease Pulmonary hypertension Endothelin 1 Bosentan Surgery Adrenomedullin Treatment Outcome endothelin-1 medicine.anatomical_structure Pulmonary artery Exercise Test Vascular resistance Female Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies medicine.drug |
| Zdroj: | International Journal of Cardiology. 167:220-224 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2011.12.104 |
| Popis: | article i nfo Objectives: To address if baseline endothelin-1 (ET-1) plasma levels might predict clinical worsening (CW) in patients with idiopathic pulmonary hypertension (IPAH) treated with bosentan. Methods: Forty-four consecutive patients with IPAH (WHO classes II-III) were included in this study. After an initial assessment (clinical status, pulmonary hemodynamics, samples for adrenomedullin (ADM), ET-1 and brain natriuretic peptide (BNP) plasma levels), patients were treated with bosentan and followed-up for CW. Results: We observed CW in 24 patients. Actuarial rates of freedom from CW were 74% at 1 year, 56% at 2 years, and 43% at 3 years. Patients with CW had a worse WHO functional class (II/III; no-CW 14/6 vs CW 5/19, p=0.002), six- minute walk-test distance (no-CW 439+94 m vsCW 385+82 m, p=0.04), mean pulmonary artery pressure (no- CW 47.4+10.6 mm Hg vs CW 56+12.6 mm Hg, p=0.02) and pulmonary vascular resistance (PVR no-CW 12.5+ 4.8 WU vs CW 16.4+6.3 WU, p=0.03) than the no-CW group. Moreover ET-1 (no-CW 14.1+4.2 pg/ml vs CW 21.3+6.3 pg/ml, p=0.0001), ADM (no-CW 14.9+7 pg/ml vs CW 21.5+10.4 pg/ml p=0.002) and BNP (no- CW 82.8+35.3 pg/ml vs CW 115.4+39.6 pg/ml, p=0.007) plasma levels were significantly higher in the CW group than in the no-CW group. The multivariate Cox proportional hazards model identified WHO class III (RR 4.6, 95%CI 14.6-1.45), ET-1 plasma levels (RR 1.1, 95%CI 2.05-1.01) and PVR (RR 1.2, 95%CI 1.3- 1.03) as indepen- dent risk factors for CW. Conclusions: These data confirm the high rate of CW in patients with IPAH treated with bosentan and document the impact of the endothelin system on CW of these patients. © 2011 Published by Elsevier Ireland Ltd. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect