Long-Term Bosentan in Chronic Thromboembolic Pulmonary Hypertension
| Autor: | Hans-Jürgen Seyfarth, Hans Pankau, Jörg Winkler, Hubert Wirtz, Stefan Hammerschmidt |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Heart disease Hypertension Pulmonary Kaplan-Meier Estimate Pulmonary heart disease Thromboembolism Internal medicine medicine Humans Prospective Studies Antihypertensive Agents Sulfonamides Exercise Tolerance Lung business.industry Respiratory disease Bosentan medicine.disease Thrombosis Pulmonary hypertension Treatment Outcome medicine.anatomical_structure Embolism Anesthesia Chronic Disease Ventricular Function Right Cardiology Female business Follow-Up Studies medicine.drug |
| Zdroj: | Respiration. 74:287-292 |
| ISSN: | 1423-0356 0025-7931 |
| Popis: | Background: There is no approved pharmacological treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are not suitable for pulmonary endarterectomy (PEA). Objective: The study investigates the effect of the dual endothelin receptor antagonist bosentan on exercise tolerance (6-min walking distance, 6MWD) and right ventricular function (Tei index) in patients with CTEPH over 24 months. Methods: Twelve consecutive patients (5 males and 7 females) with CTEPH not eligible for PEA or following partial or complete failure of PEA were included in a non-randomized, open-label prospective study. All patients were WHO class III. They were included, if progressive pulmonary hypertension was diagnosed despite best supportive treatment. Bosentan was started at 62.5 mg b.i.d. and increased to the final dose of 125 mg b.i.d. Results: 6MWD and the Tei index were assessed every 6 months. We observed a significant increase in 6MWD from 319 ± 85.0 m at baseline to 391 ± 76.9 m at 6 months and a significant decrease in the Tei index from 0.39 ± 0.10 at baseline to 0.34 ± 0.08 at 6 months. This improvement was maintained over 24 months (6 MWD: 381 ± 101 m; Tei index: 0.31 ± 0.03). Six patients exhibited an improvement in WHO class at 6, 12 and 18 months, 5 demonstrated improvement at the 24-month follow-up. The remainder were stable throughout the study period. Conclusion: This is the first study demonstrating a long-term beneficial effect of bosentan on exercise tolerance (6MWD) and right heart function (Tei index) in CTEPH. |
| Databáze: | OpenAIRE |
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