Document Detail


Changes in exercise capacity and cardiac performance in a series of patients with Eisenmenger's syndrome transitioned from selective to dual endothelin receptor antagonist.
MedLine Citation:
PMID:  22819097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Differences in clinical effects between selective and dual endothelin (ET) receptor antagonists (ERA) in patients with pulmonary arterial hypertension (PAH) are currently unknown. We aimed to assess prospectively how transition from selective (sitaxsentan) to dual (bosentan) ERA affected exercise capacity and cardiocirculatory performance in patients with Eisenmenger's syndrome.
METHODS: A series of seven stable patients with Eisenmenger's syndrome aged 40.0 (30.0-56.0) years old treated with sitaxsentan were assessed before and three months after transition to bosentan. Six minute walk test and magnetic resonance to assess LV and RV mass, volume and ejection fraction, and pulmonary flow, and laboratory tests were performed.
RESULTS: We observed an increase in LV mass [96.5 (66.0-116.0) vs. 123.0 (93.0-146.0)g; p=0.03], LV ejection fraction [55.0 (44.0-63.0) vs. 65.0 (58.0-70.0)%; p=0.02)], and pulmonary flow [64 (53.0-71.0) vs. 69.0 (55.0-84.0)ml/beat; p=0.046]. This was accompanied by an increase of oxygen saturation, elongation of 6MWD [435.0 (378.0-482.3) vs. 474 (405.0-534.7); p=0.02], decrease of NTproBNP level and increase of ET-1 level.
CONCLUSIONS: Three month follow-up of stable patients with Eisenmenger's syndrome transitioned from sitaxsentan to bosentan revealed improvement of exercise capacity despite significant elevation of ET-1 level. Concurrent increase of LV ejection fraction and pulmonary flow might have contributed to these favourable effects.
Authors:
Grzegorz Kopeć; Anna Tyrka; Tomasz Miszalski-Jamka; Tomasz Mikołajczyk; Marcin Waligóra; Tomasz Guzik; Piotr Podolec
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-20
Journal Detail:
Title:  Heart, lung & circulation     Volume:  21     ISSN:  1444-2892     ISO Abbreviation:  Heart Lung Circ     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  2013-05-03     Revised Date:  2013-06-18    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  671-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
Affiliation:
John Paul II Hospital in Krakow, Department of Cardiac and Vascular Diseases, Pradnicka 80, 31-202 Krakow, Poland. gkopec@szpitaljp2.krakow.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / administration & dosage*
Eisenmenger Complex / blood,  drug therapy*,  physiopathology
Endothelin-1 / blood
Exercise*
Female
Follow-Up Studies
Humans
Isoxazoles / administration & dosage*
Magnetic Resonance Imaging
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Receptors, Endothelin / antagonists & inhibitors*
Stroke Volume / drug effects
Sulfonamides / administration & dosage*
Thiophenes / administration & dosage*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Endothelin-1; 0/Isoxazoles; 0/Peptide Fragments; 0/Receptors, Endothelin; 0/Sulfonamides; 0/Thiophenes; 0/pro-brain natriuretic peptide (1-76); 0/sitaxsentan; 114471-18-0/Natriuretic Peptide, Brain; Q326023R30/bosentan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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