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Long-term efficacy of bosentan in inoperable chronic thromboembolic pulmonary hypertension.
MedLine Citation:
PMID:  19949474     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background. Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) is associated with a poor survival.Objectives. To evaluate the long-term response to a dual endothelin receptor antagonist in patients with inoperable CTEPH.Methods. All consecutive 18 patients (mean age 63+/-14 years) treated with bosentan for symptomatic inoperable CTEPH were included. Efficacy was evaluated by the log value of serum levels of N-terminal-pro brain natriuretic peptide (log NTpro BNP), New York Heart Association functional class (NYHA), and the six-minute walk test (6-MWT). All follow-up data (median 31 months) were compared with baseline and divided into: short-term (<12 months), mid-term (between 12 and 24 months), and long-term follow-up (>24 months).Results. At baseline, 15 patients were in NYHA class III and three in NYHA class IV, mean log NT-pro BNP level was 7.2+/-1.4 log pg/ml, and mean 6-MWT distance was 404+/-125 m. During short-term follow-up (n=18), the NYHA class improved (p=0.001), 6-MWT distance increased by 33 m (p=0.03), and log NT-pro BNP decreased to 6.9+/-1.4 log pg/ml (p=0.007). During mid-term follow-up (n=17), the NYHA class improved (p<0.001), the mean 6-MWT distance increased by 41 m (p=0.01), and log NT-pro BNP was 6.9+/-1.4 log pg/ml (p=0.31). During late followup (n=14) the NYHA class was still improved (p=0.03), the 6-MWT distance decreased by 9 m (p=0.73), and log NT-pro BNP was 7.1+/-1.5 log pg/ml (p=0.91). The overall four year survival rate was 88%.Conclusion: Bosentan seems to be effective during long-term treatment in patients with inoperable CTEPH. (Neth Heart J 2009;17:329-33.).
Authors:
M C Post; H W M Plokker; J C Kelder; R J Snijder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation     Volume:  17     ISSN:  1568-5888     ISO Abbreviation:  Neth Heart J     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-12-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095458     Medline TA:  Neth Heart J     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  329-33     Citation Subset:  -    
Affiliation:
Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands.
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