Document Detail


Therapy for pulmonary arterial hypertension due to congenital heart disease and Down's syndrome.
MedLine Citation:
PMID:  21802156     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Oral bosentan is effective in pulmonary arterial hypertension (PAH) related to congenital heart disease (CHD). In patients with Down's syndrome, the effect of bosentan is largely unknown. Aim of the study was to evaluate the long-term effects of bosentan in adult patients with CHD-related PAH with and without Down's syndrome. METHODS: WHO functional class, resting oxygen saturation, 6-minute walk test (6MWT) and hemodynamics were assessed at baseline and after 12months of bosentan therapy in patients with CHD-related PAH with and without Down's syndrome. RESULTS: Seventy-four consecutive patients were enrolled: 18 with and 56 without Down's syndrome. After 12months of bosentan therapy, both with and without Down's syndrome patients showed an improvement in WHO functional class (Down: 2.5±0.5 vs 2.9±0.6, p=0.005; controls: 2.5±0.5 vs 2.9±0.5, p=0.000002), 6-minute walk distance (Down: 288±71 vs 239±74m, p=0.0007; controls: 389±80 vs 343±86m, p=0.00003), and hemodynamics (pulmonary flow, Down: 4.0±1.6 vs 3.5±1.4l/m/m(2), p=0.006; controls: 3.5±1.4 vs 2.8±1.0l/m/m(2), p=0.0005; pulmonary to systemic flow ratio, Down: 1.4±0.7 vs 1.0±0.4, p=0.003; controls: 1.1±0.7 vs 0.9±0.3, p=0.012; pulmonary vascular resistance index, Down: 15±9 vs 20±13WUm(2), p=0.007; controls: 20±10 vs 26±15WUm(2), p=0.002). No differences in the efficacy of therapy were observed between the two groups. CONCLUSIONS: Bosentan was safe and well tolerated in adult patients with CHD-related PAH with and without Down's syndrome during 12months of treatment. Clinical status, exercise tolerance, and pulmonary hemodynamics improved, regardless of the presence of Down's syndrome.
Authors:
Michele D'Alto; Emanuele Romeo; Paola Argiento; Antonello D'Andrea; Berardo Sarubbi; Anna Correra; Giancarlo Scognamiglio; Silvia Papa; Eduardo Bossone; Raffaele Calabrò; Carmine D Vizza; Maria G Russo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-27
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
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