TY - JOUR
T1 - Duration of right ventricular contraction predicts the efficacy of bosentan treatment in patients with pulmonary hypertension
AU - Duffels, Marielle G. J.
AU - Hardziyenka, Maxim
AU - Surie, Sulaiman
AU - de Bruin-Bon, Rianne H. A. C. M.
AU - Hoendermis, Elke S.
AU - van Dijk, Arie P. J.
AU - Bouma, Berto J.
AU - Tan, Hanno L.
AU - Berger, Rolf M. F.
AU - Bresser, Paul
AU - Mulder, Barbara J. M.
PY - 2009/5
Y1 - 2009/5
N2 - AIMS: In patients with pulmonary hypertension (PH), elevated endothelin-1 levels are associated with prolonged duration of right ventricular (RV) contraction, which induces leftward ventricular septal bowing with impaired left diastolic filling. We hypothesized that baseline RV contraction duration predicts efficacy of endothelin receptor antagonist, bosentan.METHODS AND RESULTS: Eighteen PH patients (age 57, range 35-79 years, 33% male) received bosentan. Six minute walk distance (6-MWD) and echocardiography were performed at baseline and after 1 year follow-up. After 1 year of treatment, 6-MWD increased (mean 60 +/- 41 m) in 67% of patients (responders). Baseline RV contraction duration was longer in responders, compared with non-responders (612 +/- 66 vs. 514 +/- 23 ms; P < 0.01). A baseline RV contraction duration >550 ms was associated with improved 6-MWD (sensitivity 83%, specificity 83%; P < 0.01).CONCLUSION: An improvement of 6-MWD during bosentan treatment was associated with a decrease in RV contraction duration and could be predicted by a baseline RV contraction duration >550 ms.
AB - AIMS: In patients with pulmonary hypertension (PH), elevated endothelin-1 levels are associated with prolonged duration of right ventricular (RV) contraction, which induces leftward ventricular septal bowing with impaired left diastolic filling. We hypothesized that baseline RV contraction duration predicts efficacy of endothelin receptor antagonist, bosentan.METHODS AND RESULTS: Eighteen PH patients (age 57, range 35-79 years, 33% male) received bosentan. Six minute walk distance (6-MWD) and echocardiography were performed at baseline and after 1 year follow-up. After 1 year of treatment, 6-MWD increased (mean 60 +/- 41 m) in 67% of patients (responders). Baseline RV contraction duration was longer in responders, compared with non-responders (612 +/- 66 vs. 514 +/- 23 ms; P < 0.01). A baseline RV contraction duration >550 ms was associated with improved 6-MWD (sensitivity 83%, specificity 83%; P < 0.01).CONCLUSION: An improvement of 6-MWD during bosentan treatment was associated with a decrease in RV contraction duration and could be predicted by a baseline RV contraction duration >550 ms.
KW - Pulmonary hypertension
KW - Congenital heart disease
KW - Chronic thromboembolic pulmonary hypertension
KW - Echocardiography
KW - Bosentan treatment
KW - CONGENITAL HEART-DISEASE
KW - RECEPTOR ANTAGONIST BOSENTAN
KW - ARTERIAL-HYPERTENSION
KW - EISENMENGER-SYNDROME
KW - PRESSURE-OVERLOAD
KW - THERAPY
KW - ENDOTHELIN
KW - TOLERABILITY
KW - SAFETY
U2 - 10.1093/ejechocard/jen308
DO - 10.1093/ejechocard/jen308
M3 - Article
C2 - 19042941
SN - 1525-2167
VL - 10
SP - 433
EP - 438
JO - European journal of echocardiography
JF - European journal of echocardiography
IS - 3
ER -