PMID- 16100158
OWN - NLM
STAT- MEDLINE
DCOM- 20050906
LR  - 20181201
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 128
IP  - 2
DP  - 2005 Aug
TI  - Bosentan improves exercise tolerance and Tei index in patients with pulmonary 
      hypertension and prostanoid therapy.
PG  - 709-13
AB  - STUDY OBJECTIVE: Pulmonary arterial hypertension (PAH) is a progressive disease 
      with a bad prognosis. Prostanoids are well established in the medical treatment 
      of this disease. Treatment of patients with progressive disease despite 
      prostanoids remains a therapeutic challenge. In this study, we examined the 
      effect of adding bosentan, an endothelin antagonist, to existing prostanoid 
      therapy on exercise capacity (6-min walking distance [6MWD]) and right 
      ventricular (RV) function (Tei index) in patients with progressive pulmonary 
      hypertension. DESIGN: Prospective, nonrandomized, open-label study. SETTING: 
      University hospital. PATIENTS: Sixteen patients with pulmonary hypertension (PAH, 
      n = 10; pulmonary hypertension due to other cause, n = 6) with progressive 
      disease receiving either beraprost (n = 3), inhaled iloprost (n = 10), or 
      iloprost IV (n = 3). INTERVENTIONS: Combination therapy with bosentan (final 
      dosage, 125 mg bid) was initiated following an interval of 3-months minimum of 
      unchanged prostanoid therapy. MEASUREMENTS AND RESULTS: Tei index, 6MWD, and New 
      York Heart Association (NYHA) functional class were assessed prior to the 
      initiation of combination therapy (baseline), at 6 months after initiation of 
      combination therapy, and every 3 months thereafter. Two patients were followed up 
      for 6 months only; all remaining patients reached a mean follow-up period (+/- 
      SD) of 13.5 +/- 5.0 months (range, 9 to 22 months). 6MWD increased by 42.5 +/- 66 
      m at 6 months and 44.6 +/- 66 m at the last follow-up (both time points vs 
      baseline, p < 0.001), and Tei index improved by -0.13 +/- 0.08 at 6 months and - 
      0.13 +/- 0.11 at the last follow-up (both time points vs baseline, p < 0.001). 
      All patients reported subjective improvements. Nine of 16 patients exhibited 
      improvement in NYHA functional class at 6 months. No side effects occurred that 
      required dose adjustment or discontinuation of the study medication. CONCLUSION: 
      Bosentan administered to patients with progressive pulmonary hypertension 
      receiving prostanoids resulted in an increased exercise capacity and an improved 
      RV function. Bosentan therefore appears to be well suited for combination therapy 
      with prostanoids in selected patients pending results of ongoing randomized 
      trials.
FAU - Seyfarth, Hans-Jurgen
AU  - Seyfarth HJ
AD  - Department of Pulmonary Medicine, Critical Care and Cardiology, University of 
      Leipzig, Germany. seyfarth.leipzig@freenet.de
FAU - Pankau, Hans
AU  - Pankau H
FAU - Hammerschmidt, Stefan
AU  - Hammerschmidt S
FAU - Schauer, Joachim
AU  - Schauer J
FAU - Wirtz, Hubert
AU  - Wirtz H
FAU - Winkler, Jorg
AU  - Winkler J
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Prostaglandins)
RN  - 0 (Sulfonamides)
RN  - 0 (Vasodilator Agents)
RN  - 35E3NJJ4O6 (beraprost)
RN  - DCR9Z582X0 (Epoprostenol)
RN  - JED5K35YGL (Iloprost)
RN  - Q326023R30 (Bosentan)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antihypertensive Agents/*therapeutic use
MH  - Bosentan
MH  - Epoprostenol/*analogs & derivatives/therapeutic use
MH  - Exercise Tolerance/*drug effects
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*diagnostic imaging/*drug therapy
MH  - Iloprost/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Prostaglandins/*therapeutic use
MH  - Sulfonamides/*therapeutic use
MH  - Ultrasonography
MH  - Vasodilator Agents/*therapeutic use
EDAT- 2005/08/16 09:00
MHDA- 2005/09/07 09:00
CRDT- 2005/08/16 09:00
PHST- 2005/08/16 09:00 [pubmed]
PHST- 2005/09/07 09:00 [medline]
PHST- 2005/08/16 09:00 [entrez]
AID - S0012-3692(15)50416-9 [pii]
AID - 10.1378/chest.128.2.709 [doi]
PST - ppublish
SO  - Chest. 2005 Aug;128(2):709-13. doi: 10.1378/chest.128.2.709.