Effects of the endothelin receptor antagonist bosentan on hemodynamics and exercise capacity in Japanese patients with mildly symptomatic pulmonary arterial hypertension

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• 作者：Masaru Hatano ; Hidehiro Yamada ; Keiichi Fukuda ; Koichiro Yoshioka…
• 关键词：Bosentan ; Endothelin receptor antagonist ; Pulmonary arterial hypertension ; Hemodynamics ; World Health Organization functional class
• 刊名：Heart and Vessels
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：30
• 期：6
• 页码：798-804
• 全文大小：384 KB
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• 作者单位：Masaru Hatano (1)
  Hidehiro Yamada (2)
  Keiichi Fukuda (3)
  Koichiro Yoshioka (4)
  Masanori Funauchi (5)
  Masataka Kuwana (6)
  Masataka Sata (7)
  Mitsugu Taniguchi (8)
  Norifumi Nakanishi (9)
  Takefumi Saito (10)
  Tsutomu Saji (11)
  Shigetake Sasayama (12)
  
  1. Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
  2. Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
  3. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
  4. Department of Cardiovascular Medicine, Tokai University School of Medicine, Kanagawa, Japan
  5. Department of Hematology and Rheumatology, Kinki University Faculty of Medicine, Osaka, Japan
  6. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
  7. Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  8. Division of Cardiology, Kinki University Faculty of Medicine, Osaka, Japan
  9. Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
  10. Department of Respiratory Medicine, National Hospital Organization Ibaraki-Higashi National Hospital, Ibaraki, Japan
  11. Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan
  12. Kyoto University, Kyoto, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

Pulmonary arterial hypertension (PAH) trial has mostly enrolled patients with World Health Organization functional class (WHO FC) III or IV. However, PAH is rapidly progressive in nature even in patients with less severe forms at diagnosis. Following the recent studies in Western population, here we assessed the efficacy of bosentan in Japanese patients with WHO FCII PAH. In this open-label trial, bosentan 125 mg twice daily was administered for 12 weeks in 16 patients, and a hemodynamic evaluation was performed. Treatment was continued for a further 12 weeks, where the effect on exercise capacity was assessed in 13 patients. In 16 patients, mean pulmonary arterial pressure decreased from 40.4 ± 10.4 to 35.6 ± 12.6 mmHg (p = 0.018) and cardiac index increased from 2.54 ± 0.73 to 2.96 ± 0.82 L/min/m2 (p = 0.023). Thus, pulmonary vascular resistance decreased from 792 ± 565 to 598 ± 558 dyn·sec/cm5 (p = 0.006). In 13 patients followed up for 24 weeks, 6-min walking distance increased from baseline at Week 12 (p = 0.003) and Week 24 (p = 0.011). All patients were mildly symptomatic at baseline with dyspnea index (Borg scale) of 2.50 ± 1.58 and the specific activity scale (SAS) of 5.0 ± 1.4 METs. These values remained unchanged throughout the study. These results suggest that bosentan treatment was beneficial for Japanese patients with WHO FC II PAH and treatment should be started in the early stage of the disease. Keywords Bosentan Endothelin receptor antagonist Pulmonary arterial hypertension Hemodynamics World Health Organization functional class