Key result
Bosentan is linked to a ~50-meter increase in 6-minute walk distance and improved biventricular performance.
Why the study?
Does bosentan treatment improve echocardiographic variables of right ventricular function and exercise capacity in patients with pulmonary arterial hypertension?
Cohort (n=19)
Yes
Does bosentan treatment improve echocardiographic variables of right ventricular function and exercise capacity in patients with pulmonary arterial hypertension?
In patients with pulmonary arterial hypertension, 6 months of bosentan treatment improved exercise capacity and right ventricular function, with changes in RV and LV MPI-TDI correlating strongly with improvements in 6-minute walk distance.
Answers are grounded in this paper and cite their sources.
May support bosentan evaluation in PAH; hypothesis-generating for MPI-6MWD links, needs RCTs before practice change.
PURPOSE: Bosentan reduces pulmonary arterial pressure and improves exercise capacity in patients with pulmonary arterial hypertension (PAH). However, there are limited data regarding the extent to which the changes in echocardiographic variables reflect improvements in exercise capacity. We aimed to assess the improvement of echocardiographic variables and exercise capacity after 6 months of bosentan treatment for PAH. METHODS: We performed a prospective study from June 2012 to June 2015 in seven participating medical centers. Echocardiography, including tissue Doppler imaging (TDI) and the 6-minute walk test distance (6MWD), was performed at baseline and after 6 months of bosentan treatment. RESULTS: We analyzed 19 patients with PAH: seven with congenital shunt, six with collagen vascular disease, and six with idiopathic PAH. After bosentan treatment, mean 6MWD increased by 50 meters. Right ventricle (RV) systolic pressure, tricuspid annular plane systolic excursion, myocardial performance index (MPI) derived from TDI (MPI-TDI) of RV and left ventricle (LV), RV fractional area change, and RV ejection fraction were significantly improved. In particular, the magnitude of RV and LV MPI-TDI showed good correlation with changes in the 6MWD. CONCLUSIONS: The magnitude of RV and LV MPI-TDI was strongly associated with improvements in exercise capacity.
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Kim et al. (2016) conducted a cohort in pulmonary arterial hypertension (n=19). bosentan was evaluated on improvement of echocardiographic variables and exercise capacity. Bosentan treatment for 6 months increased mean 6-minute walk distance by 50 meters, with improvements strongly correlating with right and left ventricular myocardial performance index.
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