Key result
A baseline right ventricular contraction duration >550 ms predicted improved 6-minute walk distance after 1 year of bosentan treatment (sensitivity 83%, specificity 83%; P<0.01).
Why the study?
Does baseline right ventricular contraction duration predict the efficacy of bosentan in improving 6-minute walk distance in patients with pulmonary hypertension?
Cohort (n=18)
Does baseline right ventricular contraction duration predict the efficacy of bosentan in improving 6-minute walk distance in patients with pulmonary hypertension?
Baseline right ventricular contraction duration >550 ms measured by echocardiography can predict functional improvement in pulmonary hypertension patients treated with bosentan.
Answers are grounded in this paper and cite their sources.
May identify bosentan responders in pulmonary hypertension; hypothesis-generating and requires prospective validation.
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.
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Duffels et al. (2008) conducted a cohort in Pulmonary hypertension (n=18). Bosentan was evaluated on Improvement in 6-minute walk distance (6-MWD) (p=<0.01). A baseline right ventricular contraction duration >550 ms predicted improved 6-minute walk distance after 1 year of bosentan treatment (sensitivity 83%, specificity 83%; P<0.01).
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