Long-term effect of bosentan therapy on cardiac function and symptomatic benefits in adult patients with eisenmenger syndrome

Journal of Cardiac Failure, 05/04/2012

Sustained improvement of pulmonary arterial hypertension and RV function in eisenmenger syndrome (ES) patients was evident 2 years after bosentan therapy, and this may provide insights on the symptomatic benefits gained in these patients.

Methods

  • 23 consecutive adult ES patients (15 with ventricular septal defect, 6 with atrial septal defect, and 2 with patent ductus arteriosus) underwent standard and tissue Doppler echocardiography before and 24 ± 9 months after bosentan therapy.
  • Echocardiographic measurements included pulmonary arterial systolic pressure (PASP), myocardial performance index (MPI), tricuspid and lateral mitral annular pulsed–wave tissue Doppler systolic (Sa) and early diastolic (Ea) long–axis motions.
  • Patients’ World Health Organization (WHO) functional class, 6–minute walk distance (6MWD), and systemic arterial oxygen saturations (SaO2) were also recorded.
  • The PASP, WHO functional class, 6MWD, and SaO2 all improved (118 ± 22 to 111 ± 19 mm Hg, 3.2 ± 0.4 to 2.4 ± 0.5, 286 ± 129 m to 395 ± 120 m, and 84.6 ± 6.5% to 88.8 ± 3.9%, respectively; all P < .01) after therapy.

Results

  • There was also significant improvement in right ventricular (RV) MPI (by 23.9%: 0.46 ± 0.15 to 0.35 ± 0.09) and biventricular long–axis function (tricuspid Sa and Ea: 6.7 ± 1.5 to 8.8 ± 1.7 cm/s and 5.7 ± 1.3 to 7.0 ± 1.2 cm/s, respectively; lateral Sa and Ea: 6.8 ± 1.3 to 8.4 ± 1.5 cm/s and 7.6 ± 2.0 to 8.5 ± 2.1 cm/s, respectively; all P < .05).
  • Posttherapy RV MPI was moderately correlated with PASP and 6MWD.

Go to Abstract Print Article Summary