title: Selective pulmonary vasodilators for severe pulmonary hypertension: comparison between endpoints.
abstract: The therapeutic approach to severe pulmonary arterial hypertension (PAH), whether primary or secondary to connective tissue disorders, thromboembolic phenomena or congenital heart disease with Eisenmenger syndrome, has evolved in recent years following the introduction of selective pulmonary vasodilators, including prostacyclin analogs and endothelin receptor antagonists.
  
  
  OBJECTIVE
  To correlate three different endpoints (6-minute walk test, Tei index and peak tricuspid regurgitation velocity by Doppler echocardiographic study) during follow-up of PAH patients under selective vasodilator therapy.
  
  
  METHODS
  Eleven patients (9 female, age 42 +/- 18 years) with severe PAH (> or = 65 mmHg), 64% with Eisenmenger syndrome, in NYHA class > or = II, were assessed during a follow-up of 11 +/- 8 months. Eight patients were already under therapy with iloprost or bosentan.
  
  
  RESULTS
  There was no correlation between the three endpoints before and after therapy as assessed by Pearson's correlation coefficient. There was, however, an improvement in all of them after selective vasodilatory therapy.
  
  
  CONCLUSIONS
  Therapeutic response can be accurately measured by the traditional endpoint (6-minute walk test) or by echocardiographic endpoints. However, the lack of correlation between them excludes their use as alternatives in patient follow-up.
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Lisboa, Portugal. joanafeliciano@netcabo.pt
authors.forename: Joana
authors.initials: J
authors.lastname: Feliciano
authors.forename: Duarte
authors.initials: D
authors.lastname: Cacela
authors.forename: Ana
authors.initials: A
authors.lastname: Agapito
authors.forename: Lídia
authors.initials: L
authors.lastname: de Sousa
authors.forename: Nuno
authors.initials: N
authors.lastname: Pelicano
authors.forename: António
authors.initials: A
authors.lastname: Fiarresga
authors.forename: Ana Teresa
authors.initials: AT
authors.lastname: Timóteo
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Oliveira
authors.forename: Jorge
authors.initials: J
authors.lastname: Quininha
mesh_terms: D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014463:Ultrasonography; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents