Bosentan increases myocardial perfusion and function in systemic sclerosis: a magnetic resonance imaging and Tissue-Doppler echography study.
OBJECTIVE
To evaluate the short-term effects of bosentan on myocardial perfusion and function assessed by cardiac magnetic resonance imaging (MRI) and Tissue-Doppler echography (TDE) respectively in patients with systemic sclerosis (SSc).


METHODS
We prospectively evaluated 18 SSc patients without clinical heart failure and with normal pulmonary arterial pressure. MRI perfusion index and systolic and diastolic strain rates (SR) determined by TDE were assessed at baseline for comparison with healthy controls (after a 72-hour vasodilator washout period), and repeated after 4 weeks of bosentan treatment (62.5 mg bid for 2 weeks titrated to 125 mg bid for 2 weeks).


RESULTS
Patients with SSc had decreased MRI perfusion index and TDE SR in comparison with healthy controls. Bosentan treatment led to a significant increase in median (range) global MRI perfusion index [from 0.17 (0.09-0.23) at Day 0 to 0.22 (0.13-0.30) after bosentan treatment; p = 0.0004], systolic SR [from 2.1 (1.3-3.1) s-1 to 2.8 (2.1-4.8) s-1; p = 0.0002), and diastolic SR [from 2.6 (1.4-6.7) to 3.6 (2.0-7.6) s-1; p = 0.0003].


CONCLUSIONS
Short-term treatment with bosentan simultaneously improves myocardial perfusion and function, as evaluated by highly sensitive and quantitative methods, in patients with SSc. Whether additional remodeling effect may be observed after longterm treatment with bosentan remains to be determined.
Allanore
Yannick
Y
Services de Rhumatologie A, Cardiologie, and Radiologie A, Université Paris-Descartes, Faculté de Médecine, Hôpital Cochin, Paris, France.
Meune
Christophe
C
Vignaux
Olivier
O
Weber
Simon
S
Legmann
Paul
P
Kahan
Andre
A
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D000077300:Bosentan; D003326:Coronary Circulation / Q000187:drug effects*; D015150:Echocardiography, Doppler / Q000379:methods; D006321:Heart / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects* / Q000502:physiology; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D013449:Sulfonamides / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D013449:Sulfonamides; D000077300:Bosentan