[Role of bosentan in patients with chronic venous thromboembolic pulmonary hypertension].
OBJECTIVE
Chronic thromboembolic pulmonary hypertension (CTEPH) has a dismal prognosis when there are no central pulmonary thrombi amenable to surgical thromboendarterectomy. Pulmonary vasodilators could be useful in this setting. Initial experience with bosentan in a small group of patients with CTEPH has shown favourable results on the short term (3 to 6 months), but long-term effects remain unknown.


METHODS
We retrospectively describe the effects of bosentan in 6 CTEPH patients with a mean follow-up period of 15 months (range, 8-26).


RESULTS
At 3-month follow-up, all patients had experienced clinical improvement, with a statistical trend towards reduced pulmonary vascular resistance [1,008 (624) dyn/sec/cm-5 versus 768 (392), p = 0.07]. Clinical improvement persisted on the long-term, [baseline NYHA functional class 3.0 (0.4) versus 2.0 (0) at the last follow-up visit, p < 0.01]. Six-minute walk-test results [baseline 230 (124) meters versus a 313 (70) at 1 year] and NTproBNP [2,225 (2,079) pg/ml versus a 1,056 (1,104) at 1 year] were also consistent with persistent beneficial effect.


CONCLUSIONS
Bosentan seemed to provide long-term benefits in this small series of patients with CTEPH.
Segovia Cubero
Javier
J
Unidad de Trasplante Cardíaco e Hipertensión Pulmonar, Hospital Universitario Puerta de Hierro, San Martín de Porres 4, 28035 Madrid, Spain. jsecu@telefonica.net
Ortiz Uribe
Juan Camilo
JC
Gómez Bueno
Manuel
M
Moñivas Palomero
Vanessa
V
González González
Magdalena
M
Alonso-Pulpón Rivera
Luis
L
D000284:Administration, Oral; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000077300:Bosentan; D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy*; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D013449:Sulfonamides; D000077300:Bosentan