A comparison of echocardiographic variables of right ventricular function with exercise capacity after bosentan treatment in patients with pulmonary arterial hypertension: Results from a multicenter, prospective, cohort study.
OBJECTIVE
Bosentan reduces pulmonary arterial pressure and improves exercise capacity in patients with pulmonary arterial hypertension (PAH). However, there are limited data regarding the extent to which the changes in echocardiographic variables reflect improvements in exercise capacity. We aimed to assess the improvement of echocardiographic variables and exercise capacity after 6 months of bosentan treatment for PAH.


METHODS
We performed a prospective study from June 2012 to June 2015 in seven participating medical centers. Echocardiography, including tissue Doppler imaging (TDI) and the 6-minute walk test distance (6MWD), was performed at baseline and after 6 months of bosentan treatment.


RESULTS
We analyzed 19 patients with PAH: seven with congenital shunt, six with collagen vascular disease, and six with idiopathic PAH. After bosentan treatment, mean 6MWD increased by 50 meters. Right ventricle (RV) systolic pressure, tricuspid annular plane systolic excursion, myocardial performance index (MPI) derived from TDI (MPI-TDI) of RV and left ventricle (LV), RV fractional area change, and RV ejection fraction were significantly improved. In particular, the magnitude of RV and LV MPI-TDI showed good correlation with changes in the 6MWD.


CONCLUSIONS
The magnitude of RV and LV MPI-TDI was strongly associated with improvements in exercise capacity. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:28-34, 2017.
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
Hyungseop
H
Kim
Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea.
Jin
J
Bae Lee
Cardiology Division in Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
Jae-Hyeong
JH
Park
Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea.
Byung-Su
BS
Yoo
Division of Cardiology, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
Jang-Won
JW
Son
Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Dong Heon
DH
Yang
Department of Cardiology, Fatima General Hospital, Daegu, Korea.
Bong-Ryeol
BR
Lee
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000077300:Bosentan; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000187:drug effects*; D011446:Prospective Studies; D013449:Sulfonamides / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000187:drug effects*
D000959:Antihypertensive Agents; D013449:Sulfonamides; D000077300:Bosentan
bosentan; myocardial performance index; pulmonary arterial hypertension; tissue Doppler imaging