Published in:
01-09-2014 | Original Paper
Effect of bosentan therapy on ventricular and atrial function in adults with Eisenmenger syndrome. A prospective, multicenter study using conventional and Speckle tracking echocardiography
Published in: Clinical Research in Cardiology | Issue 9/2014
Login to get accessAbstract
Background
The effect of bosentan on the ventricular and atrial performance in patients with Eisenmenger syndrome is unclear. In adult patients with Eisenmenger syndrome, we aimed to evaluate the midterm effect of bosentan on physical exercise, ventricular and atrial function, and pulmonary hemodynamics.
Methods
Forty adult patients before and after 24 weeks bosentan therapy underwent 6 min walk test, two-dimensional speckle tracking echocardiography, plasma NT-proBNP measurement and cardiac catheterization.
Results
After 24 weeks, bosentan therapy an improvement was observed regarding the 6 min walk distance from a median (quartile 1–quartile 3) of 382.5 (312–430) to 450 (390–510) m (p = 0.0001), NT-proBNP from 527.5 (201–1,691.25) to 369 (179–1,246) pg/ml (p = 0.021), right ventricular mean longitudinal systolic strain from 18 (13–22) to 19 (14.5–25) % (p = 0.004), left ventricular mean longitudinal systolic strain from 16 (12–21) to 17 (16–22) % (p = 0.001), right atrial mean peak longitudinal strain from 26 (18–34) to 28 (22–34) % (p = 0.01) and right atrial mean peak contraction strain from 11 (8–16) to 13 (11–16) % (p = 0.005). The invasively obtained Qp:Qs and Rp:Rs did not significantly change under bosentan therapy.
Conclusions
In adult patients with Eisenmenger syndrome, bosentan therapy improves ventricular and atrial functions resulting in enhancement of physical exercise and reduction in the NT-proBNP level, while the pulmonary vascular resistance does not change substantially.