Cardiopulmonary exercise testing to evaluate the exercise capacity of patients with inoperable chronic thromboembolic pulmonary hypertension: An endothelin receptor antagonist improves the peak PETCO2

LIFE SCIENCES

卷:118

Article

Hirashiki, Akihiro¹  Adachi, Shiro²  Nakano, Yoshihisa²  Kono, Yuji³  Shimazu, Shuzo²  Shimizu, Shinya²  Morimoto, Ryota²  Okumura, Takahiro²  Takeshita, Kyosuke²  Yamada, Sumio³  Murohara, Toyoaki²  Kondo, Takahisa¹ 

[1] Nagoya Univ, Grad Sch Med, Dept Adv Med Cardiopulm Dis, Nagoya, Aichi 4668560, Japan

[2] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Aichi 4668560, Japan

[3] Nagoya Univ, Grad Sch Med, Dept Rehabil Sci, Nagoya, Aichi 4618673, Japan

关键词: Endothelin receptor antagonist;    Cardiopulmonary exercise testing;    Pulmonary arterial hypertension;    Chronic thromboembolic pulmonary hypertension;   

DOI  :  10.1016/j.lfs.2014.03.009

来源: Elsevier

【 摘 要 】

Aims: The 6-min walking distance is often used for assessing the exercise capacity under the treatment with an endothelin receptor antagonist (ERA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The cardiopulmonary exercise testing (CPX) was reported to be more useful for the patients with pulmonary arterial hypertension (PAH), however, few reports exist in patients with inoperable CTEPH. The aim of this study was to investigate the effects of an oral dual ERA, bosentan, on exercise capacity using CPX in patients with PAH and inoperable CTEPH. Main methods: This study included all patients diagnosed with 17 PAN and 12 CTEPH in the World Health Organization functional classes II-IV who started treatment with bosentan therapy. They underwent CPX, which was performed before bosentan therapy and at 3 to 6 months of the treatment. Key findings: In PAH patients, peak VO2 significantly increased after the bosentan treatment (p = 0.009). On the other hand, in CTEPH patients, there were no significant differences in the peak VO2. However, the peak PETCO2 was significantly increased from 23.9 +/- 5.2 mm Hg at baseline to 29.3 +/- 10.7 mm Hg after the bosentan treatment (p = 0.040). In addition, peak heart rate during exercise tended to decrease after the bosentan therapy (p = 0.089). Significance: Bosentan therapy improved peak PETCO2 but not peak VO2 in patients with inoperable CTEPH. These findings demonstrated that CPX is useful for assessing the exercise capacity of patients with PAN and inoperable CTEPH under the treatment with an ERA. (C) 2014 The Authors. Published by Elsevier Inc.

【 授权许可】

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