TY - JOUR
T1 - Cardiopulmonary exercise testing to evaluate the exercise capacity of patients with inoperable chronic thromboembolic pulmonary hypertension
T2 - An endothelin receptor antagonist improves the peak PETCO2
AU - Hirashiki, Akihiro
AU - Adachi, Shiro
AU - Nakano, Yoshihisa
AU - Kono, Yuji
AU - Shimazu, Shuzo
AU - Shimizu, Shinya
AU - Morimoto, Ryota
AU - Okumura, Takahiro
AU - Takeshita, Kyosuke
AU - Yamada, Sumio
AU - Murohara, Toyoaki
AU - Kondo, Takahisa
N1 - Publisher Copyright:
© 2014 The Authors
PY - 2014/11/1
Y1 - 2014/11/1
N2 - 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 PAH 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 PAH and inoperable CTEPH under the treatment with an ERA.
AB - 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 PAH 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 PAH and inoperable CTEPH under the treatment with an ERA.
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U2 - 10.1016/j.lfs.2014.03.009
DO - 10.1016/j.lfs.2014.03.009
M3 - Article
C2 - 24641953
AN - SCOPUS:84896590395
SN - 0024-3205
VL - 118
SP - 397
EP - 403
JO - Life Sciences
JF - Life Sciences
IS - 2
ER -