Poster Presentations: Tuesday, November 2, 2010 |

Long-term Effects on Gas Exchange of Nonselective Endothelin Receptor Antagonist (ETRA) Bosentan in Patients With Severe Pulmonary Hypertension Associated With COPD or Idiopathic Chronic Interstitial Pneumonia FREE TO VIEW

Anna A. Stanziola, MD; Michele D’Alto, MD; Emanuela Carpentieri, MD; Paola Argiento, MD; Christian Russo, MD; Emanuele Romeo, MD; Raffaele Calabrò, MD; Matteo Sofia, MD
Author and Funding Information

Dpt Cardiology University Naples, Naples, Italy

Chest. 2010;138(4_MeetingAbstracts):365A. doi:10.1378/chest.9526
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PURPOSE: Specific therapy of pulmonary hypertension due to lung disease (LD) is currently not recommended because the effects on gas exchange through the inhibition of hypoxic pulmonary vasoconstriction.

METHODS: We assessed safety, clinical impact and blood gases effects of non-selective endothelin receptor antagonist (ETRA) bosentan (B) in patients with severe PH associated with LD. 15 patients with LD and “out-of-proportion” PH, defined as severe pre-capillary PH (mean pulmonary arterial pressure >45 mmHg and pulmonary wedge pressure <15 mmHg) including 8 with chronic idiopathic interstitial pneumonia (IIP) and 7 with COPD were considered. Blood gases were analyzed at -12 , 0, 12 and 24 weeks (wks) from the treatment measuring paO2 and paCO2 ; alveolar to arterial O2 gradient ( A-aO2 ) was calculated from alveolar gas equation. WHO functional class, liver enzymes, 6-min walk test (6MWT) were also assessed No significant difference was observed in haemodynamics between IIP and COPD patients No major side effects were observed during the follow-up. All patients well tolerated B at common doses.

RESULTS: At 24 weeks WHO functional class (3.1±0.9 vs 2.9±0.8; p=ns) and distance at 6MWT (284±54 vs 273±62 m; p=ns) did not change from baseline. In IIP patients B was associated to increased A-aO2 (46±8 vs T0 32±4 mmHg and T-12wks 303 mm Hg p<0.05) Differently,there was no significant difference in A-aO2 in COPD patients (30±5 vs 27±7 mmHg; p=ns).

CONCLUSION: In patients with severe PH associated to LD 24 weeks of B therapy was safe and well tolerated but it was not associated to significant change in clinical outcome.

CLINICAL IMPLICATIONS: Long term treatment with B was associated to significant abnormalities in gas exchange in IIP patients while did not affect gas exchange in severe PH associated to COPD.

DISCLOSURE: Michele D’Alto, No Financial Disclosure Information; No Product/Research Disclosure Information

12:45 PM - 2:00 PM




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