PURPOSE: To investigate the role of Bosentan in the decrease of Pulmonary Arterial Hypertension (PAH) in patients with cardiac valvular deseases - mitral, tricuspital or aortic or concomitent- in order to decrease the risk of the valve replacement surgery.
METHODS: We studied all the patients of any kind cardiac valvular desease and concurrent PAH admitted in the cardiac clinic of our Hospital. We included the patients with Systolic Pulmonary Arterial Pressure(S-PAP)> 65mmHg and Mean-Pulmonary Arterial Pressure(M-PAP)>40mmHg. The estimation of the S-PAP was done by echocardiography after the measurement of the Vmax in the tricuspidal valve. All the patients received bosentan PO 62,5 mg twice per day for 4 weeks and 125mg PO for the next 6 weeks. We reestimate the S-PAP and M-PAP after the 10 weeks treatment. All patients were tested with the Six Minutes Walking Test (SMWT)before and after therapy.
RESULTS: We studied 4 patients. The mean S-PAP of all patients before treatment was 73.63 Standard Derivation (SD) 4.61. The mean S-PAP after treatment was 59.26 SD 9.64, decreased 14.35±7.24 p=0.029. The mean M-PAP of all patients before treatment was 46.83 SD 2.29 and after treatment 39.58 SD 4.87, decreased 7.25±3.65 p=0.028. The mean SMWT was before treatment 247.75m SD 152.18, after treatment 306.50 SD 151.15, increased 58.75±12.92 p=0.003.
CONCLUSION: The 10 weeks therapy with bosentan in patients with any cardiac valvular deseases and concurrent PAH decreases the S-PAP and M-PAP and improves the patients tolerance in endurance significantly.
CLINICAL IMPLICATIONS: The treatment with bosentan in patients with cardiac valvular deseases and concurrent PAH helps decreases the risk of the cardiac surgery for valve replacement. Trials with higher numbers of patients may confirm any further this conclusion.
DISCLOSURE: Georgios Vlachogeorgos, No Financial Disclosure Information; No Product/Research Disclosure Information