Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands.
Neth Heart J. 2009 Sep;17(9):329-33. doi: 10.1007/BF03086278.
Background. Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) is associated with a poor survival.Objectives. To evaluate the long-term response to a dual endothelin receptor antagonist in patients with inoperable CTEPH.Methods. All consecutive 18 patients (mean age 63+/-14 years) treated with bosentan for symptomatic inoperable CTEPH were included. Efficacy was evaluated by the log value of serum levels of N-terminal-pro brain natriuretic peptide (log NTpro BNP), New York Heart Association functional class (NYHA), and the six-minute walk test (6-MWT). All follow-up data (median 31 months) were compared with baseline and divided into: short-term (<12 months), mid-term (between 12 and 24 months), and long-term follow-up (>24 months).Results. At baseline, 15 patients were in NYHA class III and three in NYHA class IV, mean log NT-pro BNP level was 7.2+/-1.4 log pg/ml, and mean 6-MWT distance was 404+/-125 m. During short-term follow-up (n=18), the NYHA class improved (p=0.001), 6-MWT distance increased by 33 m (p=0.03), and log NT-pro BNP decreased to 6.9+/-1.4 log pg/ml (p=0.007). During mid-term follow-up (n=17), the NYHA class improved (p<0.001), the mean 6-MWT distance increased by 41 m (p=0.01), and log NT-pro BNP was 6.9+/-1.4 log pg/ml (p=0.31). During late followup (n=14) the NYHA class was still improved (p=0.03), the 6-MWT distance decreased by 9 m (p=0.73), and log NT-pro BNP was 7.1+/-1.5 log pg/ml (p=0.91). The overall four year survival rate was 88%.
Bosentan seems to be effective during long-term treatment in patients with inoperable CTEPH. (Neth Heart J 2009;17:329-33.).
无法手术的慢性血栓栓塞性肺动脉高压（CTEPH）与较差的生存相关。
评估双重内皮素受体拮抗剂在无法手术的 CTEPH 患者中的长期疗效。
所有连续的 18 例因 CTEPH 症状而接受波生坦治疗的无法手术的患者（平均年龄 63+/-14 岁）均被纳入本研究。通过血清 N 末端前脑利钠肽（NTpro BNP）的对数、纽约心脏协会功能分级（NYHA）和 6 分钟步行试验（6-MWT）来评估疗效。所有随访数据（中位数 31 个月）均与基线进行比较，并分为短期（<12 个月）、中期（12-24 个月）和长期（>24 个月）随访。
基线时，15 例患者为 NYHA 心功能 III 级，3 例为 NYHA 心功能 IV 级，平均 log NTpro BNP 水平为 7.2+/-1.4 log pg/ml，平均 6-MWT 距离为 404+/-125 m。在短期随访（n=18）中，NYHA 心功能分级改善（p=0.001），6-MWT 距离增加 33 m（p=0.03），log NTpro BNP 降低至 6.9+/-1.4 log pg/ml（p=0.007）。在中期随访（n=17）中，NYHA 心功能分级改善（p<0.001），6-MWT 距离增加 41 m（p=0.01），log NTpro BNP 为 6.9+/-1.4 log pg/ml（p=0.31）。在晚期随访（n=14）中，NYHA 心功能仍在改善（p=0.03），6-MWT 距离下降 9 m（p=0.73），log NTpro BNP 为 7.1+/-1.5 log pg/ml（p=0.91）。4 年总生存率为 88%。
波生坦在无法手术的 CTEPH 患者的长期治疗中似乎是有效的。（荷兰心脏杂志 2009；17:329-33.）
