Abstract 2264: Long Term Effects of Bosentan Therapy on Echocardiographic Parameters in Patients With Eisenmenger Syndrome
Objectives The aim of current study was to prospectively characterize the long term effect of bosentan therapy on atrial and ventricular remodeling and its relation to patients’ symptoms.
Methods Transthoracic echocardiography was performed in 23 adult patients receiving bosentan therapy. Patients’ atrial and ventricular dimensions and function were measured prior and at 18 months after treatment. Patients’ functional (NYHA) class, functional capacity assessed by 6-minute walk test distance (6MWT) and arterial oxygen saturations were also recorded.
Results Twenty-three Eisenmenger patients with an average age of 31 ± 12 years received bosentan treatment. Mean follow-up period was 18 ± 6 months. Six-minute walk test distance improved significantly during bosentan therapy compared to baseline (286 ± 129 to 395 ± 120, p=0.001). The systemic arterial oxygen saturations increased compared to baseline (84.6 ± 6.5% to 88.8 ± 3.9%, p=0.06). NYHA class significant improved (3.19 ± 0.40 to 2.43 ± 0.50, p=0.001). By means of the evaluation of cardiac functions no significant change in left and right ventricular dimensions, RV to LV ratio, and left ventricular EF was observed during bosentan therapy. The mitral lateral annular Sm (6.8 ± 1.3 to 8.4 ± 1.5, p=0.001) and Em (7.6 ± 2.0 to 8.5 ± 2.1, p=0.010) significantly increased whereas Am did not change after 1.5 years of bosentan treatment. Sm, Em, Am and E/Em measured at the septal annulus did not change after bosentan therapy. Tricuspid Sm (6.7 ± 1.5 to 8.8 ± 1.7, p=0.003) and Em (5.7 ± 1.3 to 7.0 ± 1.2, p=0.001) were significantly improved. The RV MPI values significantly decreased, indicating an improvement of diastolic as well as systolic RV function (0.46 ± 0.15 to 0.35 ± 0.09, p=0.006). There were statistically significant correlation between RV MPI and PAP (r=0.632; p=0.032). RV MPI also correlated negatively with 6 minute walk-distance, mitral Sm, mitral Em, and the tricuspid Sm, respectively.
Conclusion The present study is the first study to evaluate the long term effects of a bosentan treatment on echocardiographic and Doppler variables in patients with Eisenmenger syndrome. Long term bosentan treatment leads to improvement of atrial dimensions and RV function in patients with Eisenmenger syndrome.