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Evaluation of treatment with bosentan in patients with carcinoid heart disease: single center study.

ΤίτλοςEvaluation of treatment with bosentan in patients with carcinoid heart disease: single center study.
Publication TypeJournal Article
Year of Publication2010
AuthorsLafaras, C. T., Mandala E. M., Platogiannis D. N., Saratzis A. N., Barbetakis N. G., Paraskevopoulos P. P., Ilonidis G. C., & Bischiniotis T. S.
JournalOnkologie
Volume33
Issue6
Pagination300-4
Date Published2010
ISSN1423-0240
Λέξεις κλειδιάAged, Antihypertensive Agents, Antineoplastic Combined Chemotherapy Protocols, Carcinoid Heart Disease, Combined Modality Therapy, Echocardiography, Doppler, Endothelin Receptor Antagonists, Exercise Test, Female, Follow-Up Studies, Gastrointestinal Neoplasms, Humans, Lung Neoplasms, Male, Middle Aged, Natriuretic Peptide, Brain, Ovarian Neoplasms, Peptide Fragments, Sulfonamides
Abstract

BACKGROUND: The primary aim of this study was to evaluate a combined therapeutic intervention, including the dual endothelin receptor antagonist bosentan, in patients with carcinoid heart disease (CaHD). The efficacy of the treatment protocol was investigated using serological, echocardiographic, and clinical markers.PATIENTS AND METHODS: Since 2003, 40 patients with neuroendocrine tumours were identified; 14 had echocardiographic findings consistent with CaHD. Six of the 14 patients with CaHD and a New York Heart Association (NYHA) functional class >or= III received bosentan and were eligible for inclusion in this study.RESULTS: N-terminal pro-brain natriuretic peptide (NT-pro-BNP) had decreased 6 months after treatment with bosentan (median: 646 pg/ml vs. 400.5 pg/ml; p = 0.02); the right ventricular systolic pressure had decreased after 3 and 6 months (median: 69 mmHg vs. 61 mmHg, p = 0.02; median: 69 mmHg vs. 48.5 mmHg, p = 0.02); the 6-minute walk distance (6MWD) had significantly improved after 3 and 6 months of treatment (median: 293.5 vs. 406.5 m; p = 0.02; median: 293.5 vs. 578.5 m; p = 0.02). The NYHA functional class improved in 5/6 patients receiving bosentan.CONCLUSIONS: Combined treatment with bosentan is effective in patients with CaHD, based on functional class, 6MWD, and NT-pro-BNP. Further clarification of the CaHD fibrosis pathogenesis is needed to facilitate development of targeted antifibrotic therapeutic agents.

DOI10.1159/000313596
Alternate JournalOnkologie
PubMed ID20523093

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