TY - JOUR
T1 - Bisoprolol in idiopathic pulmonary arterial hypertension
T2 - An explorative study
AU - Van Campen, Jasmijn S.J.A.
AU - De Boer, Karin
AU - Van De Veerdonk, Mariëlle C.
AU - Van Der Bruggen, Cathelijne E.E.
AU - Allaart, Cor P.
AU - Raijmakers, Pieter G.
AU - Heymans, Martijn W.
AU - Marcus, J. Tim
AU - Harms, Hendrik J.
AU - Handoko, M. Louis
AU - De Man, Frances S.
AU - Noordegraaf, Anton Vonk
AU - Bogaard, Harm Jan
AU - Raijmakers, Petrus
PY - 2016/9/1
Y1 - 2016/9/1
N2 - While beta-blockers are considered contraindicated in pulmonary arterial hypertension (PAH), the prognostic significance of sympathetic nervous system over-activity suggests a potential benefit of beta-blocker therapy. The aim of this randomised, placebo-controlled, crossover, single centre study was to determine the effects of bisoprolol on right ventricular ejection fraction (RVEF) in idiopathic PAH (iPAH) patients. Additional efficacy and safety parameters were explored. Patients with optimally treated, stable iPAH (New York Heart Association functional class II/III) were randomised to placebo or bisoprolol. Imaging and functional measurements were performed at baseline, crossover and end of study. 18 iPAH patients were included, because inclusion faltered before enrolment of the targeted 25 patients. 17 patients completed 6 months of bisoprolol, 15 tolerated bisoprolol, one patient required intravenous diuretics. Bisoprolol was associated with a lower heart rate (17 beats per minute, p=0.0001) but RVEF remained unchanged. A drop in cardiac index (0.5 Lmin?1m?2, p=0.015) was observed, along with a trend towards a decreased 6-min walking distance (6MWD). Although careful up-titration of bisoprolol was tolerated by most patients and resulted in a decreased heart rate, no benefit of bisoprolol in iPAH was demonstrated. Decreases in cardiac index and 6MWD suggest a deteriorated cardiac function. The results do not favour the use of bisoprolol in iPAH patients.
AB - While beta-blockers are considered contraindicated in pulmonary arterial hypertension (PAH), the prognostic significance of sympathetic nervous system over-activity suggests a potential benefit of beta-blocker therapy. The aim of this randomised, placebo-controlled, crossover, single centre study was to determine the effects of bisoprolol on right ventricular ejection fraction (RVEF) in idiopathic PAH (iPAH) patients. Additional efficacy and safety parameters were explored. Patients with optimally treated, stable iPAH (New York Heart Association functional class II/III) were randomised to placebo or bisoprolol. Imaging and functional measurements were performed at baseline, crossover and end of study. 18 iPAH patients were included, because inclusion faltered before enrolment of the targeted 25 patients. 17 patients completed 6 months of bisoprolol, 15 tolerated bisoprolol, one patient required intravenous diuretics. Bisoprolol was associated with a lower heart rate (17 beats per minute, p=0.0001) but RVEF remained unchanged. A drop in cardiac index (0.5 Lmin?1m?2, p=0.015) was observed, along with a trend towards a decreased 6-min walking distance (6MWD). Although careful up-titration of bisoprolol was tolerated by most patients and resulted in a decreased heart rate, no benefit of bisoprolol in iPAH was demonstrated. Decreases in cardiac index and 6MWD suggest a deteriorated cardiac function. The results do not favour the use of bisoprolol in iPAH patients.
UR - http://www.scopus.com/inward/record.url?scp=84986218444&partnerID=8YFLogxK
U2 - https://doi.org/10.1183/13993003.00090-2016
DO - https://doi.org/10.1183/13993003.00090-2016
M3 - Article
C2 - 27390285
SN - 0903-1936
VL - 48
SP - 787
EP - 796
JO - European respiratory journal
JF - European respiratory journal
IS - 3
ER -