Background： Eisenmenger syndrome is characterized by the development of pulmonary arterial hypertension with resultant intracardiac right-to-left shunt and hypoxemia in patients with congenital heart defects. In clin...Background： Eisenmenger syndrome is characterized by the development of pulmonary arterial hypertension with resultant intracardiac right-to-left shunt and hypoxemia in patients with congenital heart defects. In clinical practice, we found that these patients might benefit from carvedilol therapy. Thus, we designed this prospective, open label, observational study to evaluate the efficacy of carvedilol for patients with Eisenmenger syndrome. Methods Twenty patients（17.5 ± 4.8 years） with Eisenmenger syndrome were treated with carvedilol for 6 weeks. The efficacy of carvedilol on 6-minute walking distance, World Health Organization（WHO） functional class, arterial oxygen saturation and right ventricle systolic pressure were assessed.Results At the end of observation, change from baseline in 6-minute walking distance increased 36.35 meters（95% confidence intervals [CI] 25.43 to 47.27 m, P 〈 0.01）. WHO functional class was also significantly improved（P 〈 0.05）. Change from baseline in right ventricular systolic pressure assessed by echo was reduced by 8.11 mm Hg（95% confidence intervals [CI],-10.78 to-5.44 mm Hg, P 〈 0.05）. However, arterial oxygen saturation remained unchanged（87.5 ± 3.02 % at baseline versus 87.80 ± 7.29 % at the end of observation）. Conclusions Carvedilol can improve clinical function, symptoms as well as exercise capacity in patients with Eisenmenger syndrome. These findings need to be confirmed in further randomized clinical trials.展开更多
文摘Background： Eisenmenger syndrome is characterized by the development of pulmonary arterial hypertension with resultant intracardiac right-to-left shunt and hypoxemia in patients with congenital heart defects. In clinical practice, we found that these patients might benefit from carvedilol therapy. Thus, we designed this prospective, open label, observational study to evaluate the efficacy of carvedilol for patients with Eisenmenger syndrome. Methods Twenty patients（17.5 ± 4.8 years） with Eisenmenger syndrome were treated with carvedilol for 6 weeks. The efficacy of carvedilol on 6-minute walking distance, World Health Organization（WHO） functional class, arterial oxygen saturation and right ventricle systolic pressure were assessed.Results At the end of observation, change from baseline in 6-minute walking distance increased 36.35 meters（95% confidence intervals [CI] 25.43 to 47.27 m, P 〈 0.01）. WHO functional class was also significantly improved（P 〈 0.05）. Change from baseline in right ventricular systolic pressure assessed by echo was reduced by 8.11 mm Hg（95% confidence intervals [CI],-10.78 to-5.44 mm Hg, P 〈 0.05）. However, arterial oxygen saturation remained unchanged（87.5 ± 3.02 % at baseline versus 87.80 ± 7.29 % at the end of observation）. Conclusions Carvedilol can improve clinical function, symptoms as well as exercise capacity in patients with Eisenmenger syndrome. These findings need to be confirmed in further randomized clinical trials.
