Long-Term Outcomes With Ambrisentan Monotherapy in Pulmonary Arterial Hypertension

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: This study evaluated long-term outcomes in patients with pulmonary arterial hypertension (PAH) undergoing treatment with ambrisentan monotherapy, a selective oral endothelin-1 receptor antagonist. Methods and Results: Patients who participated in the Ambrisentan in Pulmonary Arterial Hypertension: A Phase 3, Randomized, Double-Blind, Placebo-Controlled Multicenter Efficacy Study (ARIES-1) clinical trial and extension phase at our institution were included. Cardiac catheterization, 6-minute walk distance (6MWD), and cardiac magnetic resonance (MRI) data were retrospectively reviewed. Twelve patients with PAH (11 idiopathic, 1 fenfluramine) had follow-up from 3 to 5.5 years from the initiation of ARIES-1. Patients received ambrisentan therapy throughout the study period and were on ambrisentan monotherapy for the first 2 years. At year 1, improvements in median mean pulmonary arterial pressure (PA), cardiac output, and pulmonary vascular resistance (PVR) were seen (P = .02, P = .03, P < .01), and the improvement in PVR persisted at 2 years. 6MWD also improved significantly between baseline (350 m) and 1 and 2 years (397 m, P < .01 and 393 m, P = .01). Cardiac MRI results were more varied, with an increase in RV ejection fraction from 29% at baseline to 46% at 2 years (P = .02), but other MRI variables did not improve. Conclusions: Ambrisentan monotherapy led to improvements in catheterization, 6MWD, and RV ejection fraction, and shows promise as a long-term treatment for pulmonary arterial hypertension.

Original languageEnglish (US)
Pages (from-to)121-127
Number of pages7
JournalJournal of Cardiac Failure
Volume16
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Hypertension
Pulmonary Hypertension
Vascular Resistance
Fenfluramine
Endothelin A Receptors
Clinical Trials, Phase I
Cardiac Catheterization
Catheterization
Cardiac Output
Multicenter Studies
Arterial Pressure
Magnetic Resonance Spectroscopy
Therapeutics
Placebos
ambrisentan
Lung

Keywords

  • 6-minute walk test
  • cardiac MRI
  • Pulmonary hypertension
  • right ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{56a4445705d34fb1bf8b90775c166ca3,
title = "Long-Term Outcomes With Ambrisentan Monotherapy in Pulmonary Arterial Hypertension",
abstract = "Background: This study evaluated long-term outcomes in patients with pulmonary arterial hypertension (PAH) undergoing treatment with ambrisentan monotherapy, a selective oral endothelin-1 receptor antagonist. Methods and Results: Patients who participated in the Ambrisentan in Pulmonary Arterial Hypertension: A Phase 3, Randomized, Double-Blind, Placebo-Controlled Multicenter Efficacy Study (ARIES-1) clinical trial and extension phase at our institution were included. Cardiac catheterization, 6-minute walk distance (6MWD), and cardiac magnetic resonance (MRI) data were retrospectively reviewed. Twelve patients with PAH (11 idiopathic, 1 fenfluramine) had follow-up from 3 to 5.5 years from the initiation of ARIES-1. Patients received ambrisentan therapy throughout the study period and were on ambrisentan monotherapy for the first 2 years. At year 1, improvements in median mean pulmonary arterial pressure (PA), cardiac output, and pulmonary vascular resistance (PVR) were seen (P = .02, P = .03, P < .01), and the improvement in PVR persisted at 2 years. 6MWD also improved significantly between baseline (350 m) and 1 and 2 years (397 m, P < .01 and 393 m, P = .01). Cardiac MRI results were more varied, with an increase in RV ejection fraction from 29{\%} at baseline to 46{\%} at 2 years (P = .02), but other MRI variables did not improve. Conclusions: Ambrisentan monotherapy led to improvements in catheterization, 6MWD, and RV ejection fraction, and shows promise as a long-term treatment for pulmonary arterial hypertension.",
keywords = "6-minute walk test, cardiac MRI, Pulmonary hypertension, right ventricle",
author = "Blalock, {Shannon E.} and Matulevicius, {Susan A} and Mitchell, {Laura C.} and Reimold, {Sharon C} and Warner, {John J} and Peshock, {Ronald M} and Fernando Torres and Chin, {Kelly M}",
year = "2010",
month = "2",
doi = "10.1016/j.cardfail.2009.09.008",
language = "English (US)",
volume = "16",
pages = "121--127",
journal = "Journal of Cardiac Failure",
issn = "1071-9164",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - Long-Term Outcomes With Ambrisentan Monotherapy in Pulmonary Arterial Hypertension

AU - Blalock, Shannon E.

AU - Matulevicius, Susan A

AU - Mitchell, Laura C.

AU - Reimold, Sharon C

AU - Warner, John J

AU - Peshock, Ronald M

AU - Torres, Fernando

AU - Chin, Kelly M

PY - 2010/2

Y1 - 2010/2

N2 - Background: This study evaluated long-term outcomes in patients with pulmonary arterial hypertension (PAH) undergoing treatment with ambrisentan monotherapy, a selective oral endothelin-1 receptor antagonist. Methods and Results: Patients who participated in the Ambrisentan in Pulmonary Arterial Hypertension: A Phase 3, Randomized, Double-Blind, Placebo-Controlled Multicenter Efficacy Study (ARIES-1) clinical trial and extension phase at our institution were included. Cardiac catheterization, 6-minute walk distance (6MWD), and cardiac magnetic resonance (MRI) data were retrospectively reviewed. Twelve patients with PAH (11 idiopathic, 1 fenfluramine) had follow-up from 3 to 5.5 years from the initiation of ARIES-1. Patients received ambrisentan therapy throughout the study period and were on ambrisentan monotherapy for the first 2 years. At year 1, improvements in median mean pulmonary arterial pressure (PA), cardiac output, and pulmonary vascular resistance (PVR) were seen (P = .02, P = .03, P < .01), and the improvement in PVR persisted at 2 years. 6MWD also improved significantly between baseline (350 m) and 1 and 2 years (397 m, P < .01 and 393 m, P = .01). Cardiac MRI results were more varied, with an increase in RV ejection fraction from 29% at baseline to 46% at 2 years (P = .02), but other MRI variables did not improve. Conclusions: Ambrisentan monotherapy led to improvements in catheterization, 6MWD, and RV ejection fraction, and shows promise as a long-term treatment for pulmonary arterial hypertension.

AB - Background: This study evaluated long-term outcomes in patients with pulmonary arterial hypertension (PAH) undergoing treatment with ambrisentan monotherapy, a selective oral endothelin-1 receptor antagonist. Methods and Results: Patients who participated in the Ambrisentan in Pulmonary Arterial Hypertension: A Phase 3, Randomized, Double-Blind, Placebo-Controlled Multicenter Efficacy Study (ARIES-1) clinical trial and extension phase at our institution were included. Cardiac catheterization, 6-minute walk distance (6MWD), and cardiac magnetic resonance (MRI) data were retrospectively reviewed. Twelve patients with PAH (11 idiopathic, 1 fenfluramine) had follow-up from 3 to 5.5 years from the initiation of ARIES-1. Patients received ambrisentan therapy throughout the study period and were on ambrisentan monotherapy for the first 2 years. At year 1, improvements in median mean pulmonary arterial pressure (PA), cardiac output, and pulmonary vascular resistance (PVR) were seen (P = .02, P = .03, P < .01), and the improvement in PVR persisted at 2 years. 6MWD also improved significantly between baseline (350 m) and 1 and 2 years (397 m, P < .01 and 393 m, P = .01). Cardiac MRI results were more varied, with an increase in RV ejection fraction from 29% at baseline to 46% at 2 years (P = .02), but other MRI variables did not improve. Conclusions: Ambrisentan monotherapy led to improvements in catheterization, 6MWD, and RV ejection fraction, and shows promise as a long-term treatment for pulmonary arterial hypertension.

KW - 6-minute walk test

KW - cardiac MRI

KW - Pulmonary hypertension

KW - right ventricle

UR - http://www.scopus.com/inward/record.url?scp=75149115729&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=75149115729&partnerID=8YFLogxK

U2 - 10.1016/j.cardfail.2009.09.008

DO - 10.1016/j.cardfail.2009.09.008

M3 - Article

VL - 16

SP - 121

EP - 127

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

SN - 1071-9164

IS - 2

ER -