Corresponding author: Elena Beciani
email: elena.beciani@virgilio.it
Elena obtained her medical degree from Bologna University, with Professor Galiè. During her studies, she participated in an externship at the Abdominal and Transplantation Surgery Department of the Medical School of Hannover, Germany as well as a cardiology externship at Emory University in Atlanta, GA. Now she is completing her residency in cardiology at S. Orsola Hospital in Bologna. She is focusing her studies on pulmonary hypertension, working closely with Professor Galiè and his team.
Abstract: Prognostic value of echocardiographic parameters in patients with pulmonary arterial hypertension (PAH) treated with targeted therapies
E. Beciani, M. Palazzini, C. Bachetti, F. Sgro, E. Conficoni, E. Gotti, G. Mazzanti, A. Manes, A. Branzi, N. Galie
Pulmonary arterial hypertension (PAH) is a severe disease with a poor prognosis and it is associated with abnormalities of right heart structure and function.
Several echocardiographic variables have been associated with outcome in previous studies but these results are derived from small cohorts of patients treated with conventional therapy or with PAH-targeted drugs as monotherapy.
Between September 2000 and December 2009, we evaluated 337 patients with PAH of different etiologies to prospectively assess the prognostic value of echocardiographic parameters in a large cohort of PAH patients treated according to current guidelines, including combination therapy.
The severity of right atrium enlargement appears to be the strongest independent echocardiographic parameter related to survival.
Corresponding author: Zhi-Cheng Jing 
email: jingzhicheng@medmail.com.cn
Zhi-Cheng Jing obtained his M.D. from Peking Union Medical College, China, and then he went to France to complete his post-doctoral fellow in HOSPITAL ANTOINE BECLERE, Paris-Sud Université, France. He currently is in Shanghai Pulmonary Hospital,Tongji University School of Medicine, as a chief of the department of Cardio-Pulmonary Circulation. He is particularly interested in clinical and basic research of pulmonary vascular disease and the severe right heart failure, including Pulmonary Hypertension and venous thrombosis.
Abstract: Vardenafil in Pulmonary Arterial Hypertension: A Randomized, Double-blind, Placebo-controlled Study
Jing ZC, Yu ZX, Shen JY, Wu BX, Xu KF, Zhu XY, Pan L, Zhang ZL, Liu XQ, Zhang YS, Jiang X, Galiè N
Although the phosphodiesterase type-5 (PDE5) inhibitors sildenafil and tadalafil have demonstrated efficacy in patients with pulmonary arterial hypertension (PAH), monotherapy with these agents has not been conclusively shown to reduce clinical worsening events. We have evaluated the safety and efficacy of the PDE5 inhibitor vardenafil in Chinese patients with PAH in a randomized, double-blind, placebo-controlled study. 66 patients with PAH were randomized 2:1 to vardenafil (5 mg once daily for 4 weeks then 5 mg twice daily, n = 44) or placebo (n = 22) for 12 weeks. Patients completing this phase were then treated with open-label vardenafil (5 mg twice daily) for a further 12 weeks.
At week 12, the mean placebo-corrected 6-minute walking distance (6MWD) was increased with vardenafil (69 meters, P < 0.001), and this improvement was maintained for at least 24 weeks. Vardenafil also increased the mean placebo-corrected cardiac index (0.39 L•min-1•m2, P = 0.005) and decreased mean pulmonary arterial pressure and pulmonary vascular resistance (5.3 mmHg, P = 0.047; and 4.7 Wood U, P = 0.003, respectively) at week 12. Four patients in the placebo group (20.0%) and one in the vardenafil group (2.3%) had clinical worsening events (hazard ratio 0.105, 95% CI 0.012 to 0.938, P = 0.044). Vardenafil was associated with only mild and transient adverse events.
We found that Vardenafil is effective and well tolerated in patients with PAH at a dose of 5 mg twice daily.
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