Abstract:
STUDY OBJECTIVES:Prior to the availability of the oral endothelin antagonist bosentan, most patients with pulmonary arterial hypertension (PAH) were treated with continuously infused prostacyclins. Many patients receiving prostacyclins would have received bosentan if it had been available at the time of their diagnosis. Noninvasive criteria (symptoms, World Health Organization [WHO] functional class, 6-min walk test [6MWT] distances, and echocardiograms) are used to govern up-titration of prostacyclins and to assess response to bosentan. The purposes of this study were to see if some patients might be able to transition safely from prostacyclin to bosentan, and whether noninvasive criteria could be used to monitor this transition. METHODS:From January 2002 to July 2003, 23 stable patients with PAH attempted a transition from prostacyclin to bosentan over an 8-week period. 6MWT results, WHO class, and echocardiograms were recorded prior to transition and 1 month after successful transition. The transition was stopped and prostacyclin was resumed or up-titrated if any symptoms of PAH worsened. RESULTS:Of 23 candidates (19 female and 4 male; age range, 17 to 73 years), 15 patients were transitioned to bosentan. Of these patients, four patients experienced worsening symptoms (range, 7 weeks to 12 months after cessation of prostacyclin) and resumed treatment with prostacyclin. Of the remaining 11 patients, 2 patients had liver function abnormalities 3 months and 10 months after transition to bosentan, respectively; 9 patients remained on bosentan 3 to 16 months after prostacyclin cessation. Patients failing transition and resuming prostacyclin returned to their pretransition functional baseline. CONCLUSION:Nine of 23 carefully selected, stable patients with PAH receiving long-term prostacyclin were successfully transitioned to oral bosentan using noninvasive monitoring. No long-term adverse events were associated with failed transition attempts. Further studies need to be carried out to determine which patients are more likely to undergo the transition successfully.
journal_name
Chestjournal_title
Chestauthors
Suleman N,Frost AEdoi
10.1378/chest.126.3.808subject
Has Abstractpub_date
2004-09-01 00:00:00pages
808-15issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(15)31223-Xjournal_volume
126pub_type
杂志文章相关文献
CHEST文献大全abstract:STUDY OBJECTIVE:The primary objective of this study was to test whether an elevated systolic pulmonary artery (PA) pressure or an elevated pulmonary dead space fraction (Vd/Vt) in early acute lung injury (ALI) is associated with poor clinical outcomes in the era of lung-protective ventilation. DESIGN:Prospective obser...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-0409
更新日期:2007-09-01 00:00:00
abstract::Among 1,700 primary tumors of the lung, there were 53 cases of bronchial adenoma (3.1 percent); 38 (72 percent) of the 53 were typical carcinoids, and the remaining 15 were of a higher grade of malignant neoplasm. There was a slight predominance of female patients, and the age of greatest incidence was between 30 and ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.77.1.81
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:Congenital airway malacia is one of the few causes of irreversible airways obstruction in children, but the incidence in the general population is unknown. Severe airway malacia or malacia associated with specific syndromes is usually recognized and diagnosed early in infancy, but information about clinical f...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.5.3391
更新日期:2005-11-01 00:00:00
abstract:STUDY OBJECTIVES:To analyze the influence of a hospital-based home-care program (HCP) on the management of patients with COPD receiving long-term oxygen therapy. DESIGN AND SETTING:Randomized, controlled study in a 1,000-bed university hospital. INTERVENTION:The HCP applied to patients in the intervention group (HCP ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.119.2.364
更新日期:2001-02-01 00:00:00
abstract:STUDY OBJECTIVE:Estimating lung volume using inspiratory capacity (IC) maneuvers is a useful way of tracking dynamic hyperinflation. An understanding of the repeatability of the IC in a clinical setting is important when evaluating an individual's response to a therapeutic intervention that might influence lung volume....
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.121.3.708
更新日期:2002-03-01 00:00:00
abstract::The first report of coincident IHSS and ostium secundum ASD is corroborated and successful septal myotomy and myectomy with patch closure of the ASD is described. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.68.2.246
更新日期:1975-08-01 00:00:00
abstract::Persisting symptoms, consisting of palpitations, dizziness, or syncope, were found in 49 of 570 consecutively followed patients (8.6 percent) with permanent pacemakers (PM). Among 540 patients with ventricular PM, 19 had syncope and 24 dizziness; among 30 patients with dual-chamber PM, five had palpitations and one di...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.2.207
更新日期:1984-02-01 00:00:00
abstract::The results of computed chest tomograms (CT) and chest roentgenograms (CR) were compared in 32 patients who presented with hemoptysis. The CT demonstrated roentgenographic abnormalities more often than CR (p less than 0.01), providing new diagnostic information in 15 patients (46.9 percent), and clarifying CR abnormal...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.1.80
更新日期:1987-01-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the functional sequelae (FS) of patients with tuberculous pleurisy (TP), to analyze the influence of different factors in the occurrence of these FS, and, finally, to evaluate the relationship between the FS and roentgenographic sequelae. DESIGN:An observational, retrospective study. SETTIN...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.6.1996
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Periodic leg movements (PLMs) may appear during nasal CPAP titration, persisting despite the elimination of hypopneas. METHODS:Systematic recordings of expiratory abdominal muscles on the right and left sides with surface electromyographic (EMG) electrodes lateral to navel, and close from the lateral side o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.11-1563
更新日期:2012-07-01 00:00:00
abstract::The findings in a 22-year-old man with Ebstein's anomaly of the tricuspid valve, Wolff-Parkinson-White syndrome, and a persistent left superior vena cava are reported. This is the first reported case of this combination of anomalies in which the atrial septum was intact and the left superior vena cava communicated wit...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.79.6.700
更新日期:1981-06-01 00:00:00
abstract:STUDY OBJECTIVES:To examine the utilization of chemoprophylaxis for tuberculosis in certain high-risk groups, ie, infected contacts 50 years and older, and to study the safety of isoniazid (INH) preventive therapy in such persons. DESIGN:From 1987 to 1992, two-part questionnaires were sent to each of the regional heal...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.3.706
更新日期:1995-09-01 00:00:00
abstract::End-tidal CO2 monitors are used to estimate arterial CO2 pressure (PaCO2), but appropriate use of this noninvasive method of assessing blood gases is unclear. In patients with lung disease, the end-tidal CO2 pressure (PETCO2) can differ from PaCO2 because of ventilation-perfusion (VA/Q) mismatching, and changes in PET...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.92.5.832
更新日期:1987-11-01 00:00:00
abstract:UNLABELLED:STUDY OBJECTIVES AND DESIGN: Health-related quality of life (QoL) instruments are generally used for studies of asthma in specialized settings. For primary care use, there is a need for brief and simple questionnaires for structured patient-reported outcomes. We validated the Mini-Asthma Quality of Life Ques...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.129.4.925
更新日期:2006-04-01 00:00:00
abstract::Disputes regarding life-prolonging treatments are stressful for all parties involved. These disagreements are appropriately almost always resolved with intensive communication and negotiation. Those rare cases that are not require a resolution process that ensures fairness and due process. We describe three recent cas...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2016.05.026
更新日期:2016-09-01 00:00:00
abstract::The endocrinometabolic effects of the aerosol administration of beclomethasone dipropionate (100 microng four times daily) were evaluated in 20 asthmatic patients (11 corticodependent and nine noncorticodependent) during one month. In the noncorticodependent group, aerosol administration of beclomethasone had no stati...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.6.698
更新日期:1977-06-01 00:00:00
abstract::Between November, 1965 and June, 1970, 175 patients underwent mitral valve replacement with the Smeloff-Cutter prosthesis (109 patients) or the toroidal valve (66 patients). The early mortality for patients with a toroidal mitral prosthesis was 18.2 percent (12 patients) and the late mortality 34.8 percent (23 patient...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.2.135
更新日期:1977-02-01 00:00:00
abstract::In 14 consecutive patients with varying myocardial function, evaluation of the Valsalva maneuver was performed using aortic pulse pressure decay to investigate a possible quantitative relationship between the pattern of response and the degree of myocardial dysfunction. The aortic pulse pressure response during strain...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.95.5.986
更新日期:1989-05-01 00:00:00
abstract::Pneumocystis carinii pneumonia is a frequent manifestation of the acquired immune deficiency syndrome (AIDS). It usually presents radiologically as diffuse bilateral infiltrates and histologically as a foamy, eosinophilic intra-alveolar exudate containing the organisms' cysts. We recently studied two rare cases of P c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.3.580
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:To evaluate changes in cerebral tissue oxygenation and blood volume during obstructive sleep apnea (OSA). METHODS:We studied eight men with moderate to severe OSA by near-infrared spectroscopy (NIRS) simultaneously with polysomnography during nocturnal sleep (five patients) and daytime naps (three). RESULTS...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.4.916
更新日期:1996-04-01 00:00:00
abstract::Cardiac toxicity is a major complication which limits the use of adriamycin as a chemotherapeutic agent. Cardiomyopathy is frequent when the total dose exceeds 600 mg/m2 and occurs within one to six months after cessation of therapy. A patient is reported who developed progressive cardiomyopathy two and one-half years...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.78.6.880
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Recent studies have implicated the 5-lipoxygenase/leukotriene (LT) pathway in cardiovascular disease (CVD), which may have important implications for asthmatics because several drugs that target this pathway are currently used to treat asthma. We sought to determine whether montelukast, a cysteinyl LT antago...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.07-0831
更新日期:2007-09-01 00:00:00
abstract::Acute hypoxemia produces opposite effects on the pulmonary and systemic vascular resistance. To assess the influence of acute hypoxemia on cardiac murmurs, 36 patients with a single valvular or congenital heart lesion were studied. As expected from these hemodynamic effects, right-sided regurgitant type murmurs increa...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.81.2.159
更新日期:1982-02-01 00:00:00
abstract:BACKGROUND:Among patients with nearly normal ventilation/perfusion (V/Q) lung scans in the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED), pulmonary embolism (PE) was diagnosed more frequently in those who underwent pulmonary angiography than in those in whom PE was diagnosed on the basis of an adve...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.110.2.395
更新日期:1996-08-01 00:00:00
abstract:STUDY OBJECTIVES:To describe the prevalence of parental prompting to smoke (eg, parent requests that their child light the parent's cigarette in his/her own mouth) in a sample of families, and to assess the agreement between child and parent reports of the prompting behaviors. DESIGN, SETTING, AND PARTICIPANTS:A total...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.2.429
更新日期:2004-02-01 00:00:00
abstract::The management of intractable hemoptysis, short of surgery, is poorly defined. A technique is described utilizing a bronchofiberscope and a Fogarty catheter that not only provides visualization of the source of bleeding, but also furnishes a means of controlling the bleeding. This technique can also be used through a ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.67.4.482
更新日期:1975-04-01 00:00:00
abstract:BACKGROUND:Guidelines are critical for facilitating cost-effective COPD care. Development and implementation in low-and middle-income countries (LMICs) is challenging. To guide future strategy, an overview of current global COPD guidelines is required. RESEARCH QUESTION:We systematically reviewed national COPD guideli...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.09.260
更新日期:2020-10-08 00:00:00
abstract::We carried out a study to assess the prevalence of respiratory disease in lead miners and to investigate the roles of silica and lead. We used a questionnaire for symptoms and examinations for signs of respiratory disease, chest roentgenograms, and spirometric study in 45 lead miners. Six underwent bronchoscopy and tr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.1.18
更新日期:1989-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the extent to which rapid on-site cytologic evaluation (ROSE) of transbronchial needle aspiration (TBNA) samples can safely and cost-effectively reduce the need for additional biopsy during bronchoscopy. SETTING:University Hospital in Long Island, NY. PATIENT AND METHODS:Forty-four bronch...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.2.869
更新日期:2005-08-01 00:00:00
abstract::The purpose of our study was to determine the frequency of cardiac ectopy during the performance of flow-volume loops. The performance of an adequate flow-volume loop entails significant shifts in intrathoracic pressure and oxyhemoglobin saturation that could heighten myocardial arrhythmogenicity and lead to increased...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.4.1006
更新日期:1993-04-01 00:00:00