Goal-Oriented Sequential Combination Therapy Evaluated Using Cardiopulmonary Exercise Parameters for the Treatment of Newly Diagnosed Pulmonary Arterial Hypertension　― Goal-Oriented Therapy Evaluated by Cardiopulmonary Exercise Testing for Pulmonary Arterial Hypertension (GOOD EYE) ―

• Hirashiki Akihiro

  Department of Cardiology, Nagoya University Graduate School of Medicine Department of Cardiology, National Center for Geriatrics and Gerontology

• Kondo Takahisa

  Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine

• Adachi Shiro

  Department of Cardiology, Nagoya University Graduate School of Medicine Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine

• Nakano Yoshihisa

  Department of Cardiology, Nagoya University Graduate School of Medicine

• Kamimura Yoshihiro

  Department of Cardiology, Nagoya University Graduate School of Medicine

• Shimokata Shigetake

  Department of Cardiology, Nagoya University Graduate School of Medicine

• Okumura Naoki

  Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine

• Shimizu Atsuya

  Department of Cardiology, National Center for Geriatrics and Gerontology

• Washimi Yukihiko

  Department of Cardiology, National Center for Geriatrics and Gerontology

• Arai Hidenori

  Department of Cardiology, National Center for Geriatrics and Gerontology

• Murohara Toyoaki

  Department of Cardiology, Nagoya University Graduate School of Medicine

• on behalf of the GOOD EYE Investigators

抄録

Background:Many treatment options are available for pulmonary arterial hypertension (PAH), but specific recommendations for long-term treatment are unavailable. We compared prognosis in PAH patients receiving goal-oriented, sequential combination therapy evaluated using cardiopulmonary exercise testing (CPX) parameters or conventional empiric therapy. Methods and Results:The Goal-Oriented Therapy Evaluated by Cardiopulmonary Exercise Testing for Pulmonary Arterial Hypertension (GOOD EYE) study was a multicenter, retrospective/prospective study in which a total of 129 patients with newly diagnosed PAH were enrolled (goal-oriented sequential combination therapy, n=42; conventional empiric therapy, n=87). Patients in the goal-oriented therapy group received sequential combination therapy, the efficacy of which was regularly evaluated using CPX parameters. Patients in the conventional empiric therapy group received conventional empiric therapy. The primary endpoint was cardiovascular death. In the goal-oriented therapy group, plasma brain natriuretic peptide, mean pulmonary arterial pressure, pulmonary vascular resistance, and 6-min walk test were significantly improved at 12 months compared with baseline. Survival in the goal-oriented therapy group at 1, 2, and 3 years (97.6%, 95.2%, and 86.0%, respectively) tended to be higher than that in the conventional empiric therapy group (P=0.082). Conclusions:Goal-oriented sequential combination therapy evaluated using CPX parameters may be associated with a favorable prognosis compared with conventional empiric therapy in patients with newly diagnosed PAH.

収録刊行物

• Circulation Reports

  Circulation Reports 1 (7), 303-311, 2019-07-10

  一般社団法人 日本循環器学会

キーワード

• Combination therapy
• Exercise capacity
• Pulmonary arterial hypertension

詳細情報

• CRID: 1390845713082841088
• NII論文ID: 130007677728
• DOI: 10.1253/circrep.cr-19-0047
• ISSN: 24340790
• Web Site: https://www.jstage.jst.go.jp/article/circrep/1/7/1_CR-19-0047/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020341885
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
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