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The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study

BACKGROUND: Palliative treatment with the Fontan procedure has greatly improved survival for children with functionally univentricular heart. Since Fontan performed the first successful operation, the procedure has evolved and is now performed as Total Cavo-Pulmonary Connection (TCPC). An increasing...

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Autores principales: Hebert, Anders, Jensen, Annette S, Idorn, Lars, Sørensen, Keld E, Søndergaard, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658877/
https://www.ncbi.nlm.nih.gov/pubmed/23663658
http://dx.doi.org/10.1186/1471-2261-13-36
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author Hebert, Anders
Jensen, Annette S
Idorn, Lars
Sørensen, Keld E
Søndergaard, Lars
author_facet Hebert, Anders
Jensen, Annette S
Idorn, Lars
Sørensen, Keld E
Søndergaard, Lars
author_sort Hebert, Anders
collection PubMed
description BACKGROUND: Palliative treatment with the Fontan procedure has greatly improved survival for children with functionally univentricular heart. Since Fontan performed the first successful operation, the procedure has evolved and is now performed as Total Cavo-Pulmonary Connection (TCPC). An increasing prevalence and longer life expectancy of TCPC patients have raised new challenges. The survivors are often suffering complications such as arrhythmias, myocardial dysfunction, thromboembolic events, neuropsychological deficit, protein-losing enteropathy and reduced exercise capacity. Several causes for the reduced exercise capacity may be present e.g. impaired function of the single ventricle, valve dysfunction and chronotropic impairment, and perhaps also increased pulmonary vascular resistance. Thus, plasma endothelin-1 has been shown to correlate with increased pulmonary vascular resistance and the risk of failing Fontan circulation. This has raised the question of the role for pulmonary vasodilation therapy, especially endothelin receptor antagonist in the management of TCPC patients. METHODS/DESIGN: The TEMPO trial aims to investigate whether Bosentan, an endothelin receptor antagonist, can be administered safely and improve exercise capacity in TCPC patients. The trial design is randomized, double-blind and placebo-controlled. Bosentan/placebo is administered for 14 weeks with control visits every four weeks. The primary endpoint is change in maximal oxygen consumption as assessed on bicycle ergometer test. Secondary endpoints include changes in pulmonary blood flow during exercise test, pro brain natriuretic peptide and quality of life. DISCUSSION: We hypothesize that treatment with Bosentan, an endothelin receptor antagonist, can be administered safely and improve exercise capacity in TCPC patients. TRIAL REGISTRATION: clinicaltrials.gov NCT01292551
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spelling pubmed-36588772013-05-23 The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study Hebert, Anders Jensen, Annette S Idorn, Lars Sørensen, Keld E Søndergaard, Lars BMC Cardiovasc Disord Study Protocol BACKGROUND: Palliative treatment with the Fontan procedure has greatly improved survival for children with functionally univentricular heart. Since Fontan performed the first successful operation, the procedure has evolved and is now performed as Total Cavo-Pulmonary Connection (TCPC). An increasing prevalence and longer life expectancy of TCPC patients have raised new challenges. The survivors are often suffering complications such as arrhythmias, myocardial dysfunction, thromboembolic events, neuropsychological deficit, protein-losing enteropathy and reduced exercise capacity. Several causes for the reduced exercise capacity may be present e.g. impaired function of the single ventricle, valve dysfunction and chronotropic impairment, and perhaps also increased pulmonary vascular resistance. Thus, plasma endothelin-1 has been shown to correlate with increased pulmonary vascular resistance and the risk of failing Fontan circulation. This has raised the question of the role for pulmonary vasodilation therapy, especially endothelin receptor antagonist in the management of TCPC patients. METHODS/DESIGN: The TEMPO trial aims to investigate whether Bosentan, an endothelin receptor antagonist, can be administered safely and improve exercise capacity in TCPC patients. The trial design is randomized, double-blind and placebo-controlled. Bosentan/placebo is administered for 14 weeks with control visits every four weeks. The primary endpoint is change in maximal oxygen consumption as assessed on bicycle ergometer test. Secondary endpoints include changes in pulmonary blood flow during exercise test, pro brain natriuretic peptide and quality of life. DISCUSSION: We hypothesize that treatment with Bosentan, an endothelin receptor antagonist, can be administered safely and improve exercise capacity in TCPC patients. TRIAL REGISTRATION: clinicaltrials.gov NCT01292551 BioMed Central 2013-05-11 /pmc/articles/PMC3658877/ /pubmed/23663658 http://dx.doi.org/10.1186/1471-2261-13-36 Text en Copyright © 2013 Hebert et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Study Protocol
Hebert, Anders
Jensen, Annette S
Idorn, Lars
Sørensen, Keld E
Søndergaard, Lars
The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study
title The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study
title_full The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study
title_fullStr The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study
title_full_unstemmed The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study
title_short The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study
title_sort effect of bosentan on exercise capacity in fontan patients; rationale and design for the tempo study
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658877/
https://www.ncbi.nlm.nih.gov/pubmed/23663658
http://dx.doi.org/10.1186/1471-2261-13-36
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