DYNAMICS OF ECHOCARDIOGRAPHIC PARAMETERS OF PULMONARY HYPERTENSION DURING BOSENTAN THERAPY IN PATIENTS UNDERGOING PROGRAM HEMODIALYSIS
Keywords:
pulmonary hypertension; chronic kidney disease; hemodialysis; bosentan; echocardiography; TAPSE; sPAP; endothelin-1Abstract
Associated pulmonary hypertension worsens the prognosis for patients undergoing scheduled hemodialysis. Endothelin receptor antagonists, including bosentan, are standard treatment for pulmonary arterial hypertension. Echocardiography (TTE) remains a key tool for screening and longitudinal monitoring of the right heart and estimating PH probability. In this cohort, the addition of bosentan to comprehensive therapy in maintenance hemodialysis patients with pulmonary hypertension was associated with a marked improvement in pulmonary hemodynamics and right- heart function, demonstrating clinical feasibility in carefully selected hemodialysis patients with regular safety monitoring.
References
Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43(38):3618–3731. doi:10.1093/eurheartj/ehac237. Oxford Academic
Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2023;61(1):2200879. doi:10.1183/13993003.00879-2022. PubMed
Price LC, Wort SJ. The new 2022 pulmonary hypertension guidelines: some small steps and some giant leaps forward for evidence-based care. Eur Respir J. 2023;61(1):2202150. publications.ersnet.org+1 Heart in Adults and Special Considerations in Pulmonary Hypertension. J Am Soc Echocardiogr. 2025;S0894-7317(25)00037-9. onlinejase.comPubMed
Cormican DS. 2025 ASE Guidelines on Echocardiographic Evaluation of the Right Heart with Focus on Pulmonary Hypertension: A Welcome and Necessary Update. J Cardiothorac Vasc Anesth. 2025;S1053-0770(25)00611-1. PubMedjcvaonline.com
Lin C, Ge Q, Wang L, et al. Predictors, prevalence and prognostic role of pulmonary hypertension in chronic kidney disease: a systematic review and meta-analysis. Ren Fail. 2024;46(2):2368082. PubMedPMC
Yu Q, Fu S, Wu H, et al. Pulmonary Hypertension in Hemodialysis Patients and Its Prognostic Role: A Meta-analysis. Int J Gen Med. 2024;17: (epub ahead of print). Tandfonline
Edmonston DL, et al. Echocardiography to Screen for Pulmonary Hypertension in CKD. Kidney Int Rep. 2020;5(12):2275–2283. PMC
Zeder K, Siew ED, Maron BA. Pulmonary hypertension and chronic kidney disease: prevalence, pathophysiology and outcomes. Nat Rev Nephrol. 2024;20: (epub ahead of print). PubMedNature
Helal EH, El-Sayed M, et al. Assessment of pulmonary hypertension in patients diagnosed with chronic kidney disease. Egypt J Bronchol. 2024;18: (article 00337). SpringerOpen
Jin J, Xu X, et al. Meta-analysis of the correlation between pulmonary hypertension and echocardiographic parameters in CKD. PeerJ. 2024;12:e17245. peerj.com+1
de Pinto M, et al. The predictive role of the TAPSE/sPAP ratio for mortality and cardiovascular events in PH (systemic sclerosis cohort). Front Cardiovasc Med. 2024;11:1430903. Frontiers
Palacios-Moguel P, et al. The role of the TAPSE/sPAP ratio as a predictor of mortality in PAH. Pulm Circ. 2025; (in press). ScienceDirect
John T, et al. Prognostic relevance of TAPSE/sPAP in suspected PH with normal–mildly elevated mPAP. Chest. 2025; (ahead of print). journal.chestnet.org
Ghio S, et al. Clinical and prognostic role of tricuspid regurgitation in pulmonary hypertension (discussion includes TAPSE/sPAP). Front Cardiovasc Med. 2025;12: (article). PMC
TRACLEER® (bosentan) US Prescribing Information. U.S. FDA label update, 2023 — note on high protein binding and lack of removal by dialysis. accessdata.fda.gov
TRACLEER® (bosentan) Product Monograph. Janssen (Canada), July 30, 2024 — note: bosentan is not removed through dialysis; hepatic monitoring. Janssen Labels
Martínez-Díaz I, Martos N, Llorens-Cebrià C, et al. Endothelin Receptor Antagonists in Kidney Disease. Int J Mol Sci. 2023;24(4):3427. MDPI+1
Schiffrin EL. Endothelin System in Hypertension and Chronic Kidney Disease. Hypertension. 2024;81(6):e— (review). AHA Journals
Heerspink HJL, et al. Endothelin Receptor Antagonists for Kidney Protection: Lessons from Clinical Trials. Clin J Am Soc Nephrol. 2022;17(7): (review). PMC
