They studied 18 patients with optimally treated, stable i-PAH (9/9 New York Heart Association II/III ) who received bisoprolol in an escalating dose up to a maximum of 10 mg or four tablets of placebo. A physical examination and physiological evaluation were performed every 2 weeks; and an ECG, a 6-minute walking distance test, and a Minnesota quality of life questionnaire were administered every month. MRI and echocardiography of the heart, heart rate variability measurements, cardiopulmonary exercise testing, and PET scans were performed at baseline, at crossover, and at the end of the study.
Dr. Van Campen will discuss how there were no reported cases of syncope during the entire study period. One patient developed fluid retention after the start of bisoprolol despite oral diuretics and had to be treated with intravenous diuretics. Four other significant adverse events were reported but not associated with the study medication. Only 2 of 18 patients did not tolerate bisoprolol due to hypotension, bradycardia, or tiredness.
CPAP managed with web-messaging program
Dr. Dominic Munafo, a pulmonologist in San Diego, and his colleagues performed an unblinded, multicenter, prospective trial of patients with newly diagnosed obstructive sleep apnea to determine whether a web-based, automated messaging program for continuous positive airway pressure (CPAP) improved adherence of patients to the treatment regimen, compared with standard coaching care.
Dr. Munafo will discuss how there was no statistically significant difference between the web-messaging sleep group and the standard coaching group in Medicare adherence, mean hours of CPAP usage, CPAP efficacy, or improvement in score on the Epworth Sleepiness Scale. However, they did find that the use of the automated web-based follow-up program utilizing text messaging and e-mail was widely accepted and yielded excellent adherence at a substantially reduced coaching labor requirement when compared to the standard coaching group.