Bosentan-sildenafil combination in the treatment of patients with severe pulmonary hypertension, and its effect on cardiac function

Purpose: To study the efficacy of bosentan combined with sildenafil in the treatment of severe pulmonary hypertension (PH), and its impact on cardiac function. Methods: In total, 90 severe PH patients treated in The First Affiliated Hospital of Harbin Medical University, Harbin, China between November 2018 and November 2019 were included and equally assigned to two groups (A and B). Group A was treated with bosentan combined with sildenafil, while group B received conventional treatment, viz, deslanoside injection followed later by 40 mg furosemide intravenous injection. Clinical efficacy, sleep quality, psychological status, and cardiac function for the two groups were compared. Results: Group A had significantly higher effectiveness than group B before treatment (p < 0.05). Similar Pittsburgh Sleep Quality Index (PSQI) scores before treatment between the two groups were found (p > 0.05). After treatment, group A had a lower PSQI score than group B (p < 0.001). Also, following treatment, group A had more level I patients and fewer level III patients than group B (p < 0.05). The Beck depression rating scale (BDI) scores at T0 and T1 were similar for the two groups (p > 0.05). Lower post-treatment BDI scores in group A at T2 and T3, than in group B were observed (p < 0.001). In contrast to the conventional treatment group, group A had a higher cardiac output and higher cardiac index, lower systemic arterial pressure, and lower incidence of adverse reactions (p < 0.05). Conclusion: Bosentan combined with sildenafil produces higher therapeutic effects on severe PH patients than conventional treatment.