{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T13:40:10Z","timestamp":1722346810399},"reference-count":0,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Actelion"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Respiratory Journal"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p>BACKGROUND: The most effective approaches to escalating advanced therapies in pulmonary arterial hypertension (PAH) are controversial.<\/jats:p><jats:p>OBJECTIVE: To compare outcomes before and after introducing a target 6 min walk distance (6MWD) treatment strategy in PAH using registry data.<\/jats:p><jats:p>METHODS: From 2001 to 2005, WHO class II to IV patients were treated with bosentan or prostanoids. In July 2005, a target 6MWD strategy was adopted. Monotherapy continued if 6MWD remained &gt;350 m. For patients in whom 6MWD was \u2264350 m, sildenafil was added. If 6MWD remained &lt;350 m, prostanoids were considered. Changes in 6MWD, WHO class and survival rate were compared between periods.<\/jats:p><jats:p>RESULTS: Before using the 6MWD strategy, there was a statistically significant improvement in mean WHO class at six, nine and 12 months (2.5\u00b10.8 [P&lt;0.015]; 2.5\u00b10.8 [P&lt;0.005]; and 2.5\u00b10.9 [P&lt;0.03], respectively) compared with baseline (2.9\u00b10.9). There was a statistically significant increase in mean 6MWD at three, six, nine and 12 months (383\u00b1113 m [P&lt;0.005]; 401\u00b1102 m [P&lt;0.006]; 400\u00b1109 m [P&lt;0.001]; and 399\u00b1110 m [P&lt;0.004], respectively) compared with baseline (321\u00b1119 m). The survival rate was 95% at one and two years. From 2005 to 2009, there was a statistically significant improvement in mean WHO class at three, six, nine and 12 months (2.6\u00b10.8 [P&lt;0.05]; 2.3\u00b10.9 [P&lt;0.0001]; 2.3\u00b10.9 [P&lt;0.0001]; and 2.3\u00b11.0 [P&lt;0.0005], respectively) compared with baseline (2.8\u00b10.7). There was statistically significant improvement in 6MWD at six months (381\u00b1126 m [P&lt;0.05]), followed by a decline toward baseline (354\u00b1117 m). One\u2010 and two\u2010year survival rates in the 6MWD target era were 95% and 80%, respectively.<\/jats:p><jats:p>CONCLUSION: Based on registry data, adoption of this strategy did not affect survival rates, nor cause a sustained improvement in 6MWD by 12 months. WHO class improved similarly in both treatment groups.<\/jats:p>","DOI":"10.1155\/2013\/474703","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T07:57:35Z","timestamp":1458028655000},"page":"111-115","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Directing Therapy in Pulmonary Arterial Hypertension Using a Target 6 Min Walk Distance"],"prefix":"10.1155","volume":"20","author":[{"given":"Nancy Rose","family":"Porhownik","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renelle","family":"Myers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoheir","family":"Bshouty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,1]]},"container-title":["Canadian Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crj\/2013\/474703.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2013\/474703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T13:26:49Z","timestamp":1722346009000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2013\/474703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1155\/2013\/474703"],"URL":"https:\/\/doi.org\/10.1155\/2013\/474703","archive":["Portico"],"relation":{},"ISSN":["1198-2241","1916-7245"],"issn-type":[{"type":"print","value":"1198-2241"},{"type":"electronic","value":"1916-7245"}],"subject":[],"published":{"date-parts":[[2013,1]]},"assertion":[{"value":"2013-01-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}