Safety and Efficacy of Bosentan in Patients With Diastolic Heart Failure and Secondary Pulmonary Hypertension

Inclusion Criteria: * Clinically signs or history of congestive heart failure NYHA II-III (Fatigue, dyspnea on exertion, lung crepitations, pulmonary edema, ankle and or lower leg swelling, jugular pressure enhancement, hepatomegaly) * Echocardiographic signs of diastolic dysfunction (heart failure with normal ejection fraction) * Right ventricle enlargement with pulmonary hypertension * 6 minute walking distance \> 150 m \< 400 m * Right Heart Catheterization: Mean PAP \> 25 mmHg, PCWP \> 15 mmHg Echocardiographic requirements for definition of heart failure with normal ejection fraction * E/E' \> 15, or * E/E' \> 8 + NTpBNP \> 220 pg/ml, or * E/E' \> 8 + E:A \< 0.5 + DT \> 280 ms or * Ard-Ad \> 30 ms or * atrial enlargement or * atrial fibrillation * NTpBNP \> 220 pg/ml + combination * IVRT - IVRTm \< 0 septal und lateral Echocardiographic requirements for pulmonary hypertension and right ventricle dysfunction * RVEDD \> 30 mm short axis parasternal, and * one of the following: * Tricuspid valve regurgitation velocity (TRV) \> 3 m/s; * RV-annular systolic velocity \< 10 cm/sec (TDI) * TAPSE \< 18 mm Exclusion Criteria: * Patients who are not on guideline conform treatments for cardiovascular disease. * Left ventricle systolic dysfunction (EF \< 50 %), aortic stenosis with peak gradient (instantane) \> 40 mm Hg,moderate and severe aortic insufficiency * moderate and severe mitral regurgitation, * acute coronary disease, stable coronary artery disease or periphe…