Zusammenfassung
BackgroundRiociguat is a soluble guanylate cyclase stimulator approved for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTPEH). The objective of this study was to evaluate right heart size and function assessed by echocardiography during long term treatment with riociguat.MethodsPatients who started riociguat treatment (1.0-2.5mg tid) within the trials ...
Zusammenfassung
BackgroundRiociguat is a soluble guanylate cyclase stimulator approved for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTPEH). The objective of this study was to evaluate right heart size and function assessed by echocardiography during long term treatment with riociguat.MethodsPatients who started riociguat treatment (1.0-2.5mg tid) within the trials phase II, PATENT, PATENTplus, EAS, CHEST and continued treatment for 3-12months were included in this study. Echocardiography was analysed off-line at baseline, after 3, 6 and 12months by investigators who were blinded to clinical data. Last and baseline observation carried forward method (LOCF, BOCF) were performed as sensitivity analysis.ResultsSeventy-one patients (45% PAH, 55% CTEPH; 53.5% female; 6013years, mean pulmonary arterial pressure 4610mmHg, mean PVR 700 +/- 282dynes<bold>seccm</bold>-5) were included. After 6months, RA and RV area, RV thickness tricuspid regurgitation velocity showed a significant reduction. After 12months, patients receiving riociguat therapy showed a significant reduction in right atrial (-2.6 +/- 4.4cm2, 95% CI -3.84, -1.33; p<0.001, n=49) and right ventricular (RV) area (-3.5 +/- 5.2cm2, 95% CI -5.1, -1.9; p<0.001; n=44), RV thickness (-0.76 +/- 2.2mm, 95% CI -1.55, 0.03; n=32), and a significant increase in TAPSE (2.95 +/- 4.78mm, 95% CI 1.52, 4.39; n=45) and RV fractional area change (8.12 +/- 8.87mm, 95% CI 4.61, 11.62; n=27).Both LOCF and BOCF showed similar results but lower effect sizes.Conclusion Patients under long-term treatment with riociguat show significantly reduced right heart size and improved RV function in PAH and CTEPH. Further controlled prospective studies are needed to confirm these results.
Altmetric