Effects of Riociguat on Right Ventricular Remodelling in Chronic Thromboembolic Pulmonary Hypertension Patients: A Prospective Study

The Canadian Journal of Cardiology
Ali AhmadiLisa M Mielniczuk

Abstract

The effects of riociguat treatment on right ventricular (RV) metabolism, perfusion, and output in patients with chronic thromboembolic pulmonary hypertension (CTEPH) are unknown. In this study, RV changes associated with riociguat therapy were investigated. Six patients with CTEPH received riociguat for 6 months. Right heart catheterization (only baseline), cardiac magnetic resonance imaging, and positron emission tomography using tracers for myocardial glucose uptake (18F-fluorodeoxyglucose [18F-FDG]) and perfusion (13N-ammonia) were performed at baseline and follow-up time points. At baseline, median RV ejection fraction (RVEF) was 47% (22%-53%) with a mean pulmonary artery pressure (PAP) of 42 mm Hg (27-57 mmHg). Two patients were New York Heart Association functional class III and the rest were class II. Baseline RV 18F-FDG uptake was inversely correlated with RVEF (rs = -0.82; P = 0.04) and positively correlated with mean PAP (rs = 0.94; P = 0.004). Riociguat treatment was associated with a significant increase in RV stroke volume index by 13.5 mL/m2 (6.8-17.5 mL/m2; P = 0.03) and a trend of improved RVEF by 5% (1%-9%; P = 0.09). Myocardial fibrosis indicated by the volume of myocardium exhibiting late gadolinium enhanceme...Continue Reading

Citations

Nov 30, 2019·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·M C J van ThorM C Post
May 3, 2019·Heart Failure Reviews·Yi ZhangZhihong Liu

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