Pulmonary vascular disease & thromboembolism
Effect of Balloon Pulmonary Angioplasty and Riociguat on Right Ventricular Afterload and Function in CTEPH: Insights From the RACE Trial
Authors' conclusion
Both riociguat and BPA are effective in improving RV afterload in inoperable chronic thromboembolic pulmonary hypertension. However, BPA provided a more substantial impact on RV afterload reduction, and RV function only improved with BPA.
Study context
- Population
- Patients with inoperable chronic thromboembolic pulmonary hypertension from the RACE trial with complete data for the primary end point assessmentpatients with complete data for the primary end point assessment, riociguat 49, balloon pulmonary angioplasty (BPA) 51, symptomatic patients with residual pulmonary vascular resistance >4 WU included in ancillary follow-up study: add-on riociguat after BPA 18, add-on BPA after riociguat 36
- Participants
- 49 / 51 / 18 / 36
- Comparison
- Riociguat Versus Balloon Pulmonary Angioplasty
- Riociguatn = 49
- BPAn = 51
- Add-on riociguatn = 18
- Add-on BPAn = 36
Methodological detailsancillary 26-week follow-up study
- Ancillary 26-week follow-up study
Primary result
As reported in the abstract
Cardiac output, stroke volume, and RV afterload · baseline to week 26
- Cardiac output, stroke volume, and right ventricular (RV) afterload improved significantly with riociguat and BPA, and the relative changes in RV afterload from baseline to week 26 were more pronounced in the BPA group
- all P <0.001
Further findings
Mediators of change in RV afterload
- Change in RV afterload was primarily mediated by decreased mean pulmonary arterial pressure in the BPA group, while increased cardiac output was the main driver in the riociguat group
RV function (RV stroke work and right atrial pressure)
- Key parameters of RV function (RV stroke work and right atrial pressure) improved only in the BPA group
RV afterload and RV function in ancillary follow-up study · week 26 to week 52
- Relative change in RV afterload from week 26 to week 52 was more pronounced with add-on BPA, and improved RV function was only observed in the add-on BPA group
Original publication
Effect of Balloon Pulmonary Angioplasty and Riociguat on Right Ventricular Afterload and Function in CTEPH: Insights From the RACE Trial. Circ Cardiovasc Interv. Published 18 February 2025. doi:10.
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