Pulmonary vascular disease & thromboembolism
Impact of Rapid Sequential Combination Therapy on Distinct Haemodynamic Measures in Newly Diagnosed Pulmonary Arterial Hypertension
Authors' conclusion
Rapid sequential combination therapy with PDE5i/sGC-S and ERA substantially ameliorates cardiopulmonary haemodynamics at early follow-up in patients without, and to a lesser extent, with cardiovascular co-morbidities.
Study context
- Population
- Newly diagnosed pulmonary arterial hypertension (PAH) (76% idiopathic), median age 57 years, 66% female
- Participants
- 50 participants
- Exposure
- Rapid sequential dual combination therapy, before vs after
- Few co-morbiditiesn = 37reference
- Multiple co-morbiditiesn = 13
- Outcome
- Haemodynamic effects at repeat right heart catheterization (mPAP, PVR, cardiac index)
- Follow-up
- 7 ± 2 months
Main finding
As reported in the abstract
mPAP 52.2 ± 13.5 to 39.0 ± 10.6 mmHg
−25.3%
PVR 12.1 ± 5.7 to 5.8 ± 3.1 WU
−52.1%
Cardiac index 2.1 ± 0.4 to 2.7 ± 0.7 mL/min/m²
+32.2%
Observational data: associations, not effects.
Further findings
Haemodynamics by co-morbidity status
Baseline PVR Few co-morbidities 13.1 ± 5.9 WU · Multiple co-morbidities 9.3 ± 4.4 WU
PVR reduction Few co-morbidities −54.7% · Multiple co-morbidities −42.7%
SVI Few co-morbidities +49.2% · Multiple co-morbidities +50.0%
PAC
Clinical parameters · 12 months
- 6-min walking distance 336 ± 315 to 389 ± 120 m
- P < 0.05
- NTproBNP 1.712 ± 2.024 to 506 ± 550 ng/L
- P < 0.05
- Improved WHO-FC and risk status
Haemodynamics by co-morbidity status
- 4-strata risk assessment better captured treatment response, particularly with co-morbidities
Original publication
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