Pulmonary vascular disease & thromboembolismCohort study
Sotatercept Improves Right Heart Mechanics Despite Reduced Myocardial Contractility in Pulmonary Arterial Hypertension: A Prospective Exercise Hemodynamic Study
- Prospective single-group study
- exercise hemodynamic study
- simultaneous echocardiography and invasive pressure measurements
Authors' conclusion
Sotatercept decreases RV contractility in proportion to reduced afterload, while preserving the RV-PA coupling relationship. Despite decreased RV contractility, global measures of right heart performance, such as RV free wall strain and RA strain, improve, alongside redistribution of RV deformation from annular motion to free wall shortening.
Study context
- Population
- Participants with pulmonary arterial (PA) hypertension recruited between July 2024 and May 2025
- Participants
- 30 participants
- Exposure
- After vs before 24 weeks of sotatercept
- Outcome
- Load-independent RV contractility (Ees), RV-PA coupling (Ea/Ees) and right heart deformation at rest and exertion
- Follow-up
- 24 weeks
Main finding
As reported in the abstract
- PA Ea decreased with sotatercept; associated with reduced right ventricular (RV) contractility, PA pulsatility index and dP/dtmax
- P<0.001 for all
- Decrease in Ees associated with decrease in PA Ea (r, 95% CI +0.44 to +0.85)
- r=+0.70; P<0.0001
- RV-PA coupling preserved
- mean difference +0.08; P=0.42 (95% CI −0.11 to +0.26)
- RV free wall strain at rest and exercise increased
- mean difference +6.2%; P<0.0001 (95% CI +4.5 to +7.8)
- Fractional area change increased
- P=0.0001
- Improved right atrial filling and contractile performance across rest and exercise
- P<0.0001 for all
Observational data: associations, not effects.
Further findings
| Outcome | mean difference (%) (95% CI) | P value |
|---|---|---|
| RV free wall strain (rest and exercise) · 24 weeks | +6.2 (+4.5 to +7.8) | P < 0.0001 |
Fractional area change · 24 weeks
- Increased
- P = 0.0001
Basal RV systolic indices (TAPSE, lateral tricuspid annulus systolic velocity) · 24 weeks
- Decreased after sotatercept
Right atrial filling and contractile performance (rest and exercise) · 24 weeks
- Improved
- P < 0.0001 for all
Original publication
Summarised from the published abstract; every number is checked against it