Effect of riociguat on pulmonary arterial compliance in the PATENT and CHEST studies

被引：6

作者：

Thenappan, Thenappan ^{[1
]}

Al-Naamani, Nadine ^{[2
]}

Ghio, Stefano ^{[3
]}

Ghofrani, Hossein-Ardeschir ^{[4
,5
,6
]}

Hassoun, Paul M. ^{[7
]}

Pritzker, Marc ^{[1
]}

Torbicki, Adam ^{[8
]}

Nikkho, Sylvia ^{[9
]}

Busse, Dennis ^{[10
]}

Preston, Ioana R. ^{[11
]}

机构：

[1] Univ Minnesota, Div Cardiol, Minneapolis, MN 55455 USA

[2] Univ Penn, Pulm Crit Care & Sleep Div, Philadelphia, PA USA

[3] Univ Hosp, Fdn IRCCS Policlin San Matteo, Div Cardiol, Pavia, Italy

[4] Univ Giessen & Marburg Lung Ctr UGMLC, Dept Med, Giessen, Germany

[5] German Ctr Lung Res DZL, Giessen, Germany

[6] Imperial Coll London, Dept Med, London, England

[7] Johns Hopkins Univ, Sch Med, Div Pulm & Crit Care Med, Baltimore, MD USA

[8] ECZ Otwock, Ctr Postgrad Med Educ, Dept Pulm Circulat & Thromboembol Dis, Otwock, Poland

[9] Bayer AG, Global Clin Dev, Berlin, Germany

[10] Chrestos Concept GmbH & Co KG Essen, Essen, Germany

[11] Tufts Univ, Med Ctr, Pulm Crit Care & Sleep Div, Boston, MA USA

来源：

PULMONARY CIRCULATION | 2020年 / 10卷 / 04期

关键词：

pulmonary hypertension; pulmonary hemodynamics; pulmonary arterial hypertension; chronic thromboembolic pulmonary hypertension; riociguat;

D O I：

10.1177/2045894020963836

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Pulmonary arterial compliance is a measure of the pulsatile afterload of the right ventricle. Lower pulmonary arterial compliance is associated with reduced right ventricular function and worse prognosis in pulmonary hypertension. The effect of pulmonary vasodilators on pulmonary arterial compliance has not been evaluated in detail in pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. In this post hoc analysis of patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension in the PATENT and CHEST studies, we evaluated the change in pulmonary arterial compliance with riociguat versus placebo. Association of pulmonary arterial compliance with clinical outcomes was assessed using Kaplan-Meier and Cox proportional hazards analyses. Compared with placebo, riociguat significantly improved pulmonary arterial compliance in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Pulmonary arterial compliance at baseline was associated with survival and clinical worsening-free survival in pulmonary arterial hypertension but only with clinical worsening-free survival in chronic thromboembolic pulmonary hypertension. In patients with pulmonary arterial hypertension, pulmonary arterial compliance at follow-up >= 1.6 mL/mmHg was associated with better outcomes than pulmonary arterial compliance <1.6 mL/mmHg. In patients with chronic thromboembolic pulmonary hypertension, pulmonary arterial compliance at follow-up did not predict outcomes. Cox proportional hazards analyses showed no association between change in pulmonary arterial compliance and outcomes in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. In conclusion, riociguat improved pulmonary arterial compliance in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Pulmonary arterial compliance at baseline or follow-up, rather than change in pulmonary arterial compliance, is of prognostic importance for outcomes.

引用

页数：11

共 35 条

[1] REVEAL risk score in patients with chronic thromboembolic pulmonary hypertension receiving riociguat [J].