Artikel ; Online: Impact of rapid sequential combination therapy on distinct haemodynamic measures in newly diagnosed pulmonary arterial hypertension.
2024 Band 11, Heft 3, Seite(n) 1540–1552
Abstract: Aims: In pulmonary arterial hypertension (PAH), upfront combination therapy with ERA and PDE5i is associated with a reduction in morbidity and mortality events and improves standard haemodynamics, but data remain limited. Aims of this study were (i) to ... ...
| Abstract | Aims: In pulmonary arterial hypertension (PAH), upfront combination therapy with ERA and PDE5i is associated with a reduction in morbidity and mortality events and improves standard haemodynamics, but data remain limited. Aims of this study were (i) to capture detailed haemodynamic effects of rapid sequential dual combination therapy in patients with newly diagnosed PAH; (ii) to monitor the impact of treatment initiation on clinical variables and patients' risk status, and (iii) to compare the treatment effect in patients with 'classical PAH' and 'PAH with co-morbidities'. Methods: Fifty patients (median age 57 [42-71] years, 66% female) with newly diagnosed PAH (76% idiopathic) were treated with a PD5i/sGC-S or ERA, followed by addition of the respective other drug class within 4 weeks. All patients underwent repeat right heart catheterization (RHC) during early follow-up. Results: At early repeat RHC (7 ± 2 months), there were substantial reductions in mean pulmonary artery pressure (mPAP: 52.2 ± 13.5 to 39.0 ± 10.6 mmHg; -25.3%), and pulmonary vascular resistance (PVR: 12.1 ± 5.7 to 5.8 ± 3.1 WU; -52.1%), and an increase in cardiac index (2.1 ± 0.4 to 2.7 ± 0.7 mL/min/m Conclusions: 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. This occurs in line with improvements of clinical parameters and risk status. |
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| Mesh-Begriff(e) | Humans ; Female ; Male ; Middle Aged ; Hemodynamics/physiology ; Hemodynamics/drug effects ; Aged ; Drug Therapy, Combination ; Adult ; Phosphodiesterase 5 Inhibitors/administration & dosage ; Phosphodiesterase 5 Inhibitors/therapeutic use ; Pulmonary Arterial Hypertension/drug therapy ; Pulmonary Arterial Hypertension/physiopathology ; Pulmonary Arterial Hypertension/diagnosis ; Follow-Up Studies ; Treatment Outcome ; Cardiac Catheterization/methods ; Antihypertensive Agents/administration & dosage ; Antihypertensive Agents/therapeutic use ; Vascular Resistance ; Time Factors ; Endothelin Receptor Antagonists/administration & dosage |
| Sprache | Englisch |
| Erscheinungsdatum | 2024-01-15 |
| Erscheinungsland | England |
| Dokumenttyp | Journal Article |
| ZDB-ID | 2814355-3 |
| ISSN | 2055-5822 ; 2055-5822 |
| ISSN (online) | 2055-5822 |
| ISSN | 2055-5822 |
| DOI | 10.1002/ehf2.14611 |
| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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