Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension

Nick H. Kim, Andrea M. D'Armini, Friedrich Grimminger, Ekkehard Grünig, Marius M. Hoeper, Pavel Jansa, Eckhard Mayer, Claus Neurohr, Gérald Simonneau, Adam Torbicki, Chen Wang, Arno Fritsch, Neil Davie, Hossein Ardeschir Ghofrani

Research output: Contribution to journalArticle

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Abstract

Objective: We compared the haemodynamic effects of riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy in the Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase-Stimulator Trial 1 study. Methods: Patients with inoperable or persistent/recurrent CTEPH (n=261; mean± SD age 59±14 years; 66% women) were randomised to riociguat (up to 2.5 mg three times daily) or placebo. Haemodynamic parameters were assessed at baseline and week 16. Results: Riociguat decreased pulmonary vascular resistance (PVR) in inoperable (n=189; least-squares mean difference: -285 dyn s/cm5 (95% CI -357 to -213); p<0.0001) and persistent/recurrent (n=72; -131 dyn s/cm5 (95% CI -214 to -48); p=0.0025) patients. Cardiac index improved in inoperable patients by a least-squares mean difference of +0.6 L/min/m2 (95% CI 0.4 to 0.7; p<0.0001), while in persistent/recurrent patients the change was +0.2 L/min/m2 (95% CI -0.1 to 0.5; p=0.17). Mean pulmonary artery pressure decreased in inoperable and persistent/recurrent patients(-4.7 mm Hg (95% CI -6.9 to -2.6; p<0.0001 and -4.8 mm Hg (-8.2 to -1.5; p=0.0055), respectively). For all patients, changes in 6 min walk distance correlated with changes in PVR (r=-0.29 (95% CI -0.41 to -0.17); p<0.0001) and cardiac index (r=0.23 (95% CI 0.10 to 0.35); p=0.0004). Conclusions: Riociguat improved haemodynamics in patients with inoperable CTEPH or persistent/recurrent CTEPH. Trial registration number: NCT00855465.

Original languageEnglish
Pages (from-to)599-606
Number of pages8
JournalHeart
Volume103
Issue number8
DOIs
Publication statusPublished - Apr 1 2017

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Pulmonary Hypertension
Hemodynamics
Least-Squares Analysis
Vascular Resistance
Endarterectomy
riociguat
Pulmonary Artery
Placebos
Pressure
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, N. H., D'Armini, A. M., Grimminger, F., Grünig, E., Hoeper, M. M., Jansa, P., ... Ghofrani, H. A. (2017). Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension. Heart, 103(8), 599-606. https://doi.org/10.1136/heartjnl-2016-309621

Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension. / Kim, Nick H.; D'Armini, Andrea M.; Grimminger, Friedrich; Grünig, Ekkehard; Hoeper, Marius M.; Jansa, Pavel; Mayer, Eckhard; Neurohr, Claus; Simonneau, Gérald; Torbicki, Adam; Wang, Chen; Fritsch, Arno; Davie, Neil; Ghofrani, Hossein Ardeschir.

In: Heart, Vol. 103, No. 8, 01.04.2017, p. 599-606.

Research output: Contribution to journalArticle

Kim, NH, D'Armini, AM, Grimminger, F, Grünig, E, Hoeper, MM, Jansa, P, Mayer, E, Neurohr, C, Simonneau, G, Torbicki, A, Wang, C, Fritsch, A, Davie, N & Ghofrani, HA 2017, 'Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension', Heart, vol. 103, no. 8, pp. 599-606. https://doi.org/10.1136/heartjnl-2016-309621
Kim, Nick H. ; D'Armini, Andrea M. ; Grimminger, Friedrich ; Grünig, Ekkehard ; Hoeper, Marius M. ; Jansa, Pavel ; Mayer, Eckhard ; Neurohr, Claus ; Simonneau, Gérald ; Torbicki, Adam ; Wang, Chen ; Fritsch, Arno ; Davie, Neil ; Ghofrani, Hossein Ardeschir. / Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension. In: Heart. 2017 ; Vol. 103, No. 8. pp. 599-606.
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abstract = "Objective: We compared the haemodynamic effects of riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy in the Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase-Stimulator Trial 1 study. Methods: Patients with inoperable or persistent/recurrent CTEPH (n=261; mean± SD age 59±14 years; 66{\%} women) were randomised to riociguat (up to 2.5 mg three times daily) or placebo. Haemodynamic parameters were assessed at baseline and week 16. Results: Riociguat decreased pulmonary vascular resistance (PVR) in inoperable (n=189; least-squares mean difference: -285 dyn s/cm5 (95{\%} CI -357 to -213); p<0.0001) and persistent/recurrent (n=72; -131 dyn s/cm5 (95{\%} CI -214 to -48); p=0.0025) patients. Cardiac index improved in inoperable patients by a least-squares mean difference of +0.6 L/min/m2 (95{\%} CI 0.4 to 0.7; p<0.0001), while in persistent/recurrent patients the change was +0.2 L/min/m2 (95{\%} CI -0.1 to 0.5; p=0.17). Mean pulmonary artery pressure decreased in inoperable and persistent/recurrent patients(-4.7 mm Hg (95{\%} CI -6.9 to -2.6; p<0.0001 and -4.8 mm Hg (-8.2 to -1.5; p=0.0055), respectively). For all patients, changes in 6 min walk distance correlated with changes in PVR (r=-0.29 (95{\%} CI -0.41 to -0.17); p<0.0001) and cardiac index (r=0.23 (95{\%} CI 0.10 to 0.35); p=0.0004). Conclusions: Riociguat improved haemodynamics in patients with inoperable CTEPH or persistent/recurrent CTEPH. Trial registration number: NCT00855465.",
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T1 - Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension

AU - Kim, Nick H.

AU - D'Armini, Andrea M.

AU - Grimminger, Friedrich

AU - Grünig, Ekkehard

AU - Hoeper, Marius M.

AU - Jansa, Pavel

AU - Mayer, Eckhard

AU - Neurohr, Claus

AU - Simonneau, Gérald

AU - Torbicki, Adam

AU - Wang, Chen

AU - Fritsch, Arno

AU - Davie, Neil

AU - Ghofrani, Hossein Ardeschir

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N2 - Objective: We compared the haemodynamic effects of riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy in the Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase-Stimulator Trial 1 study. Methods: Patients with inoperable or persistent/recurrent CTEPH (n=261; mean± SD age 59±14 years; 66% women) were randomised to riociguat (up to 2.5 mg three times daily) or placebo. Haemodynamic parameters were assessed at baseline and week 16. Results: Riociguat decreased pulmonary vascular resistance (PVR) in inoperable (n=189; least-squares mean difference: -285 dyn s/cm5 (95% CI -357 to -213); p<0.0001) and persistent/recurrent (n=72; -131 dyn s/cm5 (95% CI -214 to -48); p=0.0025) patients. Cardiac index improved in inoperable patients by a least-squares mean difference of +0.6 L/min/m2 (95% CI 0.4 to 0.7; p<0.0001), while in persistent/recurrent patients the change was +0.2 L/min/m2 (95% CI -0.1 to 0.5; p=0.17). Mean pulmonary artery pressure decreased in inoperable and persistent/recurrent patients(-4.7 mm Hg (95% CI -6.9 to -2.6; p<0.0001 and -4.8 mm Hg (-8.2 to -1.5; p=0.0055), respectively). For all patients, changes in 6 min walk distance correlated with changes in PVR (r=-0.29 (95% CI -0.41 to -0.17); p<0.0001) and cardiac index (r=0.23 (95% CI 0.10 to 0.35); p=0.0004). Conclusions: Riociguat improved haemodynamics in patients with inoperable CTEPH or persistent/recurrent CTEPH. Trial registration number: NCT00855465.

AB - Objective: We compared the haemodynamic effects of riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy in the Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase-Stimulator Trial 1 study. Methods: Patients with inoperable or persistent/recurrent CTEPH (n=261; mean± SD age 59±14 years; 66% women) were randomised to riociguat (up to 2.5 mg three times daily) or placebo. Haemodynamic parameters were assessed at baseline and week 16. Results: Riociguat decreased pulmonary vascular resistance (PVR) in inoperable (n=189; least-squares mean difference: -285 dyn s/cm5 (95% CI -357 to -213); p<0.0001) and persistent/recurrent (n=72; -131 dyn s/cm5 (95% CI -214 to -48); p=0.0025) patients. Cardiac index improved in inoperable patients by a least-squares mean difference of +0.6 L/min/m2 (95% CI 0.4 to 0.7; p<0.0001), while in persistent/recurrent patients the change was +0.2 L/min/m2 (95% CI -0.1 to 0.5; p=0.17). Mean pulmonary artery pressure decreased in inoperable and persistent/recurrent patients(-4.7 mm Hg (95% CI -6.9 to -2.6; p<0.0001 and -4.8 mm Hg (-8.2 to -1.5; p=0.0055), respectively). For all patients, changes in 6 min walk distance correlated with changes in PVR (r=-0.29 (95% CI -0.41 to -0.17); p<0.0001) and cardiac index (r=0.23 (95% CI 0.10 to 0.35); p=0.0004). Conclusions: Riociguat improved haemodynamics in patients with inoperable CTEPH or persistent/recurrent CTEPH. Trial registration number: NCT00855465.

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