Two studies presented at CHEST 2020 assessed the impact of macitentan on cardiac function in pulmonary arterial hypertension (PAH) and determined what role reproducible exercise echocardiographic parameters have in predicting survival.
Two study abstracts presented at the CHEST 2020 annual meeting explored the use of echocardiography in pulmonary arterial hypertension (PAH), with 1 study assessing the impact of macitentan on cardiac function in PAH as measured by echocardiography and the other determining what role reproducible exercise echocardiographic parameters have in predicting survival of the condition.
In the first abstract,1 researchers assessed a subgroup of 46 treatment-naïve patients with PAH enrolled in the 52-week, multicenter, open-label, single-arm phase 4 REPAIR study. Among these patients who were treated with macitentan, the researchers observed notable improvements in right ventricular (RV) function as determined by echocardiography.
By week 26, key RV variables measured by echocardiography showed:
According to the researchers, for parameters that saw significant improvements by week 26, findings were maintained at week 52.
“In the REPAIR echo substudy, macitentan treatment was associated with significant improvements in RV function measured by echo at week 26 and 52, including RVEDD, RVSV, TAPSE, and RV strain, key prognostic markers in PAH,” wrote the researchers, reflecting on the findings. “Normalization of the mitral flow (E/A ratio) suggests that these improvements in RV function are also associated with improved left ventricle diastolic function.”
The second abstract2 compiled data on 45 patients with PAH to determine the role of RV exercise stress echocardiography, a less established method than transthoracic echocardiography, in risk assessment of PAH.
Each patient received an echocardiography of their RV parameters in the apical 4-chamber view at rest and during exercise using a bicycle ergometer. Results showed that TAPSE and RV FAC during exercise had strong associations with subsequent PAH mortality. Mortality also trended with RV sphericity index, although it was not statistically significant.
“Reproducible exercise echocardiographic parameters may have a role in clinical management of PAH,” wrote the researchers. “Use of these parameters can also aid PAH study design through better identification of PAH subjects at increased risk of clinical deterioration and mortality.”
Notably, a decline in TAPSE during exercise was strongly associated with mortality, with researchers observing trends for decreasing FAC and increasing exercise RV sphericity during the exercise.
References
1. Torbicki A, Channick R, Cottreel E, et al. Effects of macitentan on cardiac function in pulmonary arterial hypertension: results from the REPAIR echocardiography substudy. Presented at: CHEST 2020; October 18-21, 2020. Abstract 2227A. doi:10.1016/j.chest.2020.08.1899
2. El-Yafawi R, Cohen A, Wirth J. Does right ventricle exercise stress echocardiography predict survival in PAH? Presented at: CHEST 2020; October 18-21, 2020. Abstract 2161A. doi:10.1016/j.chest.2020.08.1859
Initiating BP Medication Linked to Higher Fall, Fracture Risks in Nursing Home Residents
May 2nd 2024Among over 60,000 nursing home residents who initiated antihypertensive medication, rates of excess fractures due to falls per 100 person-years were as high as 5 among certain patient groups, such as those with dementia and high blood pressure (BP).
Read More
Reducing Time Sitting Can Help Lower BP in Older Adults, Randomized Trial Finds
April 20th 2024The randomized trial found that reducing sitting time over a 6-month period was association with reduced systolic blood pressure (BP) among a group of older patients with obesity and high rates of hypertension.
Read More
Targeting MACC1 Offers Promising Therapeutic Strategy for PAH
April 10th 2024Positive responses seen following experiments involving metastasis-associated in colon cancer 1 (MACC1) indicate that the biomarker can be used to better diagnose and treat patients with pulmonary arterial hypertension (PAH).
Read More
Pandemic Care Gaps Associated With Loss of Hypertension Control, Study Finds
April 3rd 2024Surprisingly, the investigators found people with uncontrolled hypertension before the pandemic actually had a slightly higher chance of getting their blood pressure under control during the crisis.
Read More