Effect of ambrisentan on echocardiographic and Doppler measures from patients in China with pulmonary arterial hypertension

Abstract

Background:We retrospectively evaluated the echocardiographic data of ambrisentan-treated patients with pulmonary arterial hypertension (PAH) (NCT01808313). Methods: Change from baseline in right ventricle (RV) systolic function, right heart structure, and pulmonary artery systolic pressure (PASP) prognosis to Weeks 12 and 24 was evaluated by echocardiography. Results: In the overall population, the mean tissue Doppler-derived tricuspid lateral annular systolic velocity (S') increased by 0.6 cm/s at both Weeks 12 (p < 0.001) and 24 (p = 0.004) and tricuspid annular plane systolic excursion increased by 0.13 cm at Week 12 and 0.15 cm at Week 24 (both p < 0.001). A marked decrease in transverse and longitudinal RV and RA diameter at Weeks 12 and 24 was observed. A significant decrease in diastolic eccentricity index at both Weeks 12 (−0.1; p = 0.02) and 24 (−0.1; p = 0.001). The decrease in PASP from baseline was significant at both Weeks 12 (−9.5 mmHg; p<0.001) and 24 (-7.6 mmHg; p<0.001), while a decrease in the estimated right atrium pressure was found to be significant at Week 24 (−0.8mmHg; p = 0.01). Conclusion:Significant improvements in a number of RV echocardiographic parameters were observed at Weeks 12 and 24 after ambrisentan treatment in patients with PAH.

Riociguat and the right ventricle in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

“…RV function was also improved in patients with PAH undergoing treatment with pharmacological therapies other than riociguat, including inhaled iloprost [50,51], bosentan [52,53], sildenafil [54,55], ambrisentan [56] and the following combination therapies: endothelin receptor antagonist (ERA) or PDE5i plus parenteral prostanoid [57], ERA plus PDE5i [57], ambrisentan plus tadalafil [58], and ambrisentan plus tadalafil plus subcutaneous treprostinil [59]. In patients with CTEPH, RV function was improved following therapy with bosentan [60] and sildenafil [61], and surgical treatment with PEA [62,63] and BPA [64][65][66][67].…”

“…Sildenafil monotherapy [ 54 ], ambrisentan monotherapy [ 56 ] and combination therapies of ERA or PDE5i plus parenteral prostanoid [ 57 ], ERA plus PDE5i [ 57 ], and ambrisentan plus tadalafil plus subcutaneous treprostinil [ 59 ] have also been shown to improve RV morphology in patients with PAH. In patients with CTEPH, RV hypertrophy was reduced after PEA [ 70 , 71 ] and BPA [ 66 , 72 ].…”