Abstract
The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.
| Original language | English (US) |
|---|---|
| Journal | Pulmonary Circulation |
| Volume | 8 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 1 2018 |
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Keywords
- cardiac magnetic resonance imaging
- combination therapy
- pulmonary arterial hypertension
- strain and strain rate
- systemic sclerosis
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients : cardiac magnetic resonance feature tracking study. / Sato, Takahiro; Ambale Venkatesh, Bharath; Lima, Joao; Zimmerman, Stefan; Tedford, Ryan J.; Fujii, Tomoki; Hulme, Olivia L.; Pullins, Erica H.; Corona Villalobos, Celia; Zamanian, Roham T.; Minai, Omar A.; Girgis, Reda E.; Chin, Kelly; Khair, Rubina; Damico, Rachel L; Kolb, Todd Matthew; Mathai, Stephen; Hassoun, Paul M.
In: Pulmonary Circulation, Vol. 8, No. 1, 01.02.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients
T2 - cardiac magnetic resonance feature tracking study
AU - Sato, Takahiro
AU - Ambale Venkatesh, Bharath
AU - Lima, Joao
AU - Zimmerman, Stefan
AU - Tedford, Ryan J.
AU - Fujii, Tomoki
AU - Hulme, Olivia L.
AU - Pullins, Erica H.
AU - Corona Villalobos, Celia
AU - Zamanian, Roham T.
AU - Minai, Omar A.
AU - Girgis, Reda E.
AU - Chin, Kelly
AU - Khair, Rubina
AU - Damico, Rachel L
AU - Kolb, Todd Matthew
AU - Mathai, Stephen
AU - Hassoun, Paul M
PY - 2018/2/1
Y1 - 2018/2/1
N2 - The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.
AB - The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.
KW - cardiac magnetic resonance imaging
KW - combination therapy
KW - pulmonary arterial hypertension
KW - strain and strain rate
KW - systemic sclerosis
UR - http://www.scopus.com/inward/record.url?scp=85044381727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044381727&partnerID=8YFLogxK
U2 - 10.1177/2045893217748307
DO - 10.1177/2045893217748307
M3 - Article
C2 - 29251556
AN - SCOPUS:85044381727
VL - 8
JO - Pulmonary Circulation
JF - Pulmonary Circulation
SN - 2045-8932
IS - 1
ER -