Effect of Macitentan in Pulmonary Arterial Hypertension and the Relationship Between Echocardiography and cMRI Variables : REPAIR Echocardiography Sub-study Results

© 2024. The Author(s)..

INTRODUCTION: The aim of this sub-study was to evaluate the relationship between echocardiography (echo) and cardiac magnetic resonance imaging (cMRI) variables and to utilize echo to assess the effect of macitentan on right ventricle (RV) structure and function.

METHODS: REPAIR (NCT02310672) was a prospective, multicenter, single-arm, open-label, 52-week, phase 4 study in pulmonary arterial hypertension (PAH) patients, which investigated the effect of macitentan 10 mg as monotherapy, or in combination with a phosphodiesterase 5 inhibitor, on RV structure, function, and hemodynamics using cMRI and right heart catheterization. In this sub-study, patients were also assessed by echo at screening and at weeks 26 and/or 52. Post hoc correlation analyses between echo and cMRI variables were performed using Pearson's correlation coefficient, Spearman's correlation coefficient, and Bland-Altman analyses.

RESULTS: The Echo sub-study included 45 patients. Improvements in echo-assessed RV stroke volume (RVSV), left ventricular SV (LVSV), LV end-diastolic volume (LVEDV), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), and in 2D global longitudinal RV strain (2D GLRVS) were observed at weeks 26 and 52 compared to baseline. There was a strong correlation between echo (LVSV, 2D GLRVS, and LVEDV) and cMRI variables, with a moderate correlation for RVSV. Bland-Altman analyses showed a good agreement for LVSV measured by echo versus cMRI, whereas an overestimation in echo-assessed RVSV was observed compared to cMRI (bias of - 15 mL). Hemodynamic and functional variables, as well as safety, were comparable between the Echo sub-study and REPAIR.

CONCLUSIONS: A good relationship between relevant echo and cMRI parameters was shown. Improvements in RV structure and function with macitentan treatment was observed by echo, consistent with results observed by cMRI in the primary analysis of the REPAIR study. Echo is a valuable complementary method to cMRI, with the potential to non-invasively monitor treatment response at follow-up.

TRIAL REGISTRATION NUMBER: REPAIR NCT02310672.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

Cardiology and therapy - 13(2024), 1 vom: 28. März, Seite 173-190

Sprache:

Englisch

Beteiligte Personen:

Torbicki, Adam [VerfasserIn]
Channick, Richard [VerfasserIn]
Galiè, Nazzareno [VerfasserIn]
Kiely, David G [VerfasserIn]
Moceri, Pamela [VerfasserIn]
Peacock, Andrew [VerfasserIn]
Swift, Andrew J [VerfasserIn]
Tawakol, Ahmed [VerfasserIn]
Vonk Noordegraaf, Anton [VerfasserIn]
Flores, Dayana [VerfasserIn]
Martin, Nicolas [VerfasserIn]
Rosenkranz, Stephan [VerfasserIn]

Links:

Volltext

Themen:

Agreement
Cardiac magnetic resonance imaging
Correlation
Echocardiography
Journal Article
Macitentan
Pulmonary arterial hypertension

Anmerkungen:

Date Revised 01.03.2024

published: Print-Electronic

ClinicalTrials.gov: NCT02310672

Citation Status PubMed-not-MEDLINE

doi:

10.1007/s40119-023-00345-2

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367717204