Non-invasive monitoring of specific therapy effectiveness in pulmonary arterial hypertension patients

Aim: to assess the dynamic of cardiac remodeling by magnetic resonance imaging (MRI) in pulmonary arterial hypertension (PAH) patients as a result of combination specific therapy including selexipag intake in long-term use (up to 12-month).

Materials and methods. The study was performed on 50 PAH patients being observed at department of pulmonary hypertension and heart diseases of E.I. Chazov National Medical Research Center of Cardiology. A comparative analysis of clinical, functional and hemodynamic parameters, including cardiac MRI, was performed in all participants and resulted in selexipag administration.

Results. Right ventricular end-systolic volume index (RVESVI) correlated with N-terminal pro-brain natriuretic peptide (NT-proBNP) ratio (p=0,0002), RVESVI also correlated with systolic pulmonary arterial pressure (SPAP) (p=0,0019), right ventricle stroke volume index (RVSVI) correlated with NT-proBNP ratio (p<0,0001), RVSVI also correlated with SPAP (p=0,0007). The use of selexipag as part of a combined PAH-specific therapy resulted in right atrial volume reduction, right ventricle ejection fraction and RVSVI increase, which were assessed by cardiac MRI.

Conclusion. Cardiac MRI as noninvasive method for assessment of right ventricle size and function in PAH patients either at therapy administration or therapy effectiveness assess is a promising direction for approaches development of new prognostic parameters in PAH risk stratification.

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