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.