B67-17 Echocardiographic Outcomes of Sotatercept-Treated Patients With Different Hemodynamic Response: A Retrospective Analysis

Methods A retrospective review was conducted using a database from a ComprehensivePulmonary Hypertension Center, including patients treated with sotatercept. Echocardiographicparameters from three hemodynamic response groups: responders (mPAP and PVRimprovement; n = 30), non-responders (mPAP and PVR unchanged or worsened; n = 3), andincongruent responders (mPAP improvement with PVR worsening; n = 7), were compared beforeand after six months of treatment. Results Data from 40 patients (88%; mean age 51 years) were analyzed. Overall, 70% receivedsystemic prostanoid therapy in combination with oral agents. Mean? baseline echocardiographicmeasures included a right atrial pressure (RAP) 4.5 mmHg, right atrial area (RAA) 19.5 cm², right ventricular systolic pressure (RVSP) 58.4 mmHg, tricuspid annular plane systolic excursion(TAPSE) 1.86 mm, fractional area change (FAC) 29.9%, right ventricular ejection fraction(RVEF) 40.2%, S’ 11.7 cm/s, right ventricular basal diameter (RVBD) 4.4 cm, and RV/LV ratio1.07. At baseline, 64.0% of patients had RV dilation and 34.0% had trace pericardial effusion.No significant differences in baseline demographic or clinical data were observed amongresponders and non-responders. Incongruent responder group had numerically lower mPAP andPVR as well as higher CO and 6MWD (Table 1).Among responders, the following parameters improved: RAA decreased by 4.8 cm² (P < 0.05),RVSP by 20.8 mmHg (P < 0.05), RVBD by 0.62 cm (P < 0.05), RV/LV ratio by 0.15 (P < 0.05),;TAPSE/RVSP by 0.3 (P < 0.05), FAC increased by 3.8% (P < 0.05), RVEF by 0.8% (NS), andS’ by 1.1 cm/s (NS). The following parameters remained stable: RAP, TAPSE, RVEF. New orworsening pericardial effusion occurred in 13.3% (4/30) with no patients developing largeeffusions and 3.3% (1/30) with moderate effusion.Among incongruent responders, RAP, RVSP, TAPSE, TAPSE/RVSP, FAC, RVEF, S’, RVBD,and RV/LV were unchanged. RAA decreased by 2.6 cm² (P < 0.05). New or pericardial effusiondeveloped in 28.6% (2/7) with a large effusion in 1/7 (14.3%) patients.Among non-responders, only one patient had a follow up echocardiogram which showedimprovement in multiple parameters of the RV function including TAPSE, TAPSE/FAFSE,FAC, RVEF, S’ without new pericardial effusion. Conclusion Patients with hemodynamic response to sotatercept showed improvement in mostechocardiogram parameters of RV function. In patients with incongruent hemodynamic response, indicators of RV function remained unchanged. This population will need to be studiedclosely in the future to determine long term effect of sotatercept therapy. This abstract is funded by: None