Key result
Macitentan treatment improved right ventricular stroke volume by 11.6 mL at 26 weeks as assessed by echocardiography, which correlated moderately with cardiac magnetic resonance imaging.
Why the study?
The study was conducted to evaluate the relationship between echocardiography and cardiac magnetic resonance imaging variables, and to use echocardiography to assess the effect of macitentan on right ventricular structure and function in pulmonary arterial hypertension.
Does macitentan improve right ventricular structure and function as assessed by echocardiography in patients with pulmonary arterial hypertension?
Does macitentan improve right ventricular structure and function as assessed by echocardiography in patients with pulmonary arterial hypertension?
Mean Difference: 11.6 (95% CI 3.2–20)
Echocardiography is a valuable complementary method to cMRI for non-invasively monitoring improvements in right ventricular structure and function following macitentan treatment in patients with PAH.
Echo may reliably surrogate cMRI for RV monitoring with macitentan in PAH; extends accessible assessment in trials and care.
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.
No takes yet. Share an insight, caveat, or question.
Torbicki et al. (2024) studied Pulmonary Arterial Hypertension (n=45). Macitentan vs. Baseline was evaluated on Change in right ventricular stroke volume (RVSV) from baseline to week 26 assessed by echocardiography (MD 11.6 mL, 95% CI 3.2-20.0). Macitentan treatment improved right ventricular stroke volume by 11.6 mL at 26 weeks as assessed by echocardiography, which correlated moderately with cardiac magnetic resonance imaging.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: