The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients

cardiac magnetic resonance feature tracking study

Takahiro Sato, Bharath Ambale-Venkatesh, Joao A.C. Lima, Stefan L. Zimmerman, Ryan J. Tedford, Tomoki Fujii, Olivia L. Hulme, Erica H. Pullins, Celia P. Corona-Villalobos, Roham T. Zamanian, Omar A. Minai, Reda E. Girgis, Kelly Chin, Rubina Khair, Rachel L. Damico, Todd M. Kolb, Stephen C. Mathai, Paul M. Hassoun

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.

Original languageEnglish (US)
JournalPulmonary Circulation
Volume8
Issue number1
DOIs
StatePublished - Feb 1 2018

Fingerprint

Pulmonary Hypertension
Right Ventricular Function
Magnetic Resonance Spectroscopy
Left Ventricular Function
Systemic Scleroderma
Atrial Pressure
Brain Natriuretic Peptide
Therapeutics
Magnetic Resonance Imaging
ambrisentan
Tadalafil

Keywords

  • cardiac magnetic resonance imaging
  • combination therapy
  • pulmonary arterial hypertension
  • strain and strain rate
  • systemic sclerosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients : cardiac magnetic resonance feature tracking study. / Sato, Takahiro; Ambale-Venkatesh, Bharath; Lima, Joao A.C.; Zimmerman, Stefan L.; Tedford, Ryan J.; Fujii, Tomoki; Hulme, Olivia L.; Pullins, Erica H.; Corona-Villalobos, Celia P.; Zamanian, Roham T.; Minai, Omar A.; Girgis, Reda E.; Chin, Kelly; Khair, Rubina; Damico, Rachel L.; Kolb, Todd M.; Mathai, Stephen C.; Hassoun, Paul M.

In: Pulmonary Circulation, Vol. 8, No. 1, 01.02.2018.

Research output: Contribution to journalArticle

Sato, T, Ambale-Venkatesh, B, Lima, JAC, Zimmerman, SL, Tedford, RJ, Fujii, T, Hulme, OL, Pullins, EH, Corona-Villalobos, CP, Zamanian, RT, Minai, OA, Girgis, RE, Chin, K, Khair, R, Damico, RL, Kolb, TM, Mathai, SC & Hassoun, PM 2018, 'The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients: cardiac magnetic resonance feature tracking study', Pulmonary Circulation, vol. 8, no. 1. https://doi.org/10.1177/2045893217748307
Sato, Takahiro ; Ambale-Venkatesh, Bharath ; Lima, Joao A.C. ; Zimmerman, Stefan L. ; Tedford, Ryan J. ; Fujii, Tomoki ; Hulme, Olivia L. ; Pullins, Erica H. ; Corona-Villalobos, Celia P. ; Zamanian, Roham T. ; Minai, Omar A. ; Girgis, Reda E. ; Chin, Kelly ; Khair, Rubina ; Damico, Rachel L. ; Kolb, Todd M. ; Mathai, Stephen C. ; Hassoun, Paul M. / The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients : cardiac magnetic resonance feature tracking study. In: Pulmonary Circulation. 2018 ; Vol. 8, No. 1.
@article{78121ecbf0804712a56cb42f5f29ca8a,
title = "The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients: cardiac magnetic resonance feature tracking study",
abstract = "The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.",
keywords = "cardiac magnetic resonance imaging, combination therapy, pulmonary arterial hypertension, strain and strain rate, systemic sclerosis",
author = "Takahiro Sato and Bharath Ambale-Venkatesh and Lima, {Joao A.C.} and Zimmerman, {Stefan L.} and Tedford, {Ryan J.} and Tomoki Fujii and Hulme, {Olivia L.} and Pullins, {Erica H.} and Corona-Villalobos, {Celia P.} and Zamanian, {Roham T.} and Minai, {Omar A.} and Girgis, {Reda E.} and Kelly Chin and Rubina Khair and Damico, {Rachel L.} and Kolb, {Todd M.} and Mathai, {Stephen C.} and Hassoun, {Paul M.}",
year = "2018",
month = "2",
day = "1",
doi = "10.1177/2045893217748307",
language = "English (US)",
volume = "8",
journal = "Pulmonary Circulation",
issn = "2045-8932",
publisher = "University of Chicago Press",
number = "1",

}

TY - JOUR

T1 - The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients

T2 - cardiac magnetic resonance feature tracking study

AU - Sato, Takahiro

AU - Ambale-Venkatesh, Bharath

AU - Lima, Joao A.C.

AU - Zimmerman, Stefan L.

AU - Tedford, Ryan J.

AU - Fujii, Tomoki

AU - Hulme, Olivia L.

AU - Pullins, Erica H.

AU - Corona-Villalobos, Celia P.

AU - Zamanian, Roham T.

AU - Minai, Omar A.

AU - Girgis, Reda E.

AU - Chin, Kelly

AU - Khair, Rubina

AU - Damico, Rachel L.

AU - Kolb, Todd M.

AU - Mathai, Stephen C.

AU - Hassoun, Paul M.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.

AB - The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH.

KW - cardiac magnetic resonance imaging

KW - combination therapy

KW - pulmonary arterial hypertension

KW - strain and strain rate

KW - systemic sclerosis

UR - http://www.scopus.com/inward/record.url?scp=85044381727&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044381727&partnerID=8YFLogxK

U2 - 10.1177/2045893217748307

DO - 10.1177/2045893217748307

M3 - Article

VL - 8

JO - Pulmonary Circulation

JF - Pulmonary Circulation

SN - 2045-8932

IS - 1

ER -