Evidence map›Paper›PMID 38224960›Full record

ArticleESC heart failure2024

Impact of rapid sequential combination therapy on distinct haemodynamic measures in newly diagnosed pulmonary arterial hypertension.

Tilmann Kramer, Phillip Nattmann, Felix Gerhardt, Patrycja Stafiej, Daniel Dumitrescu, Henrik Ten Freyhaus, Max Wißmüller, Christopher Hohmann, Stephan Baldus, Stephan Rosenkranz

Open access · goldAbstract read
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. 2024 update in heart failure.ESC heart failure · 2025
    Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Tilmann KramerKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Phillip NattmannKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Felix GerhardtKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Patrycja StafiejKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Daniel DumitrescuKlinik für Allgemeine und Interventionelle Kardiologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany.
Henrik Ten FreyhausKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Max WißmüllerKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Christopher HohmannKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Stephan BaldusKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.
Stephan RosenkranzKlinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Cologne, Germany.ORCID https://orcid.org/0000-0001-6237-1470
University of Cologne · DEHeart and Diabetes Center North Rhine-Westphalia · DE

Funding

Actelion Pharmaceuticals research grant
6 · The paper itself

Abstract

aimsIn pulmonary arterial hypertension (PAH), upfront combination therapy with ERA and PDE5i is associated with a reduction in morbidity and mortality events and improves standard haemodynamics, but data remain limited. Aims of this study were (i) to capture detailed haemodynamic effects of rapid sequential dual combination therapy in patients with newly diagnosed PAH; (ii) to monitor the impact of treatment initiation on clinical variables and patients' risk status, and (iii) to compare the treatment effect in patients with 'classical PAH' and 'PAH with co-morbidities'.

methodsFifty patients (median age 57 [42-71] years, 66% female) with newly diagnosed PAH (76% idiopathic) were treated with a PD5i/sGC-S or ERA, followed by addition of the respective other drug class within 4 weeks. All patients underwent repeat right heart catheterization (RHC) during early follow-up.

resultsAt early repeat RHC (7 ± 2 months), there were substantial reductions in mean pulmonary artery pressure (mPAP: 52.2 ± 13.5 to 39.0 ± 10.6 mmHg; -25.3%), and pulmonary vascular resistance (PVR: 12.1 ± 5.7 to 5.8 ± 3.1 WU; -52.1%), and an increase in cardiac index (2.1 ± 0.4 to 2.7 ± 0.7 mL/min/m

conclusionsRapid sequential combination therapy with PDE5i/sGC-S and ERA substantially ameliorates cardiopulmonary haemodynamics at early follow-up in patients without, and to a lesser extent, with cardiovascular co-morbidities. This occurs in line with improvements of clinical parameters and risk status.

Indexed as

Drug Therapy, CombinationHemodynamicsPhosphodiesterase 5 InhibitorsAdultAgedAntihypertensive AgentsCardiac CatheterizationEndothelin Receptor AntagonistsFemaleFollow-Up StudiesHumansMaleMiddle AgedPulmonary Arterial HypertensionTime FactorsTreatment OutcomeAntihypertensive AgentsEndothelin Receptor AntagonistsPhosphodiesterase 5 InhibitorsCombination therapyEndothelin receptor antagonistHaemodynamicsPhosphodiesterase type 5 inhibitorPulmonary arterial hypertension (PAH)

Identifiers

PMID38224960
PMCPMC11098663
OpenAlexW4390893701

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.