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Riociguat improves excessive exercise ventilation in patients with inoperable chronic thromboembolic pulmonary hypertension

Roberta Pulcheri Ramos, Priscila Figueiredo, Eloara V.M. Ferreira, Carolina Messina, Rudolf Oliveira, J. Alberto Neder, Luiz Eduardo Nery, Jaquelina Sonoe Ota Arakaki
European Respiratory Journal 2013 42: P2596; DOI:
Roberta Pulcheri Ramos
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Priscila Figueiredo
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Eloara V.M. Ferreira
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Carolina Messina
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Rudolf Oliveira
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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J. Alberto Neder
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Luiz Eduardo Nery
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Jaquelina Sonoe Ota Arakaki
1Pulmonary Circulation Group, Federal University of Sao Paulo, Sao Paulo, Brazil
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Abstract

Rationale: Excessive exercise ventilation in patients with CTEPH is thought to be mainly attributable to increased physiological dead space ventilation due to proximal obstructive thrombotic lesions. Accordingly, pulmonary endarterectomy has been shown to improve ventilatory responses during exercise. The impact of drug therapy on such alterations is still to be determined.

Objective: To evaluate the effect of riociguat on the excessive exercise ventilation in patients with inoperable CTEPH

Methods: 6 patients with inoperable CTEPH performed a symptom-limited ramp-incremental cardiopulmonary exercise testing (CPET) on a cycle ergometer before and 8-12 months after treatment with riociguat.

Results: Long term treatment with riociguat significantly improved six minute walk distance (382 ± 63 to 431 ± 75m, p< 0.05). CPET demonstrated an improvement in ventilatory response to carbon dioxide output during exercise (ΔVE/ΔVCO2) from 65 ± 18 to 46 ± 7 (p< 0.05) and Peak PETCO2 (20 ± 4 to 26 ± 4mmHg, p <0.05), despite a non-significant difference in Peak O2 (861±169mL to 927± 141mL, p>0.05).

Conclusions: Riociguat improves excessive exercise ventilation in patients with inoperable distal CTEPH.

  • Pulmonary hypertension
  • Embolism
  • Exercise
  • © 2013 ERS
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Riociguat improves excessive exercise ventilation in patients with inoperable chronic thromboembolic pulmonary hypertension
Roberta Pulcheri Ramos, Priscila Figueiredo, Eloara V.M. Ferreira, Carolina Messina, Rudolf Oliveira, J. Alberto Neder, Luiz Eduardo Nery, Jaquelina Sonoe Ota Arakaki
European Respiratory Journal Sep 2013, 42 (Suppl 57) P2596;

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Riociguat improves excessive exercise ventilation in patients with inoperable chronic thromboembolic pulmonary hypertension
Roberta Pulcheri Ramos, Priscila Figueiredo, Eloara V.M. Ferreira, Carolina Messina, Rudolf Oliveira, J. Alberto Neder, Luiz Eduardo Nery, Jaquelina Sonoe Ota Arakaki
European Respiratory Journal Sep 2013, 42 (Suppl 57) P2596;
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