Vericiguat and transcatheter edge-to-edge mitral valve repair for combined post- and pre-capillary pulmonary hypertension due to left ventricular low ejection fraction and functional mitral regurgitation

• Published in: Journal of cardiology cases Vol. 29; no. 2; pp. 78 - 81
• Main Authors: Murakami, Tsutomu, Ohno, Yohei, Horinouchi, Hitomi, Noda, Satoshi, Hashimoto, Kaho, Miyamoto, Junichi, Kamioka, Norihiko, Natsumeda, Makoto, Tanaka, Shigemitsu, Ikari, Yuji
• Format: Journal Article
• Language: English
• Published: Japan Elsevier Ltd 01.02.2024; Japanese College of Cardiology
• Subjects: Case Report; Mitral regurgitation; Oral soluble guanylate cyclase stimulator; Pulmonary hypertension; Transcatheter edge-to-edge mitral valve repair; Mitral regurgitation; Oral soluble guanylate cyclase stimulator; Transcatheter edge-to-edge mitral valve repair; Pulmonary hypertension
• ISSN: 1878-5409; 1878-5409
• DOI: 10.1016/j.jccase.2023.10.011

A 66-year-old female was diagnosed with combined post- and pre-capillary pulmonary hypertension due to heart failure with reduced ejection fraction (47 %) and functional mitral regurgitation [mean pulmonary arterial wedge pressure: 27 mmHg; pulmonary arterial pressure: 91/30 (56) mmHg; pulmonary vascular resistance: 12.9 Wood units; and cardiac index: 1.77 L/min/m2]. Following treatment with vericiguat (a novel oral soluble guanylate cyclase stimulator), hemodynamics improved [mean pulmonary arterial wedge pressure: 27 mmHg; pulmonary arterial pressure: 54/26 (35) mmHg; pulmonary vascular resistance: 2.2 Wood units; and cardiac index: 2.80 L/min/m2]. Therefore, transcatheter edge-to-edge repair for functional mitral regurgitation was performed. One month later, further improvement in hemodynamics was confirmed. Vericiguat (a novel oral soluble guanylate cyclase stimulator) and transcatheter edge-to-edge mitral valve repair may improve combined post- and pre-capillary pulmonary hypertension due to low ejection fraction of the left ventricle and functional mitral regurgitation.