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
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 vas...
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| Published in | Journal of cardiology cases Vol. 29; no. 2; pp. 78 - 81 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
Elsevier Ltd
01.02.2024
Japanese College of Cardiology |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1878-5409 1878-5409 |
| DOI | 10.1016/j.jccase.2023.10.011 |
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| Abstract | 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. |
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| AbstractList | 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. 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/m ]. 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/m ]. 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. 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.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.Learning objectiveVericiguat (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. |
| Author | Murakami, Tsutomu Ohno, Yohei Natsumeda, Makoto Hashimoto, Kaho Kamioka, Norihiko Horinouchi, Hitomi Ikari, Yuji Miyamoto, Junichi Tanaka, Shigemitsu Noda, Satoshi |
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| Cites_doi | 10.1016/j.jccase.2022.08.012 10.1016/j.jacc.2020.09.609 10.1056/NEJMoa1806640 10.1001/jama.2015.15734 10.1007/s10741-022-10251-9 10.1016/j.biopha.2022.112894 10.1056/NEJMoa1915928 10.1093/eurheartj/ehac237 |
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| Keywords | Mitral regurgitation Oral soluble guanylate cyclase stimulator Transcatheter edge-to-edge mitral valve repair Pulmonary hypertension |
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| References | Riccardi, Pagnesi, Sciatti, Lombardi, Inciardi, Metra (bb0020) 2023; 28 Xia, Hui, Tian, Liang, Zhang, Liu (bb0025) 2022; 149 Ben-Yehuda, Shahim, Chen, Liu, Redfors, Hahn (bb0040) 2020; 76 Humbert, Kovacs, Hoeper, Badagliacca, Berger, Brida (bb0010) 2022; 43 Gheorghiade, Greene, Butler, Filippatos, Lam, Maggioni (bb0030) 2015; 314 Imamura, Kinugawa (bb0035) 2022; 26 Stone, Lindenfeld, Abraham, Kar, Lim, Mishell (bb0005) 2018; 379 Armstrong, Pieske, Anstrom, Ezekowitz, Hernandez, Butler (bb0015) 2020; 382 Humbert (10.1016/j.jccase.2023.10.011_bb0010) 2022; 43 Riccardi (10.1016/j.jccase.2023.10.011_bb0020) 2023; 28 Ben-Yehuda (10.1016/j.jccase.2023.10.011_bb0040) 2020; 76 Imamura (10.1016/j.jccase.2023.10.011_bb0035) 2022; 26 Armstrong (10.1016/j.jccase.2023.10.011_bb0015) 2020; 382 Xia (10.1016/j.jccase.2023.10.011_bb0025) 2022; 149 Stone (10.1016/j.jccase.2023.10.011_bb0005) 2018; 379 Gheorghiade (10.1016/j.jccase.2023.10.011_bb0030) 2015; 314 |
| References_xml | – volume: 43 start-page: 3618 year: 2022 end-page: 3731 ident: bb0010 article-title: 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension publication-title: Eur Heart J – volume: 382 start-page: 1883 year: 2020 end-page: 1893 ident: bb0015 article-title: Vericiguat in patients with heart failure and reduced ejection fraction publication-title: N Engl J Med – volume: 28 start-page: 137 year: 2023 end-page: 148 ident: bb0020 article-title: Combined pre- and post-capillary pulmonary hypertension in left heart disease publication-title: Heart Fail Rev – volume: 26 start-page: 429 year: 2022 end-page: 431 ident: bb0035 article-title: Initial experience of vericiguat add-on therapy upon fantastic four medical therapy in a patient with systolic heart failure publication-title: J Cardiol Cases – volume: 379 start-page: 2307 year: 2018 end-page: 2318 ident: bb0005 article-title: Transcatheter mitral-valve repair in patients with heart failure publication-title: N Engl J Med – volume: 314 start-page: 2251 year: 2015 end-page: 2262 ident: bb0030 article-title: SOCRATES-REDUCED investigators and coordinators. Effect of vericiguat, a soluble guanylate cyclase stimulator, on natriuretic peptide levels in patients with worsening chronic heart failure and reduced ejection fraction: the SOCRATES-REDUCED randomized trial publication-title: JAMA – volume: 76 start-page: 2595 year: 2020 end-page: 2606 ident: bb0040 article-title: Pulmonary hypertension in transcatheter mitral valve repair for secondary mitral regurgitation: the COAPT trial publication-title: J Am Coll Cardiol – volume: 149 year: 2022 ident: bb0025 article-title: Development of vericiguat: the first soluble guanylate cyclase (sGC) stimulator launched for heart failure with reduced ejection fraction (HFrEF) publication-title: Biomed Pharmacother – volume: 26 start-page: 429 year: 2022 ident: 10.1016/j.jccase.2023.10.011_bb0035 article-title: Initial experience of vericiguat add-on therapy upon fantastic four medical therapy in a patient with systolic heart failure publication-title: J Cardiol Cases doi: 10.1016/j.jccase.2022.08.012 – volume: 76 start-page: 2595 year: 2020 ident: 10.1016/j.jccase.2023.10.011_bb0040 article-title: Pulmonary hypertension in transcatheter mitral valve repair for secondary mitral regurgitation: the COAPT trial publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2020.09.609 – volume: 379 start-page: 2307 year: 2018 ident: 10.1016/j.jccase.2023.10.011_bb0005 article-title: Transcatheter mitral-valve repair in patients with heart failure publication-title: N Engl J Med doi: 10.1056/NEJMoa1806640 – volume: 314 start-page: 2251 year: 2015 ident: 10.1016/j.jccase.2023.10.011_bb0030 publication-title: JAMA doi: 10.1001/jama.2015.15734 – volume: 28 start-page: 137 year: 2023 ident: 10.1016/j.jccase.2023.10.011_bb0020 article-title: Combined pre- and post-capillary pulmonary hypertension in left heart disease publication-title: Heart Fail Rev doi: 10.1007/s10741-022-10251-9 – volume: 149 year: 2022 ident: 10.1016/j.jccase.2023.10.011_bb0025 article-title: Development of vericiguat: the first soluble guanylate cyclase (sGC) stimulator launched for heart failure with reduced ejection fraction (HFrEF) publication-title: Biomed Pharmacother doi: 10.1016/j.biopha.2022.112894 – volume: 382 start-page: 1883 year: 2020 ident: 10.1016/j.jccase.2023.10.011_bb0015 article-title: Vericiguat in patients with heart failure and reduced ejection fraction publication-title: N Engl J Med doi: 10.1056/NEJMoa1915928 – volume: 43 start-page: 3618 year: 2022 ident: 10.1016/j.jccase.2023.10.011_bb0010 article-title: 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension publication-title: Eur Heart J doi: 10.1093/eurheartj/ehac237 |
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| SubjectTerms | Case Report Mitral regurgitation Oral soluble guanylate cyclase stimulator Pulmonary hypertension Transcatheter edge-to-edge mitral valve repair |
| Title | 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 |
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