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The soluble guanylate cyclase stimulator riociguat is the first-line therapy for chronic thromboembolic pulmonary hypertension patients

https://doi.org/10.18087/cardio.2020.8.n1198

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a precapillary type of pulmonary hypertension with chronic obstruction of large and medium branches of pulmonary arteries along with secondary alterations in pulmonary microcirculation, which cause progressive increases in pulmonary vascular resistance and pulmonary arterial pressure and ensuing severe right heart dysfunction and heart failure. Pulmonary thromboendarterectomy (PTE) is the treatment of choice for CTEPH; however, this procedure is available not for all patients. Although the surgery performed in the conditions of centers with advanced experience generally shows good results, up to 40% of patients are technically inoperable or PTE is associated with a high risk of complications. At present, riociguat, the only officially approved drug from the class of soluble guanylate cyclase stimulators, is considered as a first-line treatment for inoperable and residual forms of STEPH. Introduction of riociguat to clinical practice can be called a real breakthrough in the treatment of patients with STEPH who cannot undergo PTE or those with relapse or persistent STEPH after the surgery.

About the Authors

Z. S. Valieva
National Medical Research Center of Cardiology, Myasnikov Scientific Research Institute of Clinical Cardiology, Moscow, Russia
Russian Federation
PhD, researcher of the Department of Pulmonary Hypertension and Heart Diseases Myasnikov Scientific Research Institute of Clinical Cardiology National Medical Research Center of Cardiology.Moscow, Russia


S. E. Gratsianskaya
National Medical Research Center of Cardiology, Myasnikov Scientific Research Institute of Clinical Cardiology, Moscow, Russia
Russian Federation
Research assistant of the Department of Pulmonary Hypertension and Heart Diseases Myasnikov Scientific Research Institute of Clinical Cardiology National Medical Research Center of Cardiology.Moscow, Russia


T. V. Martynyuk
National Medical Research Center of Cardiology, Myasnikov Scientific Research Institute of Clinical Cardiology, Moscow, Russia Pirogov Russian National Research Medical University, Moscow, Russia
Russian Federation

MD.The head of the Department of Pulmonary Hypertension and Heart Diseases Myasnikov Scientific Research Institute of Clinical Cardiology National Medical Research Center of Cardiology.Moscow, Russia

Professor  of the Department of Cardiology Faculty of additional professional education Pirogov Russian National Research Medical University



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Review

For citations:


Valieva Z.S., Gratsianskaya S.E., Martynyuk T.V. The soluble guanylate cyclase stimulator riociguat is the first-line therapy for chronic thromboembolic pulmonary hypertension patients. Kardiologiia. 2020;60(8):115-123. (In Russ.) https://doi.org/10.18087/cardio.2020.8.n1198

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