Sotatercept lowers RV contractility but improves right heart mechanics in PAH

A prospective trial of 30 patients with pulmonary arterial hypertension used simultaneous echocardiography and invasive hemodynamics at rest and exercise to assess right ventricular contractility, RV-PA coupling, and cardiac deformation before and after 24 weeks of sotatercept. The study reported that sotatercept reduced RV contractility in proportion to reduced afterload while preserving RV-PA coupling, and that RV free wall strain, fractional area change, and right atrial filling and contractile performance improved at rest and during exercise despite decreased annular systolic indices. The authors state these findings suggest an energetically favorable reduction in resting RV contractility that does not appear physiologically detrimental given the concurrent improvement in RV free wall mechanics and exertional right heart reserve.

Most relevant for: Patients with pulmonary arterial hypertension being treated with sotatercept and clinicians assessing right ventricular function and hemodynamics in this population.

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