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Aims of this study were (i) to capture detailed haemodynamic effects of rapid sequential dual combination therapy in patients with newly diagnosed PAH; (ii) to monitor the impact of treatment initiation on clinical variables and patients' risk status, and (iii) to compare the treatment effect in patients with \u2018classical PAH\u2019 and \u2018PAH with co-morbidities\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty patients (median age 57 [42\u201371] years, 66% female) with newly diagnosed PAH (76% idiopathic) were treated with a PD5i\/sGC-S or ERA, followed by addition of the respective other drug class within 4 weeks. All patients underwent repeat right heart catheterization (RHC) during early follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At early repeat RHC (7 \u00b1 2 months), there were substantial reductions in mean pulmonary artery pressure (mPAP: 52.2 \u00b1 13.5 to 39.0 \u00b1 10.6 mmHg; \u221225.3%), and pulmonary vascular resistance (PVR: 12.1 \u00b1 5.7 to 5.8 \u00b1 3.1 WU; \u221252.1%), and an increase in cardiac index (2.1 \u00b1 0.4 to 2.7 \u00b1 0.7 mL\/min\/m2; +32.2%) (all P &amp;lt; 0.05). Haemodynamic improvements correlated with improved clinical parameters including 6-min walking distance (336 \u00b1 315 to 389 \u00b1 120 m), NTproBNP levels (1.712 \u00b1 2.024 to 506 \u00b1 550 ng\/L, both P &amp;lt; 0.05) and WHO-FC at 12 months, resulting in improved risk status, and were found in patients with few (n = 37) or multiple cardiovascular co-morbidities (BMI &amp;gt; 30 kg\/m2, hypertension, diabetes, coronary artery disease [\u22653]; n = 13), albeit baseline PVR in PAH patients with multiple co-morbidities was lower (9.3 \u00b1 4.4 vs. 13.1 \u00b1 5.9 WU) and PVR reduction less pronounced compared with those with few co-morbidities (\u221242.7% vs. \u221254.7%). However, comprehensive haemodynamic assessment considering further variables of prognostic relevance such as stroke volume index and pulmonary artery compliance showed similar improvements among the two groups (SVI: +50.0% vs. +49.2%; PAC: 91.7% vs. 100.0%). Finally, the 4-strata risk assessment approach was better able to capture treatment response as compared with other approaches, particularly in patients with co-morbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rapid sequential combination therapy with PDE5i\/sGC-S and ERA substantially ameliorates cardiopulmonary haemodynamics at early follow-up in patients without, and to a lesser extent, with cardiovascular co-morbidities. This occurs in line with improvements of clinical parameters and risk status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14611","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T19:49:55Z","timestamp":1705348195000},"page":"1540-1552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of Rapid Sequential Combination Therapy on Distinct Haemodynamic Measures in Newly Diagnosed Pulmonary Arterial Hypertension"],"prefix":"10.1093","volume":"11","author":[{"given":"Tilmann","family":"Kramer","sequence":"first","affiliation":[{"name":"Klinik III f\u00fcr Innere Medizin, Herzzentrum der Universit\u00e4t zu K\u00f6ln , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Nattmann","sequence":"additional","affiliation":[{"name":"Klinik III f\u00fcr Innere Medizin, Herzzentrum der Universit\u00e4t zu 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