Hemodynamic effects of ambrisentan-tadalafil combination therapy on progressive portopulmonary hypertension

Figure 1 Transthoracic echocardiography performed before and after treatment. A: Transthoracic echocardiography (TTE) performed before treatment. The parasternal short axis view at the basal level in diastole shows pronounced interventricular septal deviation toward the left ventricle accompanied by pericardial effusion; B: TTE performed after treatment. The parasternal short axis view at the basal level in diastole shows a decrease in the interventricular septal deviation toward the left ventricle. Pericardial effusion has disappeared. RV: Right ventricle; LV: Left ventricle.

Figure 2 Clinical course and treatment of case 1. Plasma brain natriuretic peptide concentration remarkably decreased from 2212 pg/mL to 46 pg/mL by intravenous dobutamin infusion and subsequent oral ambrisentan-tadalafil combination treatment.

Figure 3 Transthoracic echocardiography performed before and after treatment. A: Pre-treament. Transthoracic echocardiography (TTE) performed before treatment. The parasternal short axis view at the basal level in diastole shows pronounced interventricular septal deviation toward the left ventricle accompanied by pericardial effusion; B: Five-month after treament. TTE performed after treatment. The parasternal short axis view at the basal level in diastole shows a decrease in the interventricular septal deviation toward the left ventricle. The pericardial effusion has disappeared. RV: Right ventricle; LV: Left ventricle.

Figure 4 Clinical course and treatment of case 2. Plasma brain natriuretic peptide concentration remarkably decreased from 1897 pg/mL to 139 pg/mL by intravenous dobutamin infusion and oral ambrisentan-tadalafil combination treatment.