In the CADENCE proof-of-concept study, sotatercept demonstrated meaningful improvements in pulmonary vascular and cardiac hemodynamics in patients with combined pre‑ and post‑capillary pulmonary hypertension due to HFpEF (CpcPH‑HFpEF). Investigators selected a pulmonary vascular resistance threshold of ≥4 Wood units to enrich patients with a significant pre‑capillary component, where targeting pulmonary vascular disease was most biologically relevant. Given that CpcPH‑HFpEF—including valvular‑associated HFpEF—is underdiagnosed, associated with worse prognosis, and has no approved therapies, these findings suggest potential broader applicability pending further study.

In this interview, Clyde W. Yancy MD, MACC and Mardi Gomberg-Maitland, MD, MSc, FACC discuss the CADENCE Trial (Efficacy And Safety Of Sotatercept In Combined Post-and Pre-capillary Pulmonary Hypertension Associated With Heart Failure With Preserved Ejection Fraction).