Inhaled Treprostinil Improves Cardiac Effort in PH-ILD
INHALED treprostinil treatment improved cardiac effort and physiological function in patients with pulmonary hypertension–interstitial lung disease (PH-ILD), according to new findings from the ASCENT trial.
Assessing Cardiac Effort in Pulmonary Hypertension–ILD
PH-ILD, including combined pulmonary fibrosis and emphysema, remains a progressive condition with few therapeutic options. The ongoing ASCENT trial is a multicenter, open-label study evaluating the safety and efficacy of LIQ861, a novel dry powder formulation of inhaled treprostinil.
This analysis focused on “cardiac effort,” defined as the number of heartbeats during a six-minute walk test divided by the walk distance. This measure correlates with stroke volume and reflects the physiological stress required to achieve a given walking distance.
Improvements Observed by Week 8 and Week 16
Twenty patients with PH-ILD were included in this initial cohort. At baseline, the mean cardiac effort was 2.4 ± 1.0 beats/m. After eight weeks of inhaled treprostinil therapy, the measure improved to 2.1 ± 0.9 beats/m. Among those who reached week 16, cardiac effort improved from 2.0 ± 0.5 to 1.8 ± 0.5 beats/m.
Participants completed continuous electrocardiogram-based monitoring during the six-minute walk test, providing detailed insight into heart rate response and exercise tolerance. The median dose of LIQ861 was 132.5 mcg at week 8 and 159 mcg at week 16, administered four times daily.
Clinical Insights and Future Implications
Investigators reported that integrating continuous ECG monitoring with walk testing offered new insight into how physiological stress evolves during treatment. The findings suggest that inhaled treprostinil may improve exercise efficiency and cardiovascular performance in patients with PH-ILD.
Further results from the ASCENT trial will explore the role of cardiac effort as a potential biomarker for treatment response and disease progression in pulmonary hypertension related to interstitial lung disease.
Reference: CHEST. Inhaled Treprostinil Improves Cardiac Effort in Patients With Pulmonary Hypertension–Interstitial Lung Disease: ASCENT Trial. 2025. Available at: https://www.chestnet.org/-/media/documents/news/inhaled-treprostinil-improves-cardiac-effort-in-patients-with-pulmonary-hypertension.ashx. Last accessed: 23 October 2025.
