Pilot Study to Evaluate Right Ventricular Function With Riociguat in CTEPH

Exclusion Criteria

• •• All types of pulmonary hypertension except Dana Point Classification Group 4 (1).
• •* Patients who are currently taking Phosphodiesterase type 5 (PDE-5) inhibitors, ERAs and prostanoids ≤ 3 days prior to start of riociguat treatment.
• •* Pulmonary endarterectomy surgery within 3 months of screening.
• •* Epicardial coronary artery disease (Ejection Fraction \<40%).
• •* Previous myocardial infarction within the 3 months prior to screening.
• •* Severe proven or suspected coronary artery disease (CCS Angina Classification II-IV), and/or requiring nitrates.
• •* Uncontrolled arterial hypertension (systolic blood pressure\> 180 mmHg and/or diastolic BP\> 110 mmHg.
• •* Systolic blood pressure \<95mmHg.
• •* Resting heart rate in an awake patient \<50 beats per minute (bpm) or \>105 bpm.
• •* History of uncontrolled atrial fibrillation within the last 3 months prior to screening.
• •* Hypertrophic obstructive cardiomyopathy.
• •* Clinical evidence of symptomatic atherosclerotic disease (peripheral artery disease).
• •* Pregnant or breastfeeding women or women with childbearing potential not using highly effective contraception methods.
• •* Renal insufficiency (glomerular filtration rate \< 30 ml/min.
• •* ALT or AST \> times upper limit of normal( ULN) and/or severe hepatic insufficiency.
• •* Contraindication to MRI imaging.