PMC5133662_01
Change in NHYA functional class.
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PMC5133662_01_gr1.jpg
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Sildenafil was added to warfarin (Month 0, Fig. 1). The patient expressed reluctance to systemic prostacyclin treatment, so inhaled treprostinil was added to sildenafil (Month 24, Fig. 1). The addition of inhaled treprostinil to sildenafil resulted in significant improvement in functional class over the next 24 months (Fig. 1). She reported NYHA functional class 4 symptoms (Fig. 1) and was requiring continuous use of supplemental oxygen. After the initiation of riociguat-inhaled treprostinil, the patient experienced a significant improvement in activity tolerance (Fig. 1).