Pulmonary Circulation最新文献

{"title":"Hypopituitarism Induced by Continuous Infusion of PGI2 Analogues: A Case Series and the Role of ACTH Screening and Hydrocortisone Treatment.","authors":"Taijyu Satoh, Yuichi Tamura, Noriaki Takama, Hiromi Matsubara, Nobuhiro Tanabe, Takumi Inami, Takahiro Hiraide, Kohtaro Abe, Yoshihiro Dohi, Yoshito Ogihara, Takeshi Ogo, Shiro Adachi, Kazuhiko Nakazato, Ichizo Tsujino, Hideki Ota, Kohei Komaru, Haruka Sato, Yuta Tezuka, Yoshikiyo Ono, Rika Suda, Kazuya Hosokawa, Sarasa Isobe, Takatoyo Kiko, Yuki Koga, Junichi Nakamura, Koichiro Sugimura, Masaru Hatano, Yoshihiro Fukumoto, Satoshi Yasuda","doi":"10.1002/pul2.70116","DOIUrl":"https://doi.org/10.1002/pul2.70116","url":null,"abstract":"<p><p>Hypopituitarism has been reported in patients receiving continuous infusions of prostaglandin I2 (PGI2) analogues for pulmonary hypertension (PH). However, these patients' clinical characteristics, treatment, and prognoses remain unclear. This retrospective multicentre study included 22 patients who developed hypopituitarism while on continuous PGI2 analogue infusion between 1999 and 2021. All patients were female, and idiopathic pulmonary arterial hypertension was the most common underlying condition (63.6%). Their mean age was 38.8 ± 7.9 years. Epoprostenol was the predominant PGI2 analogue used (90.9%). At the time of hypopituitarism onset, the median PGI2 dose was 67.2 ng/kg/min (31.8-88.7 ng/kg/min), and the median treatment duration was 889.0 days (450.5-1941.5 days), suggesting that hypopituitarism occurred independent of its dose or treatment duration. Diagnoses were based on decreased adrenocorticotropic hormone levels. The hypopituitarism classification revealed isolated pituitary dysfunction in 54.5% of the cases, partial dysfunction in 18.1%, and complete dysfunction in 27.2%. Most cases could be managed without requiring specific therapies. After hypopituitarism onset, 63.6% of the patients continued to receive the same PGI2 analogue. Hydrocortisone therapy was administered to 81.8% of the patients, leading to clinical stabilisation. No deaths were reported. In conclusions, hypopituitarism may occur during continuous PGI2 analogue infusion for PH, irrespective of its dose or treatment duration. Initiating hydrocortisone therapy may be important for stabilising the clinical course.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70116"},"PeriodicalIF":2.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Depression Screening of Youth in Pediatric Pulmonary Hypertension Clinic: A Multi-Center, Cross-Sectional Study.","authors":"Claire Parker, Elise Whalen, Michael A Smith, Jasmine Becerra, Leah Stevens, Catherine M Avitabile, Anna Brown, Michelle Cash, Emma Olson Jackson, Julia McSweeney, Kathleen Miller-Reed, Janette T Reyes, Cathy Sheppard, Mary P Mullen","doi":"10.1002/pul2.70117","DOIUrl":"https://doi.org/10.1002/pul2.70117","url":null,"abstract":"<p><p>Children with chronic diseases, including pulmonary hypertension (PH), have an increased risk of anxiety and depression (AD), impacting mental health (MH), and quality of life (QoL). We sought to characterize the prevalence of AD in pediatric PH and identify associated factors. We developed a prospective cross-sectional study with 10 Pediatric Pulmonary Hypertension Network (PPHNet) centers. Eligible subjects aged 12-21, diagnosed with PH, and English or Spanish speaking, completed validated AD screening questionnaires during routine outpatient clinic visits. Caregivers provided socioeconomic status (SES) data and MH history via survey. Patient demographics and clinical characteristics were analyzed using standard descriptive statistics. Eighty-eight patients were enrolled (female = 54, 61%). Forty-six (51.7%) identified at least mild symptoms of AD. Females were more likely to report AD than males (OR 2.67, 95% CI 1.11-6.61, <i>p</i> = 0.030). There were no significant associations between AD and PH severity, MH history, family dynamics, SES status, race, or ethnicity. Twenty-seven of those patients (58.7%) received MH education/counseling by MH professionals; ten (21.7%) were referred to MH providers, and nine patients (19.6%) were assessed for suicide safety. Adolescents with PH have a high prevalence of AD. Female patients had increased AD compared to male patients; no other predictors were linked to the prevalence of AD. Routine AD screening should be integrated into outpatient PH clinic visits with a focus on psychosocial support for young females diagnosed with PH.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70117"},"PeriodicalIF":2.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Providers' Behaviors, Attitudes, and Preferences on the Treatment of Pulmonary Arterial Hypertension With Endothelin Receptor Antagonist (ERA) + Phosphodiesterase-5 Inhibitors (PDE5i).","authors":"Nicholas A Kolaitis, Martha Kingman, Melisa Wilson, Gabriela Gomez Rendon, David Lopez, Carly J Paoli, Mohammad Rahman, Ashley Martin, November McGarvey, Abraham Lee, Lana Melendres-Groves","doi":"10.1002/pul2.70113","DOIUrl":"10.1002/pul2.70113","url":null,"abstract":"<p><p>This study aims to understand healthcare providers' (HCPs) decision to adopt double combination therapy with ERA + PDE5i for pulmonary arterial hypertension (PAH), and to explore whether a single tablet combination therapy (STCT) might increase adoption practices. 195 US HCPs completed a survey evaluating their PAH treatment preferences. HCPs' willingness to use double combination ERA + PDE5i was assessed using a discrete choice experiment (DCE). The sample predominantly included physicians (73.3%) from centers of excellence (63.1%), with a mean of 117.4 PAH patients treated in the past year. Key factors influencing ERA + PDE5i adoption in the DCE were the patient's current treatment (17.9), PAH etiology (16.2), existing comorbidities (14.1), and history of side effects (12.7), with higher scores indicating stronger preference. HCPs were more likely to select ERA + PDE5i for patients currently on PDE5i monotherapy, with idiopathic PAH, and without comorbidities or a history of side effects. Regarding STCT, most HCPs reported that it would allow them to initiate ERA + PDE5i sooner (76.4%) and improve patient compliance (82.6%). However, concerns regarding cost/insurance issues (63.6%) and a history of side effects (50.8%) were identified as limitations to adopting STCT. Patients' current therapy, the cause of PAH, comorbidities, and side effects are key factors influencing whether US providers are willing to treat them with ERA + PDE5i. Providers perceive that STCT may help HCPs initiate ERA + PDE5i sooner, improve compliance, and simplify initiation of upfront double therapy and delivery of triple therapy. Addressing cost and insurance barriers will be critical to realizing these potential benefits.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70113"},"PeriodicalIF":2.2,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Use of Inhaled Iloprost.","authors":"Stephanie S Handler, Steven H Abman, Nidhy P Varghese, D Dunbar Ivy","doi":"10.1002/pul2.70115","DOIUrl":"10.1002/pul2.70115","url":null,"abstract":"","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70115"},"PeriodicalIF":2.2,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Cardiac Output Methods on the Classification of Pulmonary Hypertension.","authors":"Léon Genecand, Gaëtan Simian, Mona Lichtblau, Jean-Marc Fellrath, Julian Klug, Hugues Turbé, Christian Lovis, Stéphane Noble, Julie Wacker, Julian Müller, Roberto Desponds, Maurice Beghetti, Benoit Lechartier, David Montani, Olivier Sitbon, Silvia Ulrich, Frédéric Lador","doi":"10.1002/pul2.70112","DOIUrl":"10.1002/pul2.70112","url":null,"abstract":"<p><p>Cardiac output is essential to calculate pulmonary vascular resistance (PVR) and classify pulmonary hypertension (PH). Recent evidence has shown a lower agreement between thermodilution (COTD) and direct Fick (CODF) methods than historically estimated. The influence of the cardiac output measurement method on the classification of PH is poorly explored. We aimed to estimate the risk of diagnostic error when using COTD instead of CODF. We used a previously published mathematical model to consecutive patients diagnosed with PH at three centers in Switzerland. This model allows an individual estimation of the risk of diagnostic error when using COTD instead of CODF and is based on limits of agreement (LoA) between COTD and CODF of 2 L/min (average estimation) and 2.7 L/min (worst case scenario estimation). One thousand one hundred and forty-two patients with PH were evaluated. The mean risk of diagnostic error using the model with LoA of 2 L/min was 6.0% in the overall population (<i>n</i> = 1142). The mean risk of diagnostic error was 2.9% among the 712 patients with precapillary PH, 15.0% among the 113 patients with isolated postcapillary PH (IpcPH), 7.2% among the 247 patients with combined post- and pre-capillary PH, and 18.8% among the 70 patients with unclassified PH. The estimated diagnostic error when using COTD instead of CODF was generally low, particularly for patients with precapillary PH. Patients with PVR close to the diagnostic threshold of 2 WU (i.e., between 1 and 3 WU), mostly concerning patients with IpcPH and unclassified PH, exhibited a higher risk of diagnostic error.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70112"},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin Improves Quality of Life, Oxidative Stress, and Cardiovascular Function in Pulmonary Arterial Hypertension.","authors":"Alicia de la Fuente, Mónica Zagolín, Víctor Parra, Adolfo A Paz, Alejandro González-Candia, Osvaldo Cabrera, Cristian Olave, Constanza Bahamondes, María José Gaete, Lodz Gudenschwager, Javiera Rivas, Emilio A Herrera","doi":"10.1002/pul2.70109","DOIUrl":"10.1002/pul2.70109","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) Group 1 from the World Health Organization (WHO) is a rare, severe chronic, and progressive condition. Patients with PAH have increased oxidative stress (OS) and diminished antioxidant capacity. Melatonin is a potent antioxidant hormone with reported benefits in PAH animal models. We aimed to evaluate the functional, hemodynamic, and antioxidant response to a 6-month melatonin therapy in PAH Group 1 patients. Clinical evaluation was done at baseline (BT), as well as at 3 (T3) and 6 (T6) months of melatonin treatment in stable PAH Group 1 (WHO) patients. The principal endpoint was change in walking distance (WD) in the 6-min walking test (6MWT). Secondary endpoints were functional class (FC), quality of life (QoL), performance of right ventricle (RV), and plasma antioxidant capacity. This study included 19 patients. They were mainly women in WHO FC II and III. A significant improvement was noticed in perception of dyspnea, palpitations, and fatigue in concordance with the QoL improvement in the physical domain after 6 months of melatonin. This was represented by a significant fall in the total score of the PAH-SYMPACT questionnaire. In addition, the baseline heart rate was lower at the T6 follow-up. No significant changes were seen in the echocardiographic variables. However, the biochemical analysis showed significative increases in plasma total antioxidant (2.94 ± 0.13 vs. 8.41 ± 0.19) and ferric reducing (191 ± 12 vs. 256 ± 17) capacities. Overall, oral melatonin treatment improved the plasma antioxidant capacity and the QoL in this pilot study.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70109"},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Psychological Distress on Health-Related Quality of Life, Fatigue, and Pain in Adults With Pulmonary Hypertension.","authors":"Gregg H Rawlings, Abbie Stark, Iain Armstrong, Vlad Costin, Andrew R Thompson","doi":"10.1002/pul2.70101","DOIUrl":"10.1002/pul2.70101","url":null,"abstract":"<p><p>While anxiety and depression are commonly reported in pulmonary hypertension (PH), limited evidence exists on how these conditions interact with the pathophysiological symptoms of PH. Fatigue and, to a lesser degree, pain are key symptoms of PH; however, they have rarely been examined as separate experiences associated with PH. Using a cross-sectional research design, 68 adults with PH recruited from global Pulmonary Hypertensions Associations completed a series of self-report measures assessing fatigue, pain self-efficacy, anxiety, depression, and health-related quality of life (HRQoL). Aiming to understand the nuances of PH symptomatology, we first looked at responses on individual items from fatigue and pain measures, respectively. Then, to examine relationships between self-reported symptoms, we tested potential pathways from fatigue and pain to HRQoL through depression and anxiety. All symptoms were correlated, suggesting individuals with greater anxiety and depression also experienced more fatigue, and lower pain self-efficacy and HRQoL. Parallel mediation analyses showed that fatigue and pain had a direct effect on HRQoL, as well as an indirect effect via anxiety and depression. Explorative serial mediation models suggested the indirect path from fatigue to HRQoL was significant when depression was ordered first followed by anxiety; whereas for pain self-efficacy, the path was significant when anxiety was followed by depression. Results add to the evidence demonstrating the high co-occurrence of mental health difficulties in PH and the important role they play in pathophysiological symptomatology. Analyses support providing holistic care for this clinical group to help identify various therapeutic targets suggestive of predicting HRQoL.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70101"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Telehealth in PAH Management: Benefits, Barriers, and Solutions.","authors":"Susanne McDevitt, Martha Kingman, Lana Melendres Groves, Gabriela Gomez Rendon, Michelle Han, Christina Benninger, Sylvia Georgi, Medi Stone, Daisy Bridge, Richard Perry, Ashley Enstone, Lisa Perrett, Holly Smith, Gurinderpal Doad, Jean M Elwing","doi":"10.1002/pul2.70079","DOIUrl":"10.1002/pul2.70079","url":null,"abstract":"<p><p>Telehealth utilization increased during the coronavirus disease-2019 (COVID-19) pandemic, which encouraged remote patient management. The identification of optimal strategies to enhance telehealth and address barriers to its use for patients with pulmonary arterial hypertension (PAH) may improve patient outcomes. Physicians (<i>n</i> = 11) and advanced practice providers (<i>n</i> = 6) based in the United States with experience with telehealth in PAH were recruited to a double-blinded modified Delphi panel (two survey rounds and a virtual consensus meeting). Consensus was defined as ≥ 80% of panelists rating their agreement or disagreement using a 9-point Likert scale. A consensus in agreement was reached that telehealth is the use of virtual or remote methodologies to interact with, monitor and assess patients and deliver health care. Telehealth methodologies may be used in PAH for returning visits, diagnostic test follow-up and medication management; telehealth is convenient, enables additional visits, and provides patient access to care. There are barriers to telehealth such as socioeconomic status, patient digital literacy, visual and/or hearing impairments, developmental disabilities, geographical location, and reimbursement. Solutions to improve patient access to telehealth include health insurance reimbursements, financial resources for healthcare professionals (HCPs), and improved connectivity infrastructure for patients. There are benefits, barriers and solutions for telehealth in general, and more research is required to evaluate the impact on PAH care. Further research and insights from the present study may improve PAH management and telehealth services. Improvements in telehealth care and delivery may allow better monitoring of patients with PAH and assist in more equitable PAH care.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70079"},"PeriodicalIF":2.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmatic Approach to Outpatient Cardiac Catheterization in Children With Stable Pulmonary Arterial Hypertension.","authors":"Gregory T Adamson, Minnie N Dasgupta, Zachary Kleiman, Lynn F Peng, Michelle Ogawa, Vidhya Balasubramanian, Chandra Ramamoorthy, Jeffrey A Feinstein","doi":"10.1002/pul2.70105","DOIUrl":"10.1002/pul2.70105","url":null,"abstract":"<p><p>When performing cardiac catheterization in pediatric outpatients with pulmonary arterial hypertension (PH), our approach is to allow spontaneous ventilation, minimize procedural length, and evaluate for same-day discharge whenever safe and feasible. We describe our experience with this approach and identify clinical characteristics that influenced procedural safety. Outpatients < 21 years who underwent catheterization for PH from 2009 to 2018 were included in the retrospective cohort. Demographic, clinical, and procedural data were collected. Data were modeled using a mixed effects logistic regression for correlated data, and a patient random effect was included to account for multiple procedures in the same patient. Of 409 catheterizations screened, 250 procedures in 118 outpatients were included. Of the 250 procedures, 185 (74.0%) were discharged on the same day. There were no major adverse events within 48 h of discharge in any of the 185 nor in the 12 (197 total, 78.8%) admitted for medication titration or an unrelated procedure (i.e., could have otherwise been discharged). Median procedural duration was 51.0 (33.0, 76.8) minutes. Endotracheal intubation, younger age, longer procedural duration, and worse functional status were associated with higher odds of admission. In a prospective secondary cohort of 39 procedures in 34 patients, 32 (82%) were discharged same-day without complication, including over 90% of children over 3 years of age who were managed without endotracheal intubation. By prioritizing spontaneous ventilation and procedural efficiency, outpatient pediatric PH patients who undergo catheterization, emergence, and a 4-h observation with no complications may be considered for same-day discharge or observation in a low-acuity bed.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70105"},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Effects of Radiofrequency Electromagnetic Field on Pulmonary Ischemia-Reperfusion via HIF-1α/eNOS Pathway and BCL2/BAX Signaling.","authors":"Süleyman Emre Akin, Halil Asci, Muhammet Yusuf Tepebasi, İlter Ilhan, Özlem Ozmen, Selçuk Comlekci, Rümeysa Taner, Hasan Ekrem Camas, Ayşegül Keklik, Rasih Yazkan","doi":"10.1002/pul2.70051","DOIUrl":"10.1002/pul2.70051","url":null,"abstract":"<p><p>This study aimed to investigate the vascular effects of a radiofrequency electromagnetic field (RF-EMF) applied in the lung ischemia and reperfusion (IR) model on the hypoxia-inducible factor 1 alpha (Hif-1α)/endothelial nitric oxide synthase (eNOS) pathway and B cell lymphoma 2 (BCL2)/BCL-2 associated X protein (BAX<i>)</i> signaling. Forty male Wistar rats were randomly divided into four groups, each consisting of 10 rats: Sham, IR, IR + RF-EMF, and RF-EMF. IR was applied to rats by 60 min of clamping hilus of left lungs and 60 min of reperfusion. Rats were kept in the RF-EMF unit for 60 min with or without activation. After sacrification, lung tissues were excised for histopathological, immunohistochemical, biochemical, and genetic analyses. IR injury led to increased damage-related emphysematous findings, significant hyperemia, and increased septal tissue thickness, as observed histopathologically, and immunoexpression levels of tumor necrosis factor-alpha and caspase-3. In addition, it was noted that the biochemical parameters total oxidant status, oxidative stress index, and genetic parameters Hif 1 α, eNOS, BAX increased, and BCL2 decreased due to IR damage. In the IR-RF-EMF group, improvement has been detected in all parameters. RF-EMF applied in the IR model exerts antioxidant, antiapoptotic, and anti-inflammatory effects on lung tissue damage through the Hif-1α/eNOS pathway and BCL-2/BAX signaling. The use of RF-EMF in IR damage is promising, as models that examine the long-term effects of RF-EMF at different frequencies.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70051"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}