Pulmonary Circulation最新文献

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Practical Considerations for Managing Patients on Tyvaso DPI (Treprostinil Inhalation Powder). 替瓦索DPI(曲前列地尼吸入粉)患者管理的实际考虑。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-07-03 eCollection Date: 2025-07-01 DOI: 10.1002/pul2.70119
Jennifer H Keeley, Jacqueline Skarre, Lori Reed, Loida A Johnson, Catherine Falardeau, Brittany N J Davis, Manisit Das, Howard Castillo, Susanne McDevitt
{"title":"Practical Considerations for Managing Patients on Tyvaso DPI (Treprostinil Inhalation Powder).","authors":"Jennifer H Keeley, Jacqueline Skarre, Lori Reed, Loida A Johnson, Catherine Falardeau, Brittany N J Davis, Manisit Das, Howard Castillo, Susanne McDevitt","doi":"10.1002/pul2.70119","DOIUrl":"10.1002/pul2.70119","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) and pulmonary hypertension associated with interstitial lung disease (PH-ILD) require a multifaceted, guideline-directed management approach. This includes active patient participation in partnership with their healthcare team to minimize disease impact and improve survival. Inhaled treprostinil, a prostacyclin analog, has been approved for both PAH and PH-ILD in two formulations: Tyvaso (treprostinil nebulizer) and the more recent Tyvaso DPI (treprostinil dry powder inhaler) [United Therapeutics]. Both formulations deliver therapy directly to the lung vasculature, minimizing the risk of ventilation-perfusion mismatch, reducing systemic exposure, and decreasing the incidence of adverse events commonly associated with parenteral and oral prostacyclin formulations. While practical recommendations for the treprostinil nebulizer have been previously published, Tyvaso DPI provides a well-tolerated, convenient administration option for patients requiring prostacyclin therapy. This review provides an overview of inhaled prostacyclin therapy with a focus on practical considerations for managing PAH and PH-ILD patients treated with Tyvaso DPI. Recommendations from a panel of pulmonary hypertension advanced practice providers include patient selection, education, communication, onboarding and monitoring, transition and titration, side effect mitigation, and the availability of clinician- and patient-facing resources.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70119"},"PeriodicalIF":2.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560964","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}
引用次数: 0
Outpatient Intravenous Dobutamine as Right Ventricular Support During Inhaled Prostacyclin Uptitration in Severe PH-ILD. 门诊静脉注射多巴酚丁胺作为严重PH-ILD患者吸入前列环素时的右心室支持。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-07-02 eCollection Date: 2025-07-01 DOI: 10.1002/pul2.70111
A Kumar, Siddharth V Ramanan, Brett Carollo, Kristen Swanson, Raj Parikh
{"title":"Outpatient Intravenous Dobutamine as Right Ventricular Support During Inhaled Prostacyclin Uptitration in Severe PH-ILD.","authors":"A Kumar, Siddharth V Ramanan, Brett Carollo, Kristen Swanson, Raj Parikh","doi":"10.1002/pul2.70111","DOIUrl":"10.1002/pul2.70111","url":null,"abstract":"<p><p>PH-ILD carries a poor prognosis, particularly with PVR > 5 WU. The INCREASE trial demonstrated the successful use of inhaled treprostinil, but slow uptitration delays the effects. Our study suggests outpatient IV dobutamine as interim support, improving contractility and reducing PVR during uptitration.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70111"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554305","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}
引用次数: 0
Exercise-Induced Oxygen Desaturation and Heart Rate Response During 6-Min Walk Test Predict Pulmonary Hypertension in Exertional Dyspnea: A Retrospective Cohort Study. 6分钟步行试验中运动诱导的氧去饱和和心率反应预测运动性呼吸困难患者肺动脉高压:一项回顾性队列研究。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-25 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70120
Haojie Zhang, Menghuan Yan, Feng Li, Qi Chen, Rui Lu, Ziyu Wang, Xuan Zheng, Gangcheng Zhang
{"title":"Exercise-Induced Oxygen Desaturation and Heart Rate Response During 6-Min Walk Test Predict Pulmonary Hypertension in Exertional Dyspnea: A Retrospective Cohort Study.","authors":"Haojie Zhang, Menghuan Yan, Feng Li, Qi Chen, Rui Lu, Ziyu Wang, Xuan Zheng, Gangcheng Zhang","doi":"10.1002/pul2.70120","DOIUrl":"10.1002/pul2.70120","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is a life-threatening condition frequently associated with exertional dyspnea. It remains diagnostically challenging due to limitations in current screening modalities. While the 6-min walk test (6MWT) has been applied for risk stratification in confirmed PH, its potential role in screening remains unexplored. This retrospective cohort study investigated the diagnostic utility of 6MWT-derived parameters in 180 patients with exertional dyspnea. PH diagnosis was confirmed by right heart catheterization with the definition of mean pulmonary artery pressure > 20 mmHg. Among 79 PH patients (43.9%), a significantly reduced 6-min walk distance (6MWD) was observed compared to non-PH patients (469.5 ± 106.4 m vs. 509.8 ± 74.9 m, <i>p</i> = 0.019). Continuous physiological monitoring revealed that the SpO₂ trough and the heart rate (HR) peak occurred at different time points during 6MWT. Propensity score-matched case-control analysis further demonstrated greater exercise-induced desaturation of SpO<sub>2</sub> from the rest to minimal levels (ΔSpO₂<sub>rest</sub> <sub>-min</sub>: 9 ± 9% vs. 4 ± 6%, <i>p</i> < 0.001) and exaggerated HR response from the rest to maximal levels (ΔHR<sub>max</sub> <sub>-rest</sub>: 51±21bpm vs. 34±14bpm, <i>p</i> < 0.001) in PH patients. Multivariable analysis identified ΔSpO₂<sub>rest</sub> <sub>-min</sub> ≥ 5% (AUC = 0.715, 95% CI: 0.640-0.852; <i>p</i> < 0.001) and ΔHR<sub>max</sub> <sub>-rest</sub> ≥ 42 bpm (AUC = 0.740, 95% CI: 0.656-0.823; <i>p</i> < 0.001) as independent predictors of PH. The number of these predictors discriminated the risk of PH in dyspneic patients. A risk-stratification model incorporating these thresholds demonstrated improved predictive value for PH screening, with a C-statistic of 0.786 (95% CI: 0.710-0.863, <i>p</i> < 0.001). These findings suggest that parameters derived from the 6MWT, particularly exercise-induced SpO₂ desaturation and HR response, may facilitate noninvasive PH screening in exertional dyspneic patients.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70120"},"PeriodicalIF":2.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508024","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}
引用次数: 0
Hypopituitarism Induced by Continuous Infusion of PGI2 Analogues: A Case Series and the Role of ACTH Screening and Hydrocortisone Treatment. 连续输注PGI2类似物诱导垂体功能减退:ACTH筛查和氢化可的松治疗的病例系列。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-25 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70116
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
{"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":"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}
引用次数: 0
Anxiety and Depression Screening of Youth in Pediatric Pulmonary Hypertension Clinic: A Multi-Center, Cross-Sectional Study. 儿童肺动脉高压临床青少年焦虑和抑郁筛查:一项多中心横断面研究
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-24 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70117
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
{"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":"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}
引用次数: 0
Exploring Providers' Behaviors, Attitudes, and Preferences on the Treatment of Pulmonary Arterial Hypertension With Endothelin Receptor Antagonist (ERA) + Phosphodiesterase-5 Inhibitors (PDE5i). 探讨提供者对内皮素受体拮抗剂(ERA) +磷酸二酯酶-5抑制剂(PDE5i)治疗肺动脉高压的行为、态度和偏好
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-22 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70113
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
{"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}
引用次数: 0
Pediatric Use of Inhaled Iloprost. 吸入伊洛前列素的儿科应用。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-22 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70115
Stephanie S Handler, Steven H Abman, Nidhy P Varghese, D Dunbar Ivy
{"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}
引用次数: 0
The Impact of Cardiac Output Methods on the Classification of Pulmonary Hypertension. 心输出量测定方法对肺动脉高压分类的影响。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-19 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70112
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
{"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}
引用次数: 0
Melatonin Improves Quality of Life, Oxidative Stress, and Cardiovascular Function in Pulmonary Arterial Hypertension. 褪黑素改善肺动脉高压患者的生活质量、氧化应激和心血管功能。
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-19 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70109
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
{"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}
引用次数: 0
The Role of Psychological Distress on Health-Related Quality of Life, Fatigue, and Pain in Adults With Pulmonary Hypertension. 心理困扰对成人肺动脉高压患者健康相关生活质量、疲劳和疼痛的影响
IF 2.2 4区 医学
Pulmonary Circulation Pub Date : 2025-06-17 eCollection Date: 2025-04-01 DOI: 10.1002/pul2.70101
Gregg H Rawlings, Abbie Stark, Iain Armstrong, Vlad Costin, Andrew R Thompson
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