Pulmonary Circulation最新文献

{"title":"The Prognostic Accuracy of Three-Dimensional Echocardiography in Patients With Pre-Capillary Pulmonary Hypertension.","authors":"Bing-Yang Liu, Wen-Jie Yan, Yu Chen, Han-Wen Zhang, Bei-Lan Yang, Qi-Xian Zeng, Yan-Ru Liang, Li-Li Niu, Yue Tian, Qing Zhao, Qin Luo, Zhi-Hui Zhao, Wei-Chun Wu, Chang-Ming Xiong","doi":"10.1002/pul2.70260","DOIUrl":"https://doi.org/10.1002/pul2.70260","url":null,"abstract":"<p><p>To investigate the prognostic accuracy of three-dimensional echocardiographic (3DE) right ventricular (RV) data and compare it with that of risk stratification based on 2015 ESC Guidelines in pre-capillary pulmonary hypertension (PcPH) patients. We prospectively enrolled PcPH patients from March 2017 to May 2018. 3DE sequences were analyzed by semi-automatic software (TomTec 4D RV-Function 2.0). RV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction, longitudinal strain of septum and free wall, tricuspid annular plane systolic excursion were obtained. All participants were classified into low and intermediate-high risk groups based on 2015 ESC Guidelines. Patients were followed-up till May 2019 for death due to RV failure as an end-point. We finally enrolled 112 PcPH patients (average 36 years, 39 males and 73 females) in our study. Mean follow-up time was 18 months, and 11 patients died. Receive operating characteristic curves identified RV-3D-EDV = 150 mL and RV-3D-ESV = 109 mL as optimal cut-offs. Multivariate Cox proportional regression analyses indicated RV-3D-EDV > 150 mL and RV-3D-ESV > 109 mL were independent predictors of mortality after adjusted by Risk stratification. McNemar-Bowker test revealed that compared with risk stratification, RV-3D-EDV > 150 mL (67.3% vs. 44.6%, <i>p</i> < 0.01) and RV-3D-ESV > 109 mL (62.4% vs. 44.6%, <i>p</i> < 0.01) had better predictive specificities for end-point. RV volumes detected by three-dimensional echocardiography suggested potential prognostic value for risk stratification in PH patients, warranting validation in larger cohorts.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70260"},"PeriodicalIF":2.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326851","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":"Contrast Reflux Into IVC in Acute Pulmonary Embolism Predicts Clinical Deterioration Risk.","authors":"Nicholas A Leverone, Alisse G Singer, Amanda A Lopez, Charlotte Ellberg, Patrick J Henry, Alisha A Kabadi, Alyssa A Self, Danielle M Leverone, Andrew Yen, Lewis Hahn, Jennifer Karunamuni, Elizabeth Weihe, Jenny Z Yang, W Cameron McGuire, Demosthenes G Papamatheakis, Timothy A Morris, Timothy M Fernandes","doi":"10.1002/pul2.70273","DOIUrl":"10.1002/pul2.70273","url":null,"abstract":"<p><p>Reflux of contrast medium into the inferior vena cava (IVC) on computed tomography pulmonary angiogram (CTPA) is an independent risk factor for mortality in patients with acute pulmonary embolism (PE). This study's aim was to determine if reflux into the IVC correlates with objective scores of clinical risk in acute PE. Patient-level data were collected for adults diagnosed with acute PE by CTPA at University of California, San Diego Health between January 1 and June 30, 2023. Contrast reflux into the IVC was graded on a 4-point scale. The primary endpoint was the correlation between reflux severity and risk for clinical deterioration as measured by the National Early Warning Score (NEWS). The secondary endpoint was interobserver reliability grading reflux amongst 16 reviewers. Fifty-six subjects with acute PE were included. Extent of contrast reflux into the IVC correlated with NEWS (<i>Spearman's ρ</i> 0.2932; <i>p</i> = 0.028). Subjects with grade 3 reflux had increased NEWS (7.80) compared to those with reflux grades 0 (3.63; <i>p</i> = 0.014) or 1 (4.29; <i>p</i> = 0.05). NEWS was elevated in those with contrast below the diaphragm compared to those without when grading was pooled (<i>p</i> = 0.036). Interobserver reliability for reflux grading was \"moderate\" (<i>κ</i> = 0.58), yet increased to \"almost perfect\" (<i>κ</i> = 0.87) for pooled grading. Contrast reflux into the IVC during acute PE correlates with risk for clinical deterioration, as reflected by NEWS. Simplification of grading to contrast above or below the diaphragm improves reliability without compromising this relationship.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70273"},"PeriodicalIF":2.5,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309553","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":"Efficacy and Safety of Low-Dose Prolonged Infusion Thrombolysis With rt-PA for Acute Intermediate-High Risk Pulmonary Embolism.","authors":"Wenxiang Qi, Maofeng Gong, Hao Huang, Yangyi Zhou, Haobo Su","doi":"10.1002/pul2.70274","DOIUrl":"10.1002/pul2.70274","url":null,"abstract":"<p><p>Thrombolytic therapy alleviates pulmonary embolism (PE) symptoms rapidly but increases bleeding risk, with no consistent consensus on acute intermediate-high risk PE. This study evaluated the efficacy and safety of low-dose prolonged infusion thrombolysis for acute intermediate-high risk PE to provide a safer clinical option. A total of 120 patients were collected and divided into anticoagulant (Group A, <i>n</i> = 58) and thrombolytic (Group B, <i>n</i> = 62) groups. Efficacy outcomes included pulmonary artery thrombus clearance rate, 30-day all-cause mortality, and 3-6 month pulmonary hypertension incidence; the primary safety outcome was treatment-related bleeding. Both groups showed improved SBP, DBP, SpO₂, and RV/LV ratio (all <i>p</i> < 0.05) with no inter-group differences, but Group B had higher thrombus clearance rate ([64.85 ± 17.47]% vs. [41.65 ± 16.19]%, <i>p</i> < 0.001), with similar 30-day mortality (1.61% vs. 5.17%, <i>p</i> = 0.278). At 1 day, post-treatment, Group B had higher D-dimer (26.78 ± 16.57 μg/mL vs. 7.60 ± 7.23 μg/mL) and FDP (91.45 ± 97.37 μg/mL vs. 18.60 ± 26.34 μg/mL, all <i>p</i> < 0.001) but comparable FIB (<i>p</i> = 0.091); these differences persisted until discharge (all <i>p</i> < 0.05 for D-dimer/FDP). Although the incidence of bleeding events in group B was numerically higher than that in group A (17.74% vs. 6.90%, <i>p</i> = 0.073), the difference between the two groups was not statistically significant. No fatal bleeding, intracranial hemorrhage, or recurrent pulmonary embolism occurred in either group. Group B had lower 3-6 month pulmonary artery systolic pressure (PASP) (30.70 ± 9.70 vs. 34.44 ± 10.04 mmHg, <i>p</i> = 0.045) and pulmonary hypertension incidence (27.87% vs. 54.55%, <i>p</i> = 0.004). Thrombus clearance rate correlated with treatment group (<i>r</i> = 0.57, <i>p</i> < 0.001), and D-dimer (<i>r</i> = 0.42) and FDP (<i>r</i> = 0.32) levels at 1 day post-treatment (both <i>p</i> < 0.001). Low-dose prolonged infusion can effectively clear pulmonary artery thrombi in patients with acute intermediate-high-risk PE, which may be associated with a reduced incidence of pulmonary hypertension. Patients in the thrombolysis group showed significant dynamic changes in D-dimer and FDP levels, which were significantly correlated with a higher thrombus clearance rate.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70274"},"PeriodicalIF":2.5,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309580","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":"Supraventricular Arrhythmias in Pulmonary Hypertension: A Comprehensive Review From Preclinical Evidence to Clinical Practice.","authors":"Abdulkadir Kiris, Peng Zhang, Peter Bronk, Kurt W Prins, Bum-Rak Choi, Gaurav Choudhary","doi":"10.1002/pul2.70268","DOIUrl":"https://doi.org/10.1002/pul2.70268","url":null,"abstract":"<p><p>Pulmonary Hypertension (PH) is a chronic disease that causes significant structural deterioration in the right atrium and ventricle. In the past 1-2 decades, life expectancy in patients with PH has increased due to improved awareness, diagnosis and advancements in treatment. Increasingly, PH is recognized in older patients with comorbidities. With the changing demographics, supraventricular arrhythmias (SVAs), especially atrial fibrillation and flutter, are emerging as important outcomes in PH. Here, we comprehensively summarize findings from preclinical and clinical studies to define the mechanistic drivers and clinical implications of SVA. In sum, we propose early recognition and targeted management of SVA is important to improve quality of life, morbidity and mortality in patients with PH.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70268"},"PeriodicalIF":2.5,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309489","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":"Pulmonary Venous Vasculopathy in Connective Tissue Disease-Associated Pulmonary Arterial Hypertension With Reduced Diffusion Capacity for Carbon Monoxide.","authors":"Shinya Fujisaki, Ryotaro Asano, Hiroyuki Endo, Atsushi Kuraishi, Ryo Takano, Hiroya Hayashi, Keiko Ohta-Ogo, Kinta Hatakeyama, Kenichi Tsujita, Teruo Noguchi, Takeshi Ogo","doi":"10.1002/pul2.70271","DOIUrl":"https://doi.org/10.1002/pul2.70271","url":null,"abstract":"<p><p>Connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) has a poorer prognosis than idiopathic PAH, potentially attributable to pulmonary veno-occlusive disease (PVOD)-like involvement. The diffusing capacity for carbon monoxide (DLco) may reflect small pulmonary venous obliteration. Whether severely reduced DLco reflects the severity of venous remodelling in CTD-PAH remains incompletely characterised, particularly with quantitative morphometric assessment. Thus, we evaluated the association of reduced DLco with clinical characteristics and venous vasculopathy in patients with CTD-PAH. We retrospectively reviewed patients with CTD-PAH without interstitial pneumonia. Patients were categorised into two groups based on %DLco (< 45%: severely reduced DLco or ≥ 45%: non-severely reduced DLco). Clinical characteristics and survival rates were compared. Histopathological characteristics of the pulmonary vasculature were analysed in eight autopsy cases. Of the 86 patients (mean age, 49.2 ± 16.8 years), 25 (29.1%) were classified into the severely reduced DLco group. They were older, showed a higher prevalence of systemic sclerosis, and exhibited lower arterial oxygen saturation and mean pulmonary arterial pressure compared with the other group. The severely reduced DLco group had a worse survival in unadjusted analysis (<i>p</i> = 0.048). Histopathological analysis revealed that the severity of small pulmonary venous stenosis was inversely correlated with %DLco (<i>R</i> ² = 0.537, <i>p</i> = 0.039; 95% CI, -0.69 to -0.03). Patients with CTD-PAH and a severely reduced DLco demonstrated a poorer prognosis than those without. Reduced DLco was associated with the severity of small pulmonary venous stenosis, consistent with a PVOD-like venous remodelling spectrum in CTD-PAH. DLco may serve as a clinically accessible marker of venous involvement within the PVOD-like spectrum of CTD-PAH.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70271"},"PeriodicalIF":2.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271910","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":"Plasma GDF-15 and PSP-D Predict the Development of Pulmonary Arterial Hypertension in Systemic Sclerosis.","authors":"Adam Engel Sällberg, Salaheldin Ahmed, Abdulla Ahmed, Kriss Kania, Jørn Carlsen, Roger Hesselstrand, Kristofer Andréasson, Göran Rådegran","doi":"10.1002/pul2.70251","DOIUrl":"https://doi.org/10.1002/pul2.70251","url":null,"abstract":"<p><p>Patients with pulmonary arterial hypertension (PAH) experience long diagnostic delays, high functional class at diagnosis and poor prognosis. We aimed to study the differentiative and predictive value of 90 inflammatory and immunomodulatory related proteins in idiopathic and hereditary PAH (IPAH/HPAH) and systemic sclerosis-associated PAH (SSc-APAH). Cohort 1 comprised patients with SSc-APAH (<i>n</i> = 36), IPAH/HPAH (<i>n</i> = 54) and healthy controls (<i>n</i> = 55). Cohort 2 comprised SSc patients without PAH (<i>n</i> = 15) and SSc-APAH (<i>n</i> = 15), with blood samples both ~6 years before, and at PAH diagnosis. This cohort was used for internal validation and to predict future development of PAH in SSc. Cohort 3 comprised connective tissue disease (CTD) APAH (<i>n</i> = 19) and IPAH (<i>n</i> = 20), and was used for external validation. Plasma protein levels were measured with proximity extension assay. In cohort 1, we found that higher IL-27 differentiated PAH patients from controls (odds ratio (OR) = 1.24; area under the curve (AUC) = 0.94), whereas higher TNFRSF4 differentiated SSc-APAH from IPAH/HPAH (OR = 1.14; AUC = 0.82), and controls (OR = 1.30; AUC = 0.99). In cohort 2, GDF-15 and PSP-D were higher in female SSc patients that would develop vs those that wouldn't develop PAH, and predicted PAH-development ~6 years before diagnosis (OR = 1.24; AUC = 0.78 and 1.22; 0.73, respectively). Using equivalence testing, levels of IL-27, GDF-15 and PSP-D were equivalent (<i>p</i> = 0.0072, <i>p</i> = 0.0048 and <i>p</i> = 0.00076) in cohort 3 and 1. In conclusion, GDF-15 and PSP-D emerged as promising potential biomarkers in early screening and prediction of future PAH development in SSc, whereas IL-27 and TNFRSF4 appeared promising in diagnosis and subtype differentiation of PAH and SSc-APAH.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70251"},"PeriodicalIF":2.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271900","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":"Right Ventricular Pressure-Volume Loop Analysis in Large Animal Research: A Scoping Review of Current Practices Using Conductance and Admittance Catheters.","authors":"Michaela Orlitová, Joachim Hellinck, Mads Dam Lyhne, Asger Granfeldt, Arne P Neyrinck, Tom Verbelen, Piet Claus","doi":"10.1002/pul2.70267","DOIUrl":"https://doi.org/10.1002/pul2.70267","url":null,"abstract":"<p><p>Right ventricular (RV) function assessment using catheter-derived pressure-volume (PV) loops is used in translational research, providing detailed insights into cardiac mechanics. Its practical implementation requires methodological accuracy to ensure rigor, reproducibility and transparency. However, current practices for PV loop acquisition are set at individual laboratories, resulting in overall practice remaining largely unknown. This study aimed to explore current practices in RV PV loop acquisition in large animal research. We therefore conducted a scoping review registered on the Open Science Framework and guided by PRISMA Extension for Scoping Reviews, with comprehensive searches in PubMed, Embase, Scopus, and Web of Science (December 2024). Eligible studies included large animal models published after 2014 using conductance or admittance catheters. Out of 5133 identified records, 62 met inclusion criteria. The review revealed underreporting and substantial variability in methodology, particularly in catheter placement, calibration, and ventilatory mode during PV loop recording. Catheter insertion sites included RV inflow (42%) and outflow tracts (19.4%); fluoroscopy was used in 51.6%. Calibration was not reported in one-third of studies. Loop recording during apnea were reported in 23%, mechanical ventilation in 26%, and was not specified in 51%. Overall, RV PV loop protocols show substantial heterogeneity, highlighting the need for standardized methodological reporting, to improve transparency, research reproducibility and translational significance. Expert consensus is warranted to establish methodological guidelines.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70267"},"PeriodicalIF":2.5,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228382","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":"Performance of Guideline-Recommended Approaches to Echocardiographic Investigation for Pulmonary Hypertension: Analysis of the CIPHER Study.","authors":"Luke S Howard, David G Kiely, Allan Lawrie, Bradley A Maron, Ioana R Preston, Stephan Rosenkranz, Mark Toshner, Martin R Wilkins, Yiu-Lian Fong, Debbie Quinn, Dimitri Stamatiadis, Matthieu Villeneuve, Kelly M Chin","doi":"10.1002/pul2.70258","DOIUrl":"https://doi.org/10.1002/pul2.70258","url":null,"abstract":"<p><p>Guidelines recommend different approaches to investigate for pulmonary hypertension (PH) by transthoracic echocardiography (TTE). We used data from the CIPHER study (NCT04193046) to prospectively evaluate TTE detection of PH. Participants newly referred to PH clinics who underwent right heart catheterization (RHC) within 6 weeks and TTE within 60 days of enrolment (blinded central TTE reading) were classified by TTE probability of PH applying (i) the 2015 European Society of Cardiology (ESC)/European Respiratory Society (ERS) TTE algorithm or (ii) right ventricular systolic pressure (RVSP) > 40 mmHg. For calculation of sensitivity and specificity, 'non-assessable' patients (peak tricuspid regurgitation velocity [TRV] missing or ≤ 2.8 m/s with missing data on other echocardiographic signs) and patients with missing RVSP were counted as PH-negative. Performance was measured against RHC-confirmed diagnosis of mean pulmonary artery pressure > 20 mmHg. Of 475 patients included, 345 (73%) had PH. Using the ESC/ERS algorithm, PH probability was high, intermediate, low and non-assessable for 198, 104, 22 and 151 patients and PH prevalence was 98%, 75%, 23%, and 44%, respectively. Seventy-three patients were missing RVSP and 292 had RVSP > 40 mmHg. The two TTE approaches achieved similar results: sensitivity was 79%-77%, specificity was 78%-79%. This prospective study of patients newly referred to PH centres for RHC found similar sensitivity and specificity when using either RVSP > 40 mmHg or the 2015 ESC/ERS TTE algorithm. Among patients who were low-probability or non-assessable by ESC/ERS algorithm, 42% had PH, highlighting the persistent need for additional non-invasive investigative tools.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70258"},"PeriodicalIF":2.5,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220495","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":"Impact of Right Heart Catheterization and the 2022 ESC/ERS Definition of Pulmonary Hypertension in Patients With Mitral Regurgitation Undergoing Valve Repair/Replacement.","authors":"Mark Güpfert, Lukas Weber, Philipp K Haager, Philipp Baier, Sebastian Kopp, Johannes Rigger, Joannis Chronis, Marc Gerhard, Hans Rickli, Micha T Maeder","doi":"10.1002/pul2.70265","DOIUrl":"10.1002/pul2.70265","url":null,"abstract":"<p><p>In patients with mitral regurgitation (MR), the role of invasive hemodynamics is not well defined. We evaluated the value of right heart catheterization (RHC) and the 2022 ESC/ERS pulmonary hypertension (PH) definition prior to a mitral valve procedure for the prediction of PH several months thereafter. We studied 274 patients (mean age 68 ± 11 years) with at least moderate MR (84% degenerative, 11% functional, 5% combined) undergoing RHC (baseline) followed by surgical (70%) or transcatheter (30%) valve repair/replacement who had an echocardiogram after a median follow-up of 3 months. PH was defined as a mean pulmonary artery pressure (mPAP) > 20 mmHg and was subclassified by mean pulmonary artery wedge pressure (mPAWP) and pulmonary vascular resistance (PVR). The PH follow-up probability was assessed by peak tricuspid regurgitant velocity and indirect PH signs. At baseline, 143/274 (52%) patients had any PH: 40 had isolated post-capillary, 65 had combined pre- and post-capillary (CpcPH), 27 had pre-capillary, and 11 had unclassified PH. Follow-up PH probability was low in 149, intermediate in 73, or high in 42 patients. There was a progressive increase in baseline mPAP, mPAWP, and PVR (<i>p</i> < 0.001 for all) in patients with low, intermediate or high follow-up PH probability. Patients with baseline CpcPH had a nearly 11-fold higher risk (odds ratio 10.7) for a high follow-up PH probability compared to those without PH. In conclusion, in MR patients the hemodynamic constellation according to the 2022 ESC/ERS PH definition predicts the PH probability several months after a mitral valve procedure.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70265"},"PeriodicalIF":2.5,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202478","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":"Association of Immunoglobulin E With Right Ventricular Dysfunction in Pulmonary Arterial Hypertension.","authors":"Fengxia Wu, Xing Chen, Keren Chen, Jingrong Wei, Chen Gong, Weifeng Wu","doi":"10.1002/pul2.70263","DOIUrl":"10.1002/pul2.70263","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Pulmonary arterial hypertension (PAH) is characterized by pulmonary vasoconstriction and vascular remodeling, leading to increased pulmonary vascular resistance, pathological right ventricular (RV) remodeling, and ultimately right heart failure and death. RV function and right ventricle-pulmonary artery (RV-PA) coupling are critical determinants of patient prognosis, and echocardiography remains the preferred tool for assessing RV function and predicting RV-PA coupling. Recent studies have revealed that immunoglobulin E(IgE) plays a regulatory role in cardiac and pulmonary vascular remodeling; however, its role in PAH-related RV dysfunction remains unclear. This study aimed to investigate the association between serum IgE levels and RV dysfunction in patients with PAH through echocardiography, serological testing, and right heart catheterization (RHC), to provide potential evidence for novel diagnostic and therapeutic strategies in PAH. A total of 30 patients diagnosed with idiopathic pulmonary arterial hypertension (IPAH) at the First Affiliated Hospital of Chinese Guangxi Medical University between 2024 and 2025 were prospectively enrolled, along with an equal number of age- and sex-matched individuals with normal cardiac function and no cardiopulmonary disease as controls. Clinical baseline data and serum samples were collected from all participants, and serum IgE concentrations were determined using enzyme-linked immunosorbent assay (ELISA). For IPAH patients, serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, RHC parameters, and World Health Organization (WHO) functional class were obtained from the electronic medical record system. Transthoracic echocardiography (TTE) was performed to assess RV morphology, structural characteristics, and functional alterations. Statistical analysis was performed using &lt;i&gt;t&lt;/i&gt;-tests, Mann-Whitney &lt;i&gt;U&lt;/i&gt;-tests, one-way ANOVA, correlation, and regression analysis to evaluate the differences in IgE levels between groups and the relationship with RV function parameters. The results showed that in the IPAH group, 13 patients (43.3%) were male, with a mean age of 41.27 ± 11.50 years, whereas the control group included 14 males (46.7%) with a mean age of 41.35 ± 10.78 years. Serum IgE levels were significantly higher in IPAH patients compared with controls (859 [702, 1031] vs. 430 [359, 568], ng/mL, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Correlation analyses based on electronic medical record data demonstrated that serum IgE levels in IPAH patients were positively associated with NT-proBNP concentrations (&lt;i&gt;r&lt;/i&gt; = 0.79, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Moreover, patients in WHO functional class III with right heart failure exhibited significantly higher serum IgE levels than those in functional class I, and IgE levels showed a positive correlation with WHO functional class. Serum IgE levels were also positively correlated with RV pressure and PA pressure (IgE and mPAP: &lt;i&gt;r&lt;/i&gt; = 0.37, 95% CI: 0.01-0.64, &lt;i&gt;p&lt;/i&gt; = 0.04","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"16 1","pages":"e70263"},"PeriodicalIF":2.5,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202426","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}