Pulmonary Circulation最新文献

{"title":"Use of Dupilumab to Treat Cutaneous Complications of Continuous Prostacyclin Infusion in Pulmonary Hypertension: A Case Report and Review of Literature.","authors":"Nidhy P Varghese, Erin Ely, Rozmeen Fombin, Claire Champion, Elise Whalen","doi":"10.1002/pul2.70158","DOIUrl":"10.1002/pul2.70158","url":null,"abstract":"<p><p>Adhesive reactions are common complications of continuous treprostinil infusions, limiting their recommended use as a treatment for severe pulmonary hypertension. We present the case of a 10-year-old male with recurrent adhesive-related skin reactions, which compromised both subcutaneous and intravenous continuous treatment. Due to comorbid atopic dermatitis (AD), dupilumab was initiated to decrease skin reactions to adhesives. Within 48 h of initiation, skin reactions completely resolved. With sustained dupilumab treatment, he remains symptom-free and is successfully tolerating intravenous treprostinil infusion.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70158"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065129","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 Hypertension Outcomes After Closure of Atrial Septal Defect in Infants With Developmental Lung Disease.","authors":"John L Wiegand, James A Thompson, Bruce F Landeck, Jamie L Fierstein, Dina Ashour, Joana S Machry, Amy L Kiskaddon, Marisol Betensky, Grace A Freire","doi":"10.1002/pul2.70164","DOIUrl":"10.1002/pul2.70164","url":null,"abstract":"<p><p>Pulmonary hypertension (PHTN) in infants with developmental lung disease, such as bronchopulmonary dysplasia (BPD), chronic lung disease of infancy (CLD), or congenital diaphragmatic hernia (CDH), can be exacerbated by atrial septal shunts secondary to atrial septal defects (ASD). While transcatheter ASD closure may reduce pulmonary overcirculation, data on post-closure hemodynamic and pharmacologic outcomes remain limited. This single-center retrospective study aimed to characterize changes in PHTN severity, respiratory support, and medication use 1 year after early transcatheter ASD closure (defined as closure at ≤ 1 year of age). Eligible patients were infants with BPD, CLD, or CDH who underwent early transcatheter ASD closure between 2021 and 2024 and had preprocedural PHTN medication use and respiratory support. Sixteen infants met the inclusion criteria. At 1 year, excluding the 3 who died, 10 of 13 infants (76.9%) showed improved PHTN severity, including 6 (60%) with complete resolution. Of the 13 infants, 6 (46.2%) weaned off all respiratory support. Average diuretic dosage (mg/kg/day) decreased by 92.9%, and vasodilator dosage declined by 47.0%. Infants with ASDs ≥ 5 mm and gestational age (GA) < 32 weeks required significantly longer diuretic therapy than those with smaller ASDs (< 5 mm) and GA ≥ 32 weeks. No similar associations were found with vasodilator weaning. These findings suggest early transcatheter ASD closure may offer therapeutic benefit in select high-risk infants, resulting in improved hemodynamics and reduced medication dependence. Although limited by small sample size and retrospective design, this study supports the potential for individualized weaning strategies and the need for prospective multicenter investigations.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70164"},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065139","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":"Sotatercept to Wean Off Prostacyclin Infusion Therapy for Pulmonary Arterial Hypertension: A Case Report.","authors":"Daniel J Strick, Meredith A Kaplan, Michael Bennett, Ioana R Preston, Harrison W Farber, Nicholas S Hill","doi":"10.1002/pul2.70160","DOIUrl":"10.1002/pul2.70160","url":null,"abstract":"<p><p>The activin signaling inhibitor sotatercept was approved for Group 1 pulmonary arterial hypertension (PAH) based on Phase 2 and 3 clinical trials showing significant improvements in primary outcomes; reduced pulmonary vascular resistance (PVR) and increased 6-min walk distance (6MWD), respectively. However, the efficacy and safety of transitioning off background therapies, including infusion prostacyclins, in patients receiving sotatercept are currently unknown. We report here a patient who was enrolled in sotatercept clinical trials (STELLAR/SOTERIA); during this period, he gradually transitioned from intravenous treprostinil. Subjective, physiologic, echocardiographic, and hemodynamic data after 2.5 years without intravenous therapy are presented. These results suggest that weaning off intravenous PGI2 may be feasible in some patients, but questions remain about the durability of the response and possible long-term adverse side effects.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70160"},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041189","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":"A Case Series: Pericardial Effusion in Patients Treated With Sotatercept.","authors":"Ariel M McKenna, Nicholas S Hill, Harrison W Farber","doi":"10.1002/pul2.70162","DOIUrl":"10.1002/pul2.70162","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is characterized by vasoconstriction, proliferation, fibrosis, and microthrombosis of the pulmonary vasculature, which causes elevated pulmonary arterial pressure and vascular resistance leading to right ventricular failure and death. Previous treatments targeted three known pathways involved in the development of PAH: endothelin, nitric oxide, and prostacyclin. Dysfunctional signaling of the transforming growth factor-beta (TGF-β) family, via bone morphogenetic protein (BMP) receptor 2 and activin signaling, has also been implicated in PAH leading to the development of a new class of therapies. Sotatercept, the first medication in this class, has shown significant promise as an add-on therapy. Another drug in the class, cibotercept, is under investigation; however, the clinical trial has been suspended because of the development of pericardial effusions in some patients. In light of this new finding, we investigated whether our patients treated with sotatercept also experienced this possible side effect.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70162"},"PeriodicalIF":2.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024195","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":"Chronic Thromboembolic Pulmonary Hypertension in Latvia: Epidemiological Insights and Diagnostic Challenges From 2024.","authors":"Matiss Zicans, Kristaps Sablinskis, Haralds Cesnieks, Ainars Rudzitis, Ricards Kaulins, Andris Skride","doi":"10.1002/pul2.70159","DOIUrl":"10.1002/pul2.70159","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but serious disease caused by persistent thromboembolic obstruction or narrowing of the pulmonary arteries. Its prevalence varies, and many cases remain undiagnosed, contributing to a substantial clinical burden. This study aimed to summarize all CTEPH cases diagnosed in Latvia in 2024, calculate the annual incidence, and present additional epidemiological data from Latvian pulmonary hypertension (PH) registry. Additionally, we sought to document the presence of risk factors in individual patients and analyze their diagnostic pathways leading to a diagnosis of CTEPH. This observational study aimed to analyze diagnostic pathways and identify risk factors in all patients diagnosed with CTEPH in Latvia in 2024. Diagnosis was confirmed at Pauls Stradins Clinical University Hospital according to ESC guideline criteria. Patients completed the emPHasis-10 questionnaire and underwent a structured interview. In 2024, 15 patients were diagnosed with CTEPH in Latvia, corresponding to an annual incidence of 8.01 cases per million. Prevalence was 31.51 per million, and mortality-3.74 per 100 person-years. Patients diagnosed within 2 years of symptom onset had lower pulmonary vascular resistance compared to those diagnosed later. The most common risk factor was prior acute pulmonary embolism (80%). In 60% of cases, diagnosis was delayed by more than 2 years, reflecting late referral to a PH centre. CTEPH remains frequently misdiagnosed and undertreated. Improved recognition of risk factors and stronger collaboration with specialized PH centres are essential to optimize patient management and outcomes.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70159"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001457","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":"How Is Pulmonary Hypertension Characterised and Treated in Children With Trisomy 21? Observations From the TOPP Registry (Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension).","authors":"Tilman Humpl, Rolf M F Berger, Damien Bonnet, Maurice Beghetti, Dunbar Ivy","doi":"10.1002/pul2.70146","DOIUrl":"10.1002/pul2.70146","url":null,"abstract":"<p><p>Pulmonary hypertension is common in children with Trisomy 21, frequently with multifactorial aetiologies. Registry data provide better understanding of disease development, diagnostic workup and treatment patterns in children with Trisomy 21. TOPP (Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension) is a centre-based, comprehensive registry. Patients aged between 3 months and 18 years at time of diagnosis were eligible if they met predefined haemodynamic criteria. Demographic data, clinical symptoms at presentation, diagnostic tools, etiology, hemodynamic data, treatment, and follow-up were collected from the data base. Differences between the Trisomy 21 group and the non-Trisomy 21 group were analysed by the non-parametric Mann-Whitney test. Categorical variables were compared using the chi-squared test, or Fisher's exact test in the case of low expected frequencies. Out of 531 children in the registry, 62 patients (11.7%) were diagnosed with Trisomy 21. Compared to children without Trisomy 21, those with Trisomy 21 were younger at diagnosis, and had more often an associated congenital heart disease. Clinical symptoms at diagnosis were similar in children with or without Trisomy 21. However, those with Trisomy 21 presented less frequently with dyspnea with exertion, but more frequently with cyanosis, either at rest or with exertion. A comprehensive diagnostic workup in all children with Trisomy 21 was not done. Children with Trisomy 21 had lower mean pulmonary artery pressure (median 50 mmHg, IQR 38-62) and similar indexed pulmonary vascular resistance (median 11.5 WU.m², IQR 7.4-18.4) compared to patients without Trisomy 21. Children with Trisomy 21 were treated less frequently with targeted therapies for pulmonary arterial hypertension and received less combination therapy. In children with Trisomy 21 and pulmonary hypertension, early systematic diagnostic work up is essential to obtain the correct underlying pathology and guides to appropriate treatment.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70146"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001450","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":"In Situ Pulmonary Artery Thrombosis and Low Flow Stasis Artifact in Parenchymal Lung Disease: An Under-Recognized Phenomenon.","authors":"Jennifer Mansour, Ken Dekitani, Fereidoun Abtin, Rajan Saggar, Richard Channick","doi":"10.1002/pul2.70129","DOIUrl":"10.1002/pul2.70129","url":null,"abstract":"<p><p>Pulmonary emboli (PE) are a common clinical problem seen when a peripheral deep vein thrombosis (DVT) migrates to the pulmonary arteries. However, emerging literature suggests that not all filling defects in the pulmonary arteries are the result of embolism, and that in situ pulmonary arterial thrombus (ISPAT) or low-flow stasis artifact (LFSA) within the pulmonary arteries can mimic acute PE. The proposed mechanism for ISPAT is chronic stasis due to abnormal perfusion in areas of parenchymal lung disease leading to in situ thrombosis. Similarly, LFSA occurs when stasis leads to persistent visualization of intravenous contrast which is then mistaken for thrombus. The clinical scenarios in which ISPAT and LFSA develop are not yet fully defined. We report here a series of patients with parenchymal lung disease leading to ventilation-perfusion mismatch who likely had ISPAT or LFSA and not acute PE. Our aim is to further define parenchymal lung disease as a subgroup of patients who are at high risk for ISPAT. Cases initially diagnosed as acute PE leading to activation of the UCLA pulmonary embolism response team (PERT) were reviewed. Inclusion criteria were all cases of PE that led to PERT activation. Inclusion criteria included absence of DVT, previously diagnosed pulmonary disease, and presence of thrombus only in areas of abnormal parenchyma. Cases were reviewed with radiology to identify cases in which ISPAT was the likely diagnosis, and five representative cases were selected to be discussed. These cases were then analyzed qualitatively for commonalities which are described below. The five representative cases described represent patients with known chronic lung disease who were diagnosed and initially managed as acute PE but, on review, met criteria for either ISPAT or stasis artifact. These cases, which were all rediagnosed as ISPAT or LFSA, were all seen in the absence of DVT, with thrombus specifically located in areas of significant parenchymal lung disease with suspected decrease in ventilation and perfusion in these areas. ISPAT or LFSA have been described in the literature, though its presence specifically in parenchymal lung disease has yet to be described. The authors recommend considering this diagnosis in patient's diagnosed with acute PE when the following are present: significant parenchymal lung disease, absence of DVT, absence of thrombus in the areas of the lung relatively spared of parenchymal lung disease, and suspected baseline decrease in both ventilation and perfusion to the affected areas of the lung. As this phenomenon may be physiologically beneficial, the authors suggest that not all cases of ISPAT or LFSA need anticoagulation, and that treatment should be considered on a case-by-case basis.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70129"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993322","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 Vascular Compromise Is Associated With Survival in Pediatric Pulmonary Hypertension: A New Computational Model.","authors":"Maria Niccum, Catherine M Avitabile, Dana Albizem, Heather Meluskey, Christopher Penney, Brian D Hanna, Michael L O'Byrne, Zoheir Bshouty, David B Frank","doi":"10.1002/pul2.70156","DOIUrl":"10.1002/pul2.70156","url":null,"abstract":"<p><p>Pediatric pulmonary arterial hypertension (PAH) has a long asymptomatic period with progressive vascular loss. A recent computational model of simulated PAH in humans has demonstrated that up to 70% of the pulmonary vasculature is lost before clinical PAH criteria are met. We used this model in pediatric subjects with PAH to evaluate whether estimated pulmonary vascular loss or compromise (PVC) was associated with hemodynamic variables, survival, and other clinical outcomes. Retrospective and prospective cohort data were collected for subjects with PAH between 1999 and 2022 treated at our center. Cardiac catheterization and clinical data were compared with PVC estimated by the computational model. Transplant-free survival was associated with lower PVC (72% vs. 88%, <i>p</i> < 0.001) and was also associated with a decrease in PVC over time with no significant change in PVC in subjects who died or underwent transplant. By Kaplan-Meier analysis, 10-year survival was 54% (IQR 35%, 81%) when PVC was more than 80%, compared with 100% survival (IQR 100%, 100%) when PVC was less than 80% (<i>p</i> < 0.001). By Cox proportional hazard regression, PVC was associated with mortality (HR 1.44, <i>p</i> = 0.008). Lower PVC was associated with better clinical outcomes including percent predicted 6-min walk distance, brain natriuretic peptide, and estimated 1-year mortality. These findings demonstrate that PVC is a new computational hemodynamic variable estimating vascular area loss and is associated with transplant-free survival and other clinical outcomes in pediatric PAH. Further, PVC provides an adjunctive tool to potentially capture pulmonary vascular loss early in disease, progression, and response to therapy.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70156"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993373","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":"Sequential Combination of Balloon Pulmonary Angioplasty for Distal Lesions in the Left Pulmonary Artery Followed by Pulmonary Endarterectomy for Central Lesions in the Right Pulmonary Artery: A Case Report.","authors":"Ryo Takano, Jin Ueda, Yoshimasa Seike, Akiyuki Kotoku, Hiroki Horinouchi, Yosuke Inoue, Tetsuya Fukuda, Hitoshi Matsuda, Takeshi Ogo","doi":"10.1002/pul2.70155","DOIUrl":"10.1002/pul2.70155","url":null,"abstract":"<p><p>Pulmonary endarterectomy (PEA) is the gold standard treatment for chronic thromboembolic pulmonary hypertension (CTEPH). While balloon pulmonary angioplasty (BPA) is an emerging treatment for distal CTEPH, a standard therapeutic strategy for CTEPH with unilateral central lesions has yet to be established. Herein, we describe the successful treatment of a patient with CTEPH who underwent BPA for left distal lesions, followed by PEA for unilateral right central lesions, without serious complications. BPA before PEA may reduce perioperative complications by improving hemodynamics and contribute to a better clinical course by shortening deep hypothermic circulatory arrest time through reduction of the PEA treatment area. Depending on the anatomical characteristics of the lesions, this combination therapy should be discussed by a multidisciplinary CTEPH team.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70155"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966731","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":"Renal Outcomes After Lung or Combined Heart-Lung Transplantation in Pulmonary Hypertension.","authors":"Laura Hardy, Alexander D'Haenens, Ann Belmans, Rozenn Quarck, Gitte Aerts, Catharina Belge, Guido Claessen, Dirk Kuypers, Greet De Vlieger, Tom Verbelen, Laurens J Ceulemans, Dirk E Van Raemdonck, Bart M Vanaudenaerde, Geert Verleden, Lieven Dupont, Robin Vos, Marion Delcroix, Laurent Godinas","doi":"10.1002/pul2.70136","DOIUrl":"10.1002/pul2.70136","url":null,"abstract":"<p><p>Renal impairment is considered a contra-indication for lung (LTX) or combined heart-lung (HLTX) transplantation due to increased mortality. We hypothesized that renal impairment in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is the result of reduced cardiac output and should be partly reversible after LTX. We performed a retrospective analysis in 67 consecutive PAH and CTEPH patients who underwent (H)LTX, to investigate the postoperative evolution of renal function in function of baseline renal function using a mixed model effect test. Furthermore, we assessed potential predictors for postoperative renal dysfunction, renal replacement therapy (RRT) and mortality by multivariate analyses. Median baseline eGFR was 74 mL/min/1.73m². Fourteen patients were classified as KDIGO 3 preoperatively, 38 patients as KDIGO 2. Renal function significantly declined after 1 and 2 years in all patients. In patients with impaired renal function (KDIGO 2 and 3), we observed a significant improvement in eGFR 1 month after (H)LTX (<i>p </i>= 0.02 and <i>p </i>= 0.04, respectively). Baseline renal impairment ≤ 60 mL/min/1.73m² was associated with early RRT but not with further renal function deterioration, long-term RRT, or mortality. Age was a predictor of renal function decline and mortality. We conclude that renal function evolution can be biphasic after (H)LTX in PAH and CTEPH patients with baseline renal impairment, with initial improvement due to resolution of cardio-renal syndrome. Mild to moderate renal impairment was not significantly associated with renal deterioration or increased mortality.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 3","pages":"e70136"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966706","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}