Pulmonary Circulation最新文献

{"title":"A Subgroup Reanalysis of the Efficacy of Bufei Huoxue Capsules in Patients With \"Long-Covid-19\".","authors":"Chi Hou, Yue Xing, Yuqin Chen, Tingping Wang, Jingjing Qi, Xiaoqing Jia, Xiansheng Zeng, Jianling Bai, Wenju Lu, Yu Deng, Bihua Zhong, Yongxia Lei, Yilin Chen, Zhan Lian, Haohao Zhou, Junping Yan, Xuejiao Yang, Hao Yu, Jiawei Zhou, Lixia Qiu, Yunliang Zhai, Wanli Geng, Nanshan Zhong, Chunli Liu, Jian Wang","doi":"10.1002/pul2.70084","DOIUrl":"10.1002/pul2.70084","url":null,"abstract":"<p><p>Bufei huoxue capsules (BFHX), manufactured products of traditional Chinese medicine, have demonstrated anti-inflammatory properties and efficacy against chronic pulmonary diseases and COVID-19. This study was designed to further determine the clinical efficacy of BFHX in diverse patient subgroups during the convalescent phase of COVID-19, extending upon previously reported findings from a multicenter randomized controlled trial. Patients who had clinically recovered from COVID-19 were blindly assigned to BFHX or placebo groups. All enrolled patients underwent chest computed tomography (CT) imaging, 6-min walking distance (6MWD) test, and fatigue assessment inventory (FAI) at monthly follow-up for 3 months. A post hoc subgroup reanalysis was performed on subgroups of sex, age, severity of acute illness, and positive/negative IgG antibody against S antigen variants. A total of 129 patients were enrolled in BFHX (<i>N</i> = 64) and placebo groups (<i>N</i> = 65). The 6MWD and FAI scores were more significantly improved in females and mild patients than in males and severe patients after BFHX treatment. Lung CT image evaluated by the change in whole lung volume and mean CT value showed that the patients below 60 years gained more therapeutic effects after 3 months of BFHX treatment (<i>p</i> = 0.0008; <i>p</i> = 0.017; <i>p</i> = 0.0313, respectively). The subgroup reanalysis implies that the therapeutic effectiveness of BFHX in managing COVID-19 convalescence could potentially be influenced by factors including gender, age, and disease severity. <b>Trial registration:</b> This study was registered with the China Clinical Trial Registration Center (registration number: ChiCTR2000032573).</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70084"},"PeriodicalIF":2.2,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012422","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":"Transcriptional Signatures of the Right Ventricle in End-Stage Heart Failure.","authors":"Jonah D Garry, Giovanni E Davogustto, Vineet Agrawal, Fei Ye, Kelsey Tomasek, Yan Ru Su, Tarek Absi, James D West, Anna Hemnes, Evan L Brittain","doi":"10.1002/pul2.70090","DOIUrl":"10.1002/pul2.70090","url":null,"abstract":"<p><p>The molecular mechanisms driving right ventricular (RV) adaptation to stress and failure in end-stage heart failure (HF) are largely unknown. We aimed to characterize myocardial transcriptional changes in the RV caused by left sided HF and comparing RV compensation to failure. Additionally, we compared transcriptomic changes between right and left ventricular (LV) failure. Paired right and left ventricular myocardial tissue samples were obtained from 33 human subjects with end stage HF referred for transplantation and 8 control donors with unused transplant hearts. RV samples from end stage HF subjects were subdivided into compensated (<i>n</i> = 25) and failing (<i>n</i> = 8) categories based on pulmonary artery pulsatility index of < 1.85. All samples underwent bulk tissue RNA-sequencing. We compared gene expression between groups and performed pathway enrichment analysis. Pathways related to fatty acid metabolism and mitochondrial function were negatively enriched, while extracellular structure-related pathways were positively enriched in stressed RVs (compensated and failing) compared to controls. Compensated and failing RVs were differentiated by transcriptional changes in protein production/processing and immune system pathways. PPAR signaling and fatty acid metabolism pathways were consistently enriched in the RV compared to the LV. The RV has a distinct transcriptional signature under stress and in failure. Overlapping molecular mechanisms may underlie RV failure in pulmonary arterial hypertension and HF. Fatty Acid metabolism and associated signaling pathways appear enriched in the RV compared to the LV.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70090"},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042086","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":"Role of a New Walk Test in Pulmonary Arterial Hypertension: A Retrospective Cohort Study.","authors":"Junhao Jin, Yao Mi, Aqian Wang, Bo Li, Kaiyu Jiang, Hai Zhu, Ting Liang, Hongling Su, Yunshan Cao","doi":"10.1002/pul2.70087","DOIUrl":"10.1002/pul2.70087","url":null,"abstract":"<p><p>The 6-min walk test (6MWT) has significant prognostic value, but requires long walking distances and lacks evaluation of exercise speed. This study aimed to investigate the clinical utility of a new walk test, the 18-meter walk test (18MWT), in patients with pulmonary arterial hypertension (PAH) as a complement to the 6MWT. In summary, a total of 117 patients with PAH from January 2018 to December 2022 were included. Spearman correlation, Cox regression, and Kaplan-Meier analysis were utilized to demonstrate the value of 18MWT in predicting disease severity and clinical worsening. The median time to complete the 18MWT was 12.8 s (interquartile range: 11.3-14.6 s). 18MWT completion time showed significant correlations with indicators such as N-terminal pro-brain natriuretic peptide and 6MWT distance. Adjusted Cox regression showed 18MWT time remained an independent predictor of clinical worsening (hazard ratio = 1.10; 95% confidence interval: 1.01-1.21; <i>p</i> = 0.026). A simplified risk stratification using WHO functional class, 6MWT distance, 18MWT time and NT-proBNP was predictive of 1-year clinical outcome. These results suggest that the 18MWT provides clinicians with an efficient measure that can be used to evaluate the disease severity of PAH patients and to identify those patients at greater risk for future clinical worsening as a complement to the 6MWT.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70087"},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991235","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":"Approach to Lung Transplantation in Pulmonary Arterial Hypertension: A Delphi Consensus on Behalf of the Transplant Task Force of the Pulmonary Vascular Research Institute.","authors":"Nicholas A Kolaitis, Hayley Barnes, Deborah J Levine, Howard Castillo, Selim M Arcasoy, Matthew Bacchetta, Luke Benvenuto, Erika Berman-Rosenzweig, Marisa Cevasco, Caitlin T Demarest, Celine Dewachter, Michiel E Erasmus, Allan R Glanville, John Granton, Shaf Keshavjee, Vikramjit Khangoora, Sheila Krishnan, Olaf Mercier, Andrea N Miltiades, David Montani, Edward Murphy, Ivan Robbins, Franck F Rahaghi, Sahar A Saddoughi, Laurent Savale, Marc A Simon, Jean-Luc Vachiery, Corey E Ventetuolo, Helen M Whitford, Reda E Girgis","doi":"10.1002/pul2.70088","DOIUrl":"10.1002/pul2.70088","url":null,"abstract":"<p><p>Lung transplantation is indicated for selected patients with advanced pulmonary arterial hypertension (PAH). We used a modified Delphi process to develop recommendations on care of patients with PAH undergoing lung transplantation. This Delphi panel was recruited from the Pulmonary Vascular Research Institute's Innovative Drug Discovery Initiative - Lung Transplantation Workstream, consisting of clinical and research experts in PAH and lung transplantation. In this process, 29 panelists were given open-ended questions, querying topics related to lung transplantation in PAH. A steering group converted the responses into discrete statements. Panelists then rated agreement using a Likert scale in two further survey rounds: -5 (strongly disagree) to 5 (strongly agree). Consensus was defined as mean ≥ 2.5 or ≤ -2.5, with a standard deviation not crossing zero. Consensus was reached on 141 of 223 statements. Notable areas of consensus were for early discussions about transplantation, and agreement with previously published referral and listing criteria. There was agreement that lung transplantation could be offered in sick candidates, including those with concurrent renal or hepatic insufficiency. Bilateral lung transplantation was considered the procedure of choice for most patients, with rare indications for heart-lung transplantation. Consensus on bridging strategies included use of veno-arterial extracorporeal membrane oxygenation and preemptive awake cannulation in those with severe right ventricular dysfunction. Consensus was also achieved on intraoperative use of invasive hemodynamic monitoring, and prolonged postoperative circulatory support guided by hemodynamic response and echocardiography. Patients with PAH undergoing transplantation require specialized management, which differs somewhat from other candidates.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70088"},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028801","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":"Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center.","authors":"S Christopher Malaisrie, Stephen Chiu, Daniel Schimmel, Maanasi Samant, Ryan Avery, Amir Rahsepar, Bradley Allen, Yasmin Raza, Benjamin Freed, Ruben Mylvaganam, Michael J Cuttica","doi":"10.1002/pul2.70085","DOIUrl":"https://doi.org/10.1002/pul2.70085","url":null,"abstract":"<p><p>Recent international guidelines recommend a multidisciplinary evaluation and care model for patients with chronic thromboembolic pulmonary hypertension (CTEPH), but there is a paucity of supporting data. The aim of this study was to describe the outcomes of a multidisciplinary team approach to the comprehensive care of CTEPH patients. This single-center cohort study enrolled 166 consecutive adult patients undergoing CTEPH treatment evaluation from 2016 to 2022 at a tertiary care, academic regional referral and comprehensive CTEPH center with pulmonary thromboendarterectomy (PTE) and balloon pulmonary angioplasty (BPA) capabilities. Patients underwent PTE, BPA, or medical management after consensus evaluation by a multidisciplinary team including pulmonary hypertension physicians, surgeons, interventional cardiologists, and radiologists. 86% (142/166) of patients underwent interventional therapies; 100 (60%) underwent PTE and 42 (25%) BPA. Of the 24 (14%) medically treated patients, 13 patients were offered but deferred intervention; 11 patients had non-intervenable disease. 30-day mortality in both PTE and BPA was 0%. 1- and 3-year survival was 99% and 96% for PTE, 100% and 93% for BPA, 79% and 79% for medical management. Patients who underwent PTE had the best hemodynamic response (∆PVR: PTE -278.8 ± 366.9 dyne/sec/cm⁵; BPA -15.9 ± 171.8 dyne/sec/cm⁵; medical -60.2 ± 233.1 dyne/sec/cm⁵; <i>p</i> = 0.001), largest improvement in Borg Dyspnea Scale; [PTE -1.0 (-2.8 to 0.0), BPA + 0.5 (-0.8 to 5.0), medical +1.0 (0.75 to 3.0), <i>p</i> = 0.01], and most improvement in NYHA functional class [% improving at least 1 functional class: PTE 64% (47/73), BPA 18% (5/28), medical 21% (4/19), <i>p</i> = 0.0004].</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70085"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045971","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":"Societal Costs Associated With Pulmonary Arterial Hypertension Subgroups: A Study Utilizing Linked National Registries.","authors":"Barbro Kjellström, Bodil Ivarsson, Magnus Husberg, Lars-Åke Levin, Lars Bernfort","doi":"10.1002/pul2.70074","DOIUrl":"10.1002/pul2.70074","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a heterogenic diagnosis including idiopathic and hereditary PAH (IPAH/HPAH) and groups associated to connective tissue disease (APAH-CTD) and congenital heart disease (APAH-CHD). Pre- and post-diagnosis societal costs in PAH subgroups are not well known. By linking Swedish national databases, societal costs in a national PAH cohort 5 years before and 5 years after diagnosis were estimated and compared to an age, sex, and geographically matched control group (1:5 match). Incident patients diagnosed 2008-2019 were included (patient/control; IPAH/HPAH = 393/1965, APAH-CTD = 261/1305, APAH-CHD = 89/445). Pre-diagnosis mean societal costs were 2.9, 3.4, and 4.3 times higher for IPAH/HPAH, APAH-CTD and APAH-CHD patients, respectively, than controls. Post-diagnosis, mean costs had increased 3.1, 2.0, and 1.6 times further for IPAH/HPAH, APAH-CTD and APAH-CHD respectively, while it decreased in all control groups. Main cost driver pre-diagnosis were indirect costs (productivity loss) in both patient and control groups, however, 2.7-4.5 times higher in the patient groups. Post-diagnosis, the main cost driver for all groups were health care costs (in- and outpatient-care, drugs) that had increased 7.8, 5.4 and 6.8 times for IPAH/HPAH, APAH-CTD and APAH-CHD, respectively. Corresponding increase for controls were 17%-48%. For the PAH groups, drug treatment accounted for 70%-81% of the direct costs, while hospitalizations were the main driver for the control groups. In conclusion, PAH was associated with large societal costs. Pre-diagnosis, APAH-CHD had the highest societal costs, both in relation to their control group and compared to the other patient groups. Post-diagnosis, highest societal costs were seen in IPAH/HPAH.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70074"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012428","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":"Alterations in ECG and Right Heart Catheterization Data in PAH Patients Who Died From Sudden Death Compared With Right Heart Failure.","authors":"Alexandra B Flemington, Jeffery Annis, Evan L Brittain, Anna R Hemnes","doi":"10.1002/pul2.70082","DOIUrl":"10.1002/pul2.70082","url":null,"abstract":"<p><p>A meaningful number of patients with PAH die suddenly, and there is little data to understand the events surrounding sudden death in PAH. We tested the hypothesis that sudden death is associated with pre-mortem ECG or hemodynamics changes compared to those who died of RHF. We extracted data from the Vanderbilt University Medical Center Synthetic Derivative. Patients 18 years of age and older with Group 1 PAH secondary to any etiology who died between 2009 and 2017 with both ECG and RHC data from the inpatient and outpatient setting were included in the study. Continuous variables were compared using the Wilcoxon rank-sum test while categorical variables were compared using the <i>χ</i> ² test. Logistic regression models, adjusted for age and sex, were then used to evaluate the association between death and specific ECG or RHC measurements. Comparing the final ECG before death, those who died of SD had significantly shorter terminal 40 ms interval of the QRS than those who died of RHF, which became nonsignificant when adjusted for age and sex. We observed differences in baseline RHC data between SD and RHF including higher RV systolic pressure which remained significant when adjusted for age and sex. Using this data, we hope to find clinical data that can be used to predict increased risk of sudden death and aid in stratifying Group I PAH patients to earlier and more aggressive interventions.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70082"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993762","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":"Mas1 Receptor Activation is Necessary and Sufficient to Transduce ACE2 Effect in PAH, But Ang(1-7) Alone is Insufficient.","authors":"James West, Megha Talati, Erica Carrier, Anandharajan Rathinasabapathy, Ibragim Gaidarov, Benjamin Vigl, Ying Cai, Hongpeng Jia, Tom Blackwell, Santhi Gladson, Christie Moore, Sheila Shay, Ethan Sevier, Anna Hemnes","doi":"10.1002/pul2.70083","DOIUrl":"https://doi.org/10.1002/pul2.70083","url":null,"abstract":"<p><p>ACE2 has shown effectiveness in treating pulmonary hypertension in multiple animal models and has some promise in early human trials. The key barrier to translation is that enzymatically active ACE2 is difficult to manufacture and exhibits a short half-life in humans, making chronic administration challenging. Understanding the mechanism of effect is thus key to finding ways to bypass ACE2 while still reproducing therapeutic effects. In this study, we test the hypotheses that ACE2 produces its therapeutic effect through increased Mas1 signaling and that Ang(1-7) is sufficient as the Mas1 ligand. We found that the ACE2 effect is blocked in Mas1 knockout mice and that the Mas1 agonist AR234960 reproduces the ACE2 effect, indicating that Mas1 activation is necessary and sufficient for the ACE2 therapeutic effect. However, neither AlbudAb-stabilized Ang(1-7) nor Ang(1-7) stabilized through the use of protease inhibitors were capable of reproducing ACE2 effectiveness, indicating that Ang(1-7) alone does not activate Mas1 in this context. RNA-seq suggests that the key mechanisms downstream of Mas1 responsible for the therapeutic effect of ACE2 and AR234960 are the rescue of cytoskeletal and microtubule defects. Together, these findings indicate that direct activation of Mas1 will likely be effective in treating pulmonary arterial hypertension, but raise the question of the identity of the endogenous ligand(s).</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70083"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012425","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":"Prevalence and Economic Burden of Pulmonary Hypertension and Pulmonary Arterial Hypertension Among the Medicaid Population.","authors":"Marshaleen Henriques King, Chaohua Li, Vincent C Bond, Dimitri Ford, Peter Baltrus, Harrison W Farber","doi":"10.1002/pul2.70060","DOIUrl":"10.1002/pul2.70060","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is defined hemodynamically as a mean pulmonary arterial pressure (mPAP) ≥ 20 mmHg, measured at right heart catheterization (RHC). Pulmonary arterial hypertension (PAH) is defined as a mPAP ≥ 20 mmHg with a pulmonary capillary wedge pressure (PCWP) or left ventricular end-diastolic pressure (LVEDP) of ≤ 15 mmHg and a pulmonary vascular resistance (PVR) > 2 Woods Units (WU). The reported prevalence of PAH in the general population is 0.03-0.05 per 1000 population. However, several studies suggest that the prevalence may be higher among specific sub-populations. Using Medicaid Analytic Extract (MAX) files, we identified Medicaid beneficiaries who were diagnosed with PH or PAH between 2009 and 2012. The prevalence of PH and PAH was calculated for the overall study population and subgroups based on demographics or co-morbidities. We used one-way analysis of variance (ANOVA) tests to compare the differences in hospital bed days and total Medicaid cost across racial subgroups among those with PH and those without PH; Tukey post hoc tests were performed to calculate p-values for comparing White and Black subpopulations. Prevalence rates ranged between 1.7 and 1.8 per 1000 persons, and the PAH prevalence ranged between 0.4 and 0.5 per 1000 persons for the years reviewed. Significant racial/ethnic disparity in PH and PAH prevalence was observed (<i>p</i>-value < 0.001), with Black patients having the highest prevalence and Asian patients having the lowest prevalence. Prevalence of PH and PAH were noted to be higher for the Medicaid population than for the general population for all years reviewed. PH and PAH prevalence was noted to be higher among Blacks compared to Non-Hispanic Whites, while it was significantly lower in Hispanics and Asians. PH/PAH Medicaid patients were noted to account for a greater economic burden compared to the general Medicaid population. Stratifying economic burden by race revealed that American Indian and Alaska Natives with PH had the highest total Medicaid cost for all years reviewed.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70060"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980595","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":"Diagnostic Accuracy of the Malnutrition Universal Screening Tool and Mini Nutritional Assessment Short-Form in Outpatients With Pulmonary Hypertension.","authors":"E Grimbergen, S P M van Aarssen, D P Staal, J Peper, J J Mager, S Boerman, B J M Mulder, M C Post","doi":"10.1002/pul2.70075","DOIUrl":"10.1002/pul2.70075","url":null,"abstract":"<p><p>Several disease related factors of pulmonary hypertension (PH) can negatively impact the nutritional status, leading to an increased risk of malnutrition. However, there are no studies on the best method for nutritional screening in PH patients. Therefore, the aim of this study was to determine the diagnostic accuracy of two screening tools: the Malnutrition Universal Screening Tool (MUST) and the Mini Nutritional Assessment Short-Form (MNA-SF). This cross-sectional single center study included PH outpatients. Cut-off values MUST ≥ 1 and MNA-SF ≤ 11 were used for state of (risk of) malnutrition. The diagnostic criteria of the Global Leadership Initiative on Malnutrition (GLIM) were used as reference for diagnosing malnutrition. Diagnostic accuracy was determined by sensitivity, specificity, predictive positive value, negative predictive value, Cohen's Kappa- value (K) and area under the curve. Out of the 103 PH patients (age 67 years (SD 11.5), 66% female), 27% were malnourished according to the GLIM criteria. Both MUST and MNA-SF had an insufficient sensitivity (60.7% [CI: 41%-97%] vs. 64.3% [CI: 44%-81%]). The MUST had a specificity of 100% [CI: 95%-100%], PPV 100% [CI:94%-100%] and NPV 87.2% [CI:79%-93%]. The specificity of the MNA-SF was 81.3% [CI:70%-89%], PPV 56.3% [CI: 39%-73%] and NPV 85.9% [CI: 77%-93%]. The MUST had a higher K-value 0.692 and AUC (0.804) compared to the K-value 0.437 and AUC (0.728) of the MNA-SF. This study indicated that both MUST and MNA-SF are inaccurate to detect (risk of) malnutrition in PH outpatients. Future studies are needed to strive for a more sensitive screening tool.</p>","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 2","pages":"e70075"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051018","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}