Pulmonary Circulation最新文献_第8页

Revised Precapillary Pulmonary Hypertension Criteria and Their Prognostic Value in IPF Transplant Waitlist Survival. 修订的毛细血管前肺动脉高压标准及其在IPF移植等待者生存中的预后价值。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-02-02 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70046

Zehra Dhanani, Michael J Nicholson, Shameek Gayen

{"title":"Revised Precapillary Pulmonary Hypertension Criteria and Their Prognostic Value in IPF Transplant Waitlist Survival.","authors":"Zehra Dhanani, Michael J Nicholson, Shameek Gayen","doi":"10.1002/pul2.70046","DOIUrl":"10.1002/pul2.70046","url":null,"abstract":"Idiopathic pulmonary fibrosis (IPF) is a leading indication for lung transplantation. Pulmonary hypertension (PH), a common comorbidity in IPF, has gained renewed attention following the updated ESC/ERS guidelines, which redefine diagnostic thresholds for PH. This study evaluates the impact of the revised PH criteria on transplant waitlist outcomes among IPF patients. Specifically, we assessed the prevalence of PH under the new guidelines and its association with waitlist survival. We conducted a retrospective analysis using the OPTN/SRTR database, including 14,156 IPF candidates listed for lung transplantation. Survival analyses were performed using Kaplan-Meier and multivariate models to examine the influence of revised mPAP and PVR thresholds on waitlist mortality. The prevalence of PH, defined by the revised criteria, was significantly higher compared to the prior definition. Kaplan-Meier analysis demonstrated worse waitlist survival for patients with PH under both diagnostic thresholds. However, multivariate analysis revealed that mPAP and PVR thresholds were not independently predictive of mortality. Instead, clinical parameters, including 6MWD, functional status, BMI, FVC, PaCO2, and double lung transplant preference, were significant predictors of waitlist mortality. In conclusion, while the revised PH diagnostic criteria increase PH prevalence in IPF patients, their independent prognostic utility for waitlist survival is limited. This national transplant database study underscores the importance of comprehensive clinical evaluation and timely referral for transplantation in managing IPF with PH.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70046"},"PeriodicalIF":2.2,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123450","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

Wenshen Yiqi Granule Alleviates Chronic Obstructive Pulmonary Disease via the Long Noncoding RNA-XIST/MicroRNA-200c-3p Axis. 温参益气颗粒通过长非编码RNA-XIST/MicroRNA-200c-3p轴缓解慢性阻塞性肺疾病

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-31 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70040

Haoran Deng, Shiping Zhu, Fei Yu, Xue Song, Xinlai Jin, Xuchun Ding

{"title":"Wenshen Yiqi Granule Alleviates Chronic Obstructive Pulmonary Disease via the Long Noncoding RNA-XIST/MicroRNA-200c-3p Axis.","authors":"Haoran Deng, Shiping Zhu, Fei Yu, Xue Song, Xinlai Jin, Xuchun Ding","doi":"10.1002/pul2.70040","DOIUrl":"10.1002/pul2.70040","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is a major challenge to global public health. Evidence showed that long noncoding RNA (lncRNA)-XIST/microRNA (miRNA)-200c-3p axis regulated apoptosis and inflammation in cigarette smoke extract (CSE)-exposed human bronchial epithelial cells. Wenshen Yiqi granule (WSYQG) is a Traditional Chinese medicine compound prescription and often used for treating COPD. However, the current understanding of the mechanism by which WSYQG improves COPD is still limited, which has somewhat restrained its widespread application. Therefore, this study aims to investigate the effects and biological mechanisms of WSYQG on CSE-exposed type II alveolar epithelial (AEC II) cells with cell transfection and miRNA mimics/inhibitors intervention. Cell counting kit-8, flow cytometry, Transwell, Western blot, real-time quantitative reverse transcription PCR, and fluorescence in situ hybridization assays were used. Results showed that WSYQG intervention increased cell viability and decreased levels of IFN-γ, TNF-α and apoptosis, also preventing cell migration in CSE-exposed ACE II cells. Additionally, expression of epithelial marker (ZO-1), Notch1/4 decreased, and mesenchymal markers (vimentin) and Notch2 expression increased in CSE-exposed ACE II cells, while WSYQG intervention antagonized them and also decreased N-cadherin and increased E-cadherin. Silencing lncRNA-XIST enhanced WSYQG's effects on CSE-exposed ACE II cells, while inhibiting miR-200c-3p reversed silencing lncRNA-XIST's effects. Furthermore, dual-luciferase reporter assay system and RNA immunoprecipitation assay proved that lncRNA-XIST acts as a miR-200c-3p sponge. This study highlights the importance of the lncRNA-XIST/miR-200c-3p axis in WSYQG improving COPD, providing a research basis for WSYQG to improve COPD and expanding the possibility of expanding its clinical application.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70040"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080880","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

Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long-Term Cohort Study. 右心导管检查可准确诊断间质性肺病患者的肺动脉高压：一项长期队列研究的结果

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-26 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70035

María Berenice Torres-Rojas, Dulce Iliana Navarro-Vergara, Marisol García-Cesar, Gustavo Acosta-Altamirano, Leslie Marisol González-Hermosillo, Galileo Escobedo, Guillermo Cueto-Robledo

{"title":"Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long-Term Cohort Study.","authors":"María Berenice Torres-Rojas, Dulce Iliana Navarro-Vergara, Marisol García-Cesar, Gustavo Acosta-Altamirano, Leslie Marisol González-Hermosillo, Galileo Escobedo, Guillermo Cueto-Robledo","doi":"10.1002/pul2.70035","DOIUrl":"10.1002/pul2.70035","url":null,"abstract":"Interstitial lung disease (ILD) can lead to pulmonary hypertension (ILD-PH), worsening prognosis and increasing mortality. Diagnosing ILD-PH is challenging due to the limitations of imaging methods. Right heart catheterization (RHC) is the gold standard for diagnosing PH but is limited to ILD patients considered for lung transplantation. This study assessed the usefulness of RHC in diagnosing ILD-PH in a large cohort of 105 patients followed for at least 72 months, examining hemodynamic parameters for survival analysis. We conducted an ambispective cohort study, diagnosing PH as mean pulmonary artery pressure ≥ 20 mmHg, pulmonary arterial wedge pressure < 15 mmHg, and pulmonary vascular resistance > 2 Wood units by RHC. We registered demographic, biochemical, echocardiographic, respiratory, and hemodynamic parameters for survival analyses. Using RHC, we found a PH prevalence of 84.7% among ILD patients who previously exhibited an intermediate-to-high probability of PH by echocardiography. Thirty-nine ILD-PH patients died, yielding a 5-year survival rate of 35%, whereas ILD patients without PH had a survival rate of 100%. Connective tissue disease-associated ILD and interstitial pneumonia with autoimmune features were the predominant ILD subtypes in ILD-PH patients. The ILD-PH group had worse pulmonary function, lower forced vital capacity, and more severe hypoxemia. Kaplan-Meier analyses showed significantly lower survival rates in ILD-PH patients with a 6-min walking distance < 360 m, tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio < 0.35 mm/mmHg, venous oxygen saturation < 65%, and pulmonary artery compliance < 2.2 mm/mmHg. RHC accurately characterizes ILD-PH and provides long-term survival predictors.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70035"},"PeriodicalIF":2.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053389","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

Adding a New Dimension to PH Imaging. 添加一个新的维度PH成像。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70044

Andrew Bradley, Mardi Gomberg-Maitland

引用次数: 0

Lipid-Lowering Drugs and Pulmonary Vascular Disease: A Mendelian Randomization Study. 降脂药物与肺血管疾病：孟德尔随机研究。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-22 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70043

Xingya Yuan, Peiwei Hong, JinQiu Zhou

{"title":"Lipid-Lowering Drugs and Pulmonary Vascular Disease: A Mendelian Randomization Study.","authors":"Xingya Yuan, Peiwei Hong, JinQiu Zhou","doi":"10.1002/pul2.70043","DOIUrl":"10.1002/pul2.70043","url":null,"abstract":"The therapeutic value of lipid-lowering drugs in pulmonary vascular disease remains uncertain due to insufficient studies and evidence. This study aims to investigate the causal effects of lipid-lowering drugs (specifically, inhibitors of APOB, CETP, HMGCR, NPC1L1, and PCSK9) on pulmonary vascular diseases using a Mendelian randomization (MR) approach. We utilized summary-level statistics from genome-wide association studies (GWAS) to simulate the exposure to low-density lipoprotein cholesterol (LDL-C) and its outcomes on pulmonary arterial hypertension (PAH), pulmonary embolism (PE), and pulmonary heart disease (PHD). Single-nucleotide polymorphisms (SNPs) within or near drug target-associated LDL-C loci were selected as proxies for the lipid-lowering drugs. Data from the FinnGen cohort and UK Biobank (UKB) were incorporated to enhance the robustness and generalizability of the findings. The inverse variance weighted (IVW) and MR-Egger methods were employed to estimate MR effects. Our MR analysis indicated that LDL-C mediated by NPC1L1 (odds ratio [OR] = 104.76, 95% confidence interval [CI] = 2.01-5457.01, p = 0.021) and PCSK9 (OR = 10.20, 95% CI = 3.58-29.10, p < 0.001) was associated with an increased risk of PAH. In contrast, LDL-C mediated by APOB was associated with a decreased risk of PE (FinnGen: OR = 0.74, 95% CI = 0.60-0.91, p = 0.005; UKB: OR = 0.998, 95% CI = 0.996-1.000, p = 0.031) and PHD (FinnGen: OR = 0.73, 95% CI = 0.59-0.91, p = 0.004). However, LDL-C mediated by CETP and HMGCR did not show significant associations with the risks of PAH, PE, or PHD. This MR study revealed the causal effects of NPC1L1 and PCSK9 inhibitors on increased PAH risk, while APOB inhibitors appear to reduce the risks of PE and PHD. These findings enhance our understanding of the potential roles of lipid-lowering drugs in pulmonary vascular disease.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70043"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029458","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

PET/CT Imaging of the Right Heart Perfusion and Glucose Metabolism Depending on a Risk Status in Patients With Idiopathic Pulmonary Arterial Hypertension. 特发性肺动脉高压患者右心灌注和糖代谢与危险状态的PET/CT成像

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-22 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70042

Natalia Goncharova, Daria Ryzhkova, Kirill Lapshin, Anton Ryzhkov, Aryana Malanova, Elizaveta Andreeva, Olga Moiseeva

{"title":"PET/CT Imaging of the Right Heart Perfusion and Glucose Metabolism Depending on a Risk Status in Patients With Idiopathic Pulmonary Arterial Hypertension.","authors":"Natalia Goncharova, Daria Ryzhkova, Kirill Lapshin, Anton Ryzhkov, Aryana Malanova, Elizaveta Andreeva, Olga Moiseeva","doi":"10.1002/pul2.70042","DOIUrl":"10.1002/pul2.70042","url":null,"abstract":"Right ventricular heart failure (RV HF) is the leading cause of death in pulmonary arterial hypertension (PAH). Relevance of the low-risk status assessment using available diagnostic tools requires a reliable confirmation. The study aimed to evaluate right ventricular perfusion and glucose metabolism using positron emission tomography (PET)/computed tomography (CT) with [13N]-ammonia and [18F]-fluorodeoxyglucose ([18F]-FDG) in 30 IPAH patients (33.8 ± 9.4 years) according to ESC/ERS 2022 risk status. The ratio of SUVmaxRV/LV metabolism and SUVmaxRV/LV perfusion showed significant positive correlation with pulmonary artery pressure, right heart dilatation, NT-proBNP level and negative correlation with the RV ejection fraction. The SUVmaxRV/LV perfusion and SUVmaxRV/LV metabolism ratios differed significantly according to risk status. Low risk patients had a SUVmaxRV/LV metabolism comparable to the controls without PH. The SUVmaxRV/LV perfusion ratio was elevated in low-risk IPAH patients compared with controls. Increased SUVmaxRV/LV perfusion may be an early marker of coronary flow adaptation to RV pressure overload in low-risk IPAH patients and requires further evaluation. Further long-term studies are needed to determine the clinical relevance and cut-off values for the RV/LV PET/CT with [13N]-ammonia and [18F]-fluorodeoxyglucose ([18F]-FDG) uptake in different IPAH risk groups.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70042"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023970","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

Multiscale Three-Dimensional Evaluation and Analysis of Murine Lung Vasculature From Macro- to Micro-Structural Level. 从宏观到微观结构水平对小鼠肺血管系统的多尺度三维评价与分析。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-21 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70038

Birger Tielemans, Nora F Marain, Axelle Kerstens, Nicolas Peredo, Montserrat Coll-Lladó, Nicola Gritti, Perrine de Villemagne, Paul Dorval, Vincent Geudens, Michaela Orlitová, Sebastian Munck, Bartosz Leszczyński, Jim Swoger, Greetje Vande Velde

{"title":"Multiscale Three-Dimensional Evaluation and Analysis of Murine Lung Vasculature From Macro- to Micro-Structural Level.","authors":"Birger Tielemans, Nora F Marain, Axelle Kerstens, Nicolas Peredo, Montserrat Coll-Lladó, Nicola Gritti, Perrine de Villemagne, Paul Dorval, Vincent Geudens, Michaela Orlitová, Sebastian Munck, Bartosz Leszczyński, Jim Swoger, Greetje Vande Velde","doi":"10.1002/pul2.70038","DOIUrl":"10.1002/pul2.70038","url":null,"abstract":"The pulmonary vasculature plays a pivotal role in the development and progress of chronic lung diseases. Due to limitations of conventional two-dimensional histological methods, the complexity and the detailed anatomy of the lung blood circulation might be overlooked. In this study, we demonstrate the practical use of optical serial block face imaging (SBFI), ex vivo microcomputed tomography (micro-CT), and nondestructive optical tomography for visualization and quantification of the pulmonary circulation's 3D architecture from macro- to micro-structural levels in murine lung samples. We demonstrate that SBFI can provide rapid, cost-effective, and label-free visualization of mouse lung macrostructures and large pulmonary vessels. Micro-CT offers high-resolution imaging and captures microvascular and (pre)capillary structures, with microstructural quantification. Optical microscopy techniques such as optical projection tomography (OPT) and light sheet fluorescence microscopy, allows noninvasive, mesoscopic imaging of optically cleared mouse lungs, still enabling 3D microscopic reconstruction down to the precapillary level. By integrating SBFI, micro-CT, and nondestructive optical microscopy, we provide a framework for detailed and 3D understanding of the pulmonary circulation, with emphasis on vascular pruning and rarefaction. Our study showcases the applicability and complementarity of these techniques for organ-level vascular imaging, offering researchers flexibility in selecting the optimal approach based on their specific requirements. In conclusion, we propose 3D-directed approaches for a detailed whole-organ view on the pulmonary vasculature in health and disease, to advance our current knowledge of diseases affecting the pulmonary vasculature.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70038"},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024050","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

Optimizing Medical Pretreatment for Balloon Pulmonary Angioplasty: Overshoot or Stride Toward Optimal Multimodal Treatment. 优化球囊肺血管成形术的医学预处理：向最佳多模式治疗的超调或大步迈进。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-17 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70028

D P Staal, F J van Leusden, M C J van Thor, J Peper, B J M W Rensing, J P van Kuijk, B J M Mulder, D van den Heuvel, K A Boomars, S Boerman, J J Mager, M C Post

{"title":"Optimizing Medical Pretreatment for Balloon Pulmonary Angioplasty: Overshoot or Stride Toward Optimal Multimodal Treatment.","authors":"D P Staal, F J van Leusden, M C J van Thor, J Peper, B J M W Rensing, J P van Kuijk, B J M Mulder, D van den Heuvel, K A Boomars, S Boerman, J J Mager, M C Post","doi":"10.1002/pul2.70028","DOIUrl":"10.1002/pul2.70028","url":null,"abstract":"In patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo balloon pulmonary angioplasty (BPA), pretreatment with PH-targeted medical therapy may be beneficial to improve clinical parameters and pulmonary hemodynamics. This study aims to describe clinical results of PH-targeted therapy prior to BPA. All consecutive patients with CTEPH who underwent BPA treatment were selected from our CTEPH database. Medical treatment strategy, clinical parameters, and pulmonary hemodynamics at time of diagnosis and at the first BPA were analyzed. In total 92 CTEPH patients who started BPA treatment (64.1% women; 60.4 ± 14.1 years of age; 62.0% NYHA FC III/IV) were included. Most patients received dual oral PH-targeted medical therapy (68.5%) prior to BPA. Between diagnosis and first BPA (median time 13.9 [7.5-30.7] months) significant improvements were observed in patients treated with PH-targeted medical therapy for both clinical (6MWD: +28.2 m [5.1-51.3], log NTproBNP: -0.4 pg/ml [-0.8 to -0.1]) as well as pulmonary hemodynamic parameters (mPAP: -6.5 mmHg [-8.5 to -4.5], CO: +0.6 L/min [0.2-1.0] and PVR: -2.8 WU [-3.5 to -2.1]). The overall complication rate per BPA (out of a total of 441 procedures) was 15.0% for patients on monotherapy and 14.9% for those on dual/triple PH-targeted medical therapy. No severe complications occurred. In conclusion, pretreatment with PH-targeted medical therapy prior to BPA results in an improvement in clinical- and pulmonary hemodynamic parameters.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70028"},"PeriodicalIF":2.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010589","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

Comparing Patency of Pulmonary Stent Implantation and Balloon Angioplasty in Pulmonary Vein Stenosis: A Systematic Review and Meta-Analysis. 肺动脉支架置入术与球囊成形术治疗肺静脉狭窄通畅的比较：一项系统综述和荟萃分析。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-14 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70036

Izza Batool, Muhammad Khuzzaim Khan, Muhammad Zohaib, Ibrahim Ahmed Khan, Syed Affan Ahmed Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce Klugherz

{"title":"Comparing Patency of Pulmonary Stent Implantation and Balloon Angioplasty in Pulmonary Vein Stenosis: A Systematic Review and Meta-Analysis.","authors":"Izza Batool, Muhammad Khuzzaim Khan, Muhammad Zohaib, Ibrahim Ahmed Khan, Syed Affan Ahmed Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce Klugherz","doi":"10.1002/pul2.70036","DOIUrl":"10.1002/pul2.70036","url":null,"abstract":"Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta-analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross-sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5-year freedom from restenosis, and procedure-related complications. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Meta-regression analysis assessed factors like age and stent size. Study quality was evaluated using the Newcastle-Ottawa scale. This Systematic review and meta-analysis incorporated 11 observational studies. PSI exhibited a lower risk of restenosis requiring reintervention (OR 0.34, 95% CI 0.13, 0.87, p = 0.02) and significantly higher 5-year freedom from restenosis (OR 4.42, 95% CI 1.11, 17.62, p = 0.04) compared to PBA, with no significant difference in procedure-related complications. Meta-regression analysis showed age and stent size insignificantly affecting restenosis risk. Our review supports PSI as the preferred revascularization strategy for PVS due to superior patency benefits, emphasizing its role as the initial treatment choice. Further research is warranted for validation, considering individual patient factors in treatment selection.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70036"},"PeriodicalIF":2.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010518","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

Disparities in Clinical Outcomes Observed Within Electronic Health Record Data From a Statewide Cohort of Pulmonary Arterial Hypertension Patients. 从全国范围内肺动脉高压患者队列的电子健康记录数据中观察到临床结果的差异。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2025-01-13 eCollection Date: 2025-01-01 DOI: 10.1002/pul2.70041

Rachel Dalton, Ankit A Desai, Tianze Jiao, Julio D Duarte

{"title":"Disparities in Clinical Outcomes Observed Within Electronic Health Record Data From a Statewide Cohort of Pulmonary Arterial Hypertension Patients.","authors":"Rachel Dalton, Ankit A Desai, Tianze Jiao, Julio D Duarte","doi":"10.1002/pul2.70041","DOIUrl":"10.1002/pul2.70041","url":null,"abstract":"Health disparities in patients with pulmonary arterial hypertension (PAH) have not been extensively reported in the United States. The aim of this project was to characterize the extent of demographic and socioeconomic disparities in clinical outcomes within a large, diverse PAH patient population. A retrospective, population-based study of electronic health record data from the OneFlorida Data Trust was completed. Adult patients seeking care within one of the 12 OneFlorida Network partner healthcare systems with a documented diagnosis of any form of pulmonary hypertension (PH), including PAH, via ICD-10 code were included. Social deprivation index and healthcare provider access scores were calculated from population-based centroids derived from patient home addresses. The primary outcome was all-cause mortality, with secondary outcomes including hospitalization, emergency department (ED) visits, and similar clinical outcomes in a combined cohort of patients with other forms PH. A total of 6379 patients were included in the PAH cohort, and 37,412 patients were included in the nonspecific PH cohort. PAH patients with the greatest social deprivation exhibited increased rates of ED visits and hospitalizations. Despite having similar rates of ED visits and hospitalizations compared to non-Hispanics, Hispanic PAH patients had markedly lower mortality rates. Similar associations were also observed in the combined cohort of 37,412 patients with other forms of PH. In conclusion, healthcare disparities exist in PAH outcomes across both demographic and socioeconomic boundaries. Patients identifying as Hispanic appear to have decreased rates of mortality compared to other races/ethnicities.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"15 1","pages":"e70041"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984650","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