{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T20:52:59Z","timestamp":1769115179910,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T00:00:00Z","timestamp":1499644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R03 HL135463"],"award-info":[{"award-number":["R03 HL135463"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study evaluated the utility of a novel index, pulmonary arterial (PA) proportional pulse pressure (PAPP; range 0\u20131, defined as [PA systolic pressure \u2013 PA diastolic pressure] \/ PA systolic pressure), in predicting mortality in patients with World Health Organization group 1 pulmonary hypertension (PH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Low PAPP is associated with increased 5\u2010year mortality independent of a validated contemporary risk\u2010prediction equation (Pulmonary Hypertension Connection [PHC] equation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a group of 262 patients in the National Institutes of Health Primary Pulmonary Hypertension (NIH\u2010PPH) Registry, PAPP and the PHC risk equation were used to predict mortality during 5 years of follow\u2010up using Cox proportional hazards models. Kaplan\u2013Meier survival curves were used to compare mortality among PAPP quartiles, and significance was tested using the log\u2010rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in the lowest quartile (PAPP \u22640.47) had a significantly higher 5\u2010year mortality than did patients in higher quartiles (log\u2010rank <jats:italic>P<\/jats:italic> = 0.016). In a Cox model adjusted for the PHC equation, PAPP remained significantly associated with 5\u2010year mortality (hazard ratio: 0.74 per 0.10 increase in PAPP, 95% confidence interval: 0.61\u20100.90). The \u03c7<jats:sup>2<\/jats:sup> statistic for the single PAPP covariate in this model was 8.8 (<jats:italic>P<\/jats:italic> = 0.003), which compared favorably with the \u03c7<jats:sup>2<\/jats:sup> statistic of 15.2 (<jats:italic>P<\/jats:italic> &lt; 0.0001) for the multivariable PHC equation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PAPP, an index of ventricular\u2010arterial coupling, is independently associated with survival in World Health Organization group 1 PH. The use of this easily measurable index for guiding risk stratification needs further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22752","type":"journal-article","created":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T16:13:04Z","timestamp":1499703184000},"page":"988-992","source":"Crossref","is-referenced-by-count":6,"title":["Decreased pulmonary arterial proportional pulse pressure is associated with increased mortality in group 1 pulmonary hypertension"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-6728","authenticated-orcid":false,"given":"Hunter","family":"Mwansa","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, St. Vincent Charity Medical Center Case Western Reserve University  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth C.","family":"Bilchick","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Virginia Health System  Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4170-2976","authenticated-orcid":false,"given":"Alex M.","family":"Parker","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Virginia Health System  Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Harding","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Virginia Health System  Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Ruth","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Virginia Health System  Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie L. 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