{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T18:52:04Z","timestamp":1785610324220,"version":"3.56.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":978,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Australian Government Department of Education and Training"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The effect of pulmonary hypertension (PH) on right ventricular (RV) afterload is commonly defined by elevation of pulmonary artery (PA) pressure or pulmonary vascular resistance (PVR). In humans however, one-third to half of the hydraulic power in the PA is contained in pulsatile components of flow. Pulmonary impedance (Zc) expresses opposition of the PA to pulsatile blood flow. We evaluate pulmonary Zc relationships according to PH classification using a cardiac magnetic resonance (CMR)\/right heart catheterization (RHC) method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective study of 70 clinically indicated patients referred for same-day CMR and RHC [60 \u00b1 16 years; 77% females, 16 mPAP &amp;lt;25 mmHg (PVR &amp;lt;240 dynes.s.cm\u22125\/mPCWP &amp;lt;15 mmHg), 24 pre-capillary (PrecPH), 15 isolated post-capillary (IpcPH), 15 combined pre-capillary\/post-capillary (CpcPH)]. CMR provided assessment of PA flow, and RHC, central PA pressure. Pulmonary Zc was expressed as the relationship of PA pressure to flow in the frequency domain (dynes.s.cm\u22125).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline demographic characteristics were well matched. There was a significant difference in mPAP (P &amp;lt; 0.001), PVR (P = 0.001), and pulmonary Zc between mPAP&amp;lt;25 mmHg patients and those with PH (mPAP &amp;lt;25 mmHg: 47 \u00b1 19 dynes.s.cm\u22125; PrecPH 86 \u00b1 20 dynes.s.cm\u22125; IpcPH 66 \u00b1 30 dynes.s.cm\u22125; CpcPH 86 \u00b1 39 dynes.s.cm\u22125; P = 0.05). For all patients with PH, elevated mPAP was found to be associated with raised PVR (P &amp;lt; 0.001) but not with pulmonary Zc (P = 0.87), except for those with PrecPH (P &amp;lt; 0.001). Elevated pulmonary Zc was associated with reduced RVSWI, RVEF, and CO (all P &amp;lt; 0.05), whereas PVR and mPAP were not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Raised pulmonary Zc was independent of elevated mPAP in patients with PH and more strongly predictive of maladaptive RV remodelling than PVR and mPAP. Use of this straightforward method to determine pulmonary Zc may help to better characterize pulsatile components of RV afterload in patients with PH than mPAP or PVR alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14180","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T06:04:40Z","timestamp":1678428280000},"page":"1811-1821","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prognostic Role of Pulmonary Impedance Estimation to Predict Right Ventricular Dysfunction in Pulmonary Hypertension"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-7719","authenticated-orcid":false,"given":"Sara Louise","family":"Hungerford","sequence":"first","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]},{"name":"The University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Victor Chang Cardiac Research Institute , Sydney ,","place":["Australia"]},{"name":"Department of Cardiology, Royal North Shore Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Kearney","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]},{"name":"The University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Victor Chang Cardiac Research Institute , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]},{"name":"The University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Victor Chang Cardiac Research Institute , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Bart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]},{"name":"The University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Victor Chang Cardiac Research Institute , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Kotlyar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Royal Prince Alfred Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]},{"name":"The University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Victor Chang Cardiac Research Institute , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Simon","family":"Hayward","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent's Hospital , Darlinghurst ,","place":["Australia"]},{"name":"The University of New South Wales , Sydney ,","place":["Australia"]},{"name":"Victor Chang Cardiac Research Institute , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David William Marshall","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St 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