{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T07:03:30Z","timestamp":1775891010746,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":71,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pulmonary artery pressures (PAPs) often become abnormal during exercise in patients with systemic sclerosis (SSc). This study sought to determine whether exercise\u2010induced pulmonary hypertension (EIPH) assessed by exercise stress echocardiography (ESE) would be associated with subsequent increases in resting PAPs in patients with SSc. Patients with SSc who underwent serial echocardiography &gt;\u20096 months apart were retrospectively screened (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009543). Of those, patients undergoing ESE were divided based on the presence of EIPH, defined as estimated mean PAP (mPAP)\u2009&gt;\u200930\u2009mmHg during exercise and a mPAP\/cardiac output (CO)\u2009&gt;\u20093\u2009mmHg\/L\/min. Patients who did not undergo ESE and had a mPAP &lt;\u200920\u2009mmHg were selected as controls (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009198). The primary endpoint was a longitudinal change in sPAP from baseline to last follow\u2010up echocardiography. Compared to controls and patients with non\u2010EIPH (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200971), those with EIPH (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200956) had a higher sPAP at baseline (22\u2009\u00b1\u20094\u2009mmHg, 28\u2009\u00b1\u20096\u2009mmHg, and 31\u2009\u00b1\u20096\u2009mmHg,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Over a median follow\u2010up duration of 2.4 years, a longitudinal change in resting sPAP from baseline to follow\u2010up echocardiography was higher in patients with EIPH than those without (+\u20091.2\u2009mmHg vs. \u22121.0\u2009mmHg,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.048). In a sensitivity analysis excluding 30 patients who received pulmonary vasodilators or heart failure medications after baseline echocardiography, the difference in sPAP change over time between the two groups increased further (+\u20092.2\u2009mmHg in the EIPH group vs. \u22121.6\u2009mmHg in the non\u2010EIPH group,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0008). In conclusion, echocardiography\u2010derived EIPH was associated with a longitudinal increase in sPAP, supporting ESE as a non\u2010invasive tool for risk stratification in SSc\u2010PH.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70282","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:51:31Z","timestamp":1773406291000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Echocardiography\u2010Derived Exercise Pulmonary Hypertension and Longitudinal Changes in Pulmonary Artery Pressures in Systemic Sclerosis: A Non\u2010Invasive Assessment for Risk Stratification"],"prefix":"10.1002","volume":"16","author":[{"given":"Kazuki","family":"Kagami","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Yuasa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonari","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3058-6279","authenticated-orcid":false,"given":"Yukie","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Dermatology Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriaki","family":"Takama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8286-0669","authenticated-orcid":false,"given":"Sei\u2010Ichiro","family":"Motegi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-0123","authenticated-orcid":false,"given":"Hideki","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Obokata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi Gunma 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