{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:58:02Z","timestamp":1790841482701,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Iron deficiency aggravates hypoxic pulmonary vasoconstriction, exacerbating the increase of pulmonary arterial pressure at high altitude (HA). This may be especially relevant for patients with pulmonary hypertension (PH) travelling to HA, who moreover have a high prevalence of iron deficiency. Currently, no data is available on iron parameters and their influence on HA adaptation in PH\u2010patients. In a randomized cross\u2010over trial, 27 patients (44% female, mean age 61.7\u2009\u00b1\u200913.6\u2009y) with pulmonary arterial hypertension (67%) or chronic thromboembolic PH (33%) were assessed at baseline (Zurich, 470\u2009m) and during a stay at 2500\u2009m. Blood samples were taken at baseline and after 20\u2009h at 2500\u2009m. A significant increase in ferritin (131\u2009\u00b1\u200968 to 140\u2009\u00b1\u200975,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002), transferrin (28.0\u2009\u00b1\u20094.7 to 30.3\u2009\u00b1\u20094.4,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.012) and soluble transferrin receptor (sTfR) levels (2.7\u2009\u00b1\u20090.7 to 2.9\u2009\u00b1\u20090.6,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.014) was observed at HA, all of which correlated with decreasing hepcidin levels. Arterial partial pressure of carbon dioxide (PaCO\n                    <jats:sub>2<\/jats:sub>\n                    ) was inversely correlated with transferrin levels (Pearson's\n                    <jats:italic>r\u2009<\/jats:italic>\n                    =\u2009\u22120.57,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and baseline transferrin concentration was an independent predictor of PaCO\n                    <jats:sub>2<\/jats:sub>\n                    at baseline and HA (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.037). Furthermore, transferrin levels &lt;\u200930\u2009\u00b5mol\/L were an independent predictor of mean nocturnal oxygen saturation (SpO\n                    <jats:sub>2<\/jats:sub>\n                    ) at baseline and HA. The need for oxygen supplementation at HA could be predicted using a model including baseline transferrin, achieving a positive predictive value of 84%, suggesting that transferrin may serve as a useful clinical marker to identify PH patients at risk of oxygen desaturation at HA.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70352","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:17:31Z","timestamp":1784017051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Iron Homeostasis at High Altitude in Patients With Pulmonary Hypertension"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1079-7637","authenticated-orcid":false,"given":"Aurelia E.","family":"Reiser","sequence":"first","affiliation":[{"name":"Institute of Veterinary Physiology Vetsuisse Faculty, University of Z\u00fcrich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9118-8285","authenticated-orcid":false,"given":"Markus","family":"Thiersch","sequence":"additional","affiliation":[{"name":"Institute of Veterinary Physiology Vetsuisse Faculty, University of Z\u00fcrich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Gassmann","sequence":"additional","affiliation":[{"name":"Institute of Veterinary Physiology Vetsuisse Faculty, University of Z\u00fcrich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mayer","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology University Hospital of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Saxer","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology University Hospital of Zurich Zurich Switzerland"},{"name":"Eastern Switzerland University of Applied Sciences St. Gallen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Furian","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology University Hospital of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sparla","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, and Immunology, University of Heidelberg, Heidelberg, Germany, Molecular Medicine Partnership Unit (MMPU), European Molecular Biology Laboratory and University of Heidelberg, Heidelberg, Germany, German Centre for Cardiovascular Research (DZHK), Partner site Heidelberg\/Mannheim, Heidelberg, Germany, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL) University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther I.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology University Hospital of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Lichtblau","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology University Hospital of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina U.","family":"Muckenthaler","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, and Immunology, University of Heidelberg, Heidelberg, Germany, Molecular Medicine Partnership Unit (MMPU), European Molecular Biology Laboratory and University of Heidelberg, Heidelberg, Germany, German Centre for Cardiovascular Research (DZHK), Partner site Heidelberg\/Mannheim, Heidelberg, Germany, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL) University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Ulrich","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology University Hospital of Zurich Zurich 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