{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:58:52Z","timestamp":1790841532967,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/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"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP20ek0109371"],"award-info":[{"award-number":["JP20ek0109371"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP19lk0201102"],"award-info":[{"award-number":["JP19lk0201102"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP22lk0201125"],"award-info":[{"award-number":["JP22lk0201125"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP19lk1601003"],"award-info":[{"award-number":["JP19lk1601003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"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                    We aimed to evaluate the role of medical therapy before and after balloon pulmonary angioplasty (BPA) for non\u2010operable chronic thromboembolic pulmonary hypertension (CTEPH) in the modern management era. This Japanese nationwide, multicenter, prospective observational registry, including 37 centers, analyzed data newly registered from August 2018\u2013December 2023. Pretreatment before BPA was analyzed in patients who were treatment na\u00efve or received medical therapy only at registration (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009557). De\u2010escalation or escalation of medical therapy after BPA was analyzed in patients who underwent BPA (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009966). The BPA pretreatment analysis in 557 patients showed that approximately 70% of the patients received medical therapy, of which 18% received combination therapy. Patients who received monotherapy or combination therapy had more severe baseline hemodynamics than those who did not. The 3\u2010year survival did not significantly differ between the no, mono, and combination pretreatment groups (94%, 98%, and 97%, respectively;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.852). The BPA post\u2010treatment analysis in 966 patients showed that 20% of patients underwent de\u2010escalation of medical therapy. Patients with de\u2010escalation of medical therapy had lower mean pulmonary artery pressure (PAP) (20.9\u2009\u00b1\u20095.8 vs. 24.1\u2009\u00b1\u20097.3\u2009mmHg,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01); however, they had a lower cardiac index at last follow\u2010up compared to patients without de\u2010escalation (2.66\u2009\u00b1\u20090.61 vs. 2.84\u2009\u00b1\u20090.70\u2009L\/min\/m\n                    <jats:sup>2<\/jats:sup>\n                    ,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01). Patients with severe disease tended to undergo pre\u2010treatment before BPA; however, patient survival did not differ across pretreatment types. De\u2010escalation of medical therapy after BPA can affect cardiac index. Therefore, de\u2010escalation or continuation of medical therapy should be carefully considered even after mean PAP normalizes after BPA.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70377","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:48:48Z","timestamp":1785491328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Medical Therapy Before and After Balloon Pulmonary Angioplasty: CTEPH AC Registry Across Japan"],"prefix":"10.1002","volume":"16","author":[{"given":"Miki","family":"Sakamoto\u2010Iwata","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8430-2123","authenticated-orcid":false,"given":"Yu","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6320-739X","authenticated-orcid":false,"given":"Kohei","family":"Masaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1517-3660","authenticated-orcid":false,"given":"Kazuya","family":"Hosokawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka 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