{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:39:39Z","timestamp":1792607979611,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The prognostic relevance of the relative change in right ventricular stroke work index (RVSWI) after balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) remains uncertain. This retrospective single\u2010center study included 38 patients with CTEPH. Follow\u2010up began at post\u2010BPA catheterization. Relative change in RVSWI (%RVSWI; negative values indicate reduction) and conventional measures were compared using Cox models and direction\u2010fixed C\u2010indices. Bootstrap resampling assessed selection optimism across 14 candidates. RVSWI decreased from 16.96 to 9.83\u2009g\u00b7m\/m\n                    <jats:sup>2<\/jats:sup>\n                    \/beat. During a median 4.1 years, 7 patients reached the composite endpoint of all\u2010cause death or heart failure hospitalization. A smaller reduction was associated with higher risk (hazard ratio 1.24 per 1 percentage\u2010point increase in %RVSWI, 95% confidence interval 1.06\u20131.44;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007). %RVSWI had the highest apparent C\u2010index (0.942, 95% confidence interval 0.86\u20130.99), but its difference from achieved mean pulmonary artery pressure (C\u2010index 0.855) was not statistically distinguishable. %RVSWI ranked first in 62% of bootstrap resamples; the optimism\u2010corrected C\u2010index was 0.922. Component log\u2010ratios were essentially uncorrelated (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.01, 95% confidence interval \u22120.31 to 0.33). Greater RVSWI reduction after BPA was associated with better prognosis. With seven events, these findings are hypothesis\u2010generating; superiority over conventional measures and the physiological interpretation of the SVI component remain unestablished.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70430","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:55:44Z","timestamp":1792605344000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduction in Right Ventricular Stroke Work Index After Balloon Pulmonary Angioplasty is Associated With Long\u2010Term Prognosis in Chronic Thromboembolic Pulmonary Hypertension"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4543-596X","authenticated-orcid":false,"given":"Ryuichi","family":"Ushijima","sequence":"first","affiliation":[{"name":"The Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruhiko","family":"Imamura","sequence":"additional","affiliation":[{"name":"The Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Hida","sequence":"additional","affiliation":[{"name":"The Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9747-2511","authenticated-orcid":false,"given":"Hiroshi","family":"Ueno","sequence":"additional","affiliation":[{"name":"The Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Kinugawa","sequence":"additional","affiliation":[{"name":"The Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"6","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1161\/CIRCULATIONAHA.114.009309","article-title":"Update on Chronic Thromboembolic Pulmonary Hypertension","volume":"130","author":"Lang I. M.","year":"2014","journal-title":"Circulation"},{"issue":"4","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01294-2024","article-title":"Chronic Thromboembolic Pulmonary Disease","volume":"64","author":"Kim N. H.","year":"2024","journal-title":"European Respiratory Journal"},{"issue":"24","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1016\/j.jacc.2011.06.068","article-title":"Progressive Right Ventricular Dysfunction in Patients With Pulmonary Arterial Hypertension Responding to Therapy","volume":"58","author":"Veerdonk M. C.","year":"2011","journal-title":"Journal of the American College of Cardiology"},{"issue":"10","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1093\/eurheartj\/ehl477","article-title":"Prognostic Value of Right Ventricular Mass, Volume, and Function in Idiopathic Pulmonary Arterial Hypertension","volume":"28","author":"Wolferen S. A.","year":"2007","journal-title":"European Heart Journal"},{"issue":"6","key":"e_1_2_12_6_1","first-page":"748","article-title":"Refined Balloon Pulmonary Angioplasty for Inoperable Patients With Chronic Thromboembolic Pulmonary Hypertension","volume":"5","author":"Mizoguchi H.","year":"2012","journal-title":"Circulation: Cardiovascular Interventions"},{"issue":"2","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1253\/circj.CJ-11-1217","article-title":"Percutaneous Transluminal Pulmonary Angioplasty Markedly Improves Pulmonary Hemodynamics and Long\u2010Term Prognosis in Patients With Chronic Thromboembolic Pulmonary Hypertension","volume":"76","author":"Sugimura K.","year":"2012","journal-title":"Circulation Journal"},{"issue":"11","key":"e_1_2_12_8_1","article-title":"Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: Results of a Multicenter Registry","volume":"10","author":"Ogawa A.","year":"2017","journal-title":"Circulation: Cardiovascular Quality and Outcomes"},{"issue":"2","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jacc.2016.10.047","article-title":"The Relationship Between the Right Ventricle and its Load in Pulmonary Hypertension","volume":"69","author":"Vonk Noordegraaf A.","year":"2017","journal-title":"Journal of the American College of Cardiology"},{"issue":"2","key":"e_1_2_12_10_1","article-title":"Effect of Balloon Pulmonary Angioplasty and Riociguat on Right Ventricular Afterload and Function in CTEPH: Insights From the RACE Trial","volume":"18","author":"Gerges C.","year":"2025","journal-title":"Circulation: Cardiovascular Interventions"},{"issue":"1","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/eurheartj\/ehv317","article-title":"2015 ESC\/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension","volume":"37","author":"Gali\u00e8 N.","year":"2016","journal-title":"European Heart Journal"},{"issue":"5","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1378\/chest.12-1880","article-title":"Estimating Right Ventricular Stroke Work and the Pulsatile Work Fraction in Pulmonary Hypertension","volume":"143","author":"Chemla D.","year":"2013","journal-title":"Chest"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3389\/fcvm.2020.00077","article-title":"Reduced RVSWI is Associated With Increased Mortality in Connective Tissue Disease Associated Pulmonary Arterial Hypertension","volume":"7","author":"Clapham K. R.","year":"2020","journal-title":"Frontiers in Cardiovascular Medicine"},{"issue":"4","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","DOI":"10.1002\/pul2.12433","article-title":"Right Ventricular Stroke Work Index in Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Observational Study","volume":"14","author":"Cs\u00f3sza G.","year":"2024","journal-title":"Pulmonary Circulation"},{"issue":"38","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension","volume":"43","author":"Humbert M.","year":"2022","journal-title":"European Heart Journal"}],"container-title":["Pulmonary Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70430","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pul2.70430","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:55:46Z","timestamp":1792605346000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pul2.70430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/pul2.70430"],"URL":"https:\/\/doi.org\/10.1002\/pul2.70430","archive":["Portico"],"relation":{},"ISSN":["2045-8940","2045-8940"],"issn-type":[{"value":"2045-8940","type":"print"},{"value":"2045-8940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-08-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70430"}}