{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T21:41:50Z","timestamp":1770154910348,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100015925","name":"National Key Transform Program","doi-asserted-by":"publisher","award":["2024ZD0521802"],"award-info":[{"award-number":["2024ZD0521802"]}],"id":[{"id":"10.13039\/501100015925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012542","name":"Sichuan Provincial Science and Technology Support Program","doi-asserted-by":"publisher","award":["2024YFFK0024"],"award-info":[{"award-number":["2024YFFK0024"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>The impact of lipid abnormalities on right heart function and outcomes in pre\u2010capillary pulmonary hypertension (precPH) remains unclear. This study investigates how lipid profile alterations influence right heart function, strain, and prognosis in precPH patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From June 2013 to December 2023, 394 precPH patients were prospectively enrolled. Clinical data, cardiac MRI\u2010derived right heart systolic function, and strain parameters were compared among groups based on lipid profiles. The optimal cut\u2010off values of lipid profiles were determined using the maximally selected rank statistics. Prognostic analyses were conducted using Cox regression and Kaplan\u2013Meier survival methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow\u2010up of 36\u2009months, 18.8% of patients died. Low\u2010density lipoprotein cholesterol (LDL\u2010C) &lt;\u20091.93\u2009mmol\/L and high\u2010density lipoprotein cholesterol (HDL\u2010C) &lt;\u20090.82\u2009mmol\/L were associated with increased mortality risks (2.51\u2010fold and 2.65\u2010fold, respectively). Multivariate analysis confirmed decreased LDL\u2010C (HR 1.853, 95% CI 1.102\u20133.115,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and decreased HDL\u2010C (HR 2.019, 95% CI 1.131\u20133.603,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) as independent prognostic indicators. A decrease in either cholesterol subtype predicted worse outcomes (Log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Incorporation of LDL\u2010C and HDL\u2010C enhanced prognostic accuracy of the ESC model (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      : 50.8 to 60.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007; 50.8 to 66.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and ESC\u2010CMR model (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      : 59.3 to 66.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04; 59.3 to 72.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). HDL\u2010C\u2009&lt;\u20090.82\u2009mmol\/L was associated with impaired right ventricular global longitudinal strain (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), RV free wall strain (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and right atrial phasic strain (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Decreased HDL\u2010C and LDL\u2010C levels independently predict increased mortality in precPH patients. Notably, low HDL\u2010C significantly associates with impaired right heart function and strain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Chinese Clinical Trial Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; ID: ChiCTR1800019314 and ChiCTR1900025518)\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70145-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70145","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:53:58Z","timestamp":1761105238000},"page":"174-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Lipid Profile Alterations on the Right Heart Function and Prognosis in Pre\u2010Capillary Pulmonary Hypertension Patients: A Prospective Cohort Study"],"prefix":"10.1002","volume":"31","author":[{"given":"Jiajun","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Cardiology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology West China Hospital, Sichuan University  Chengdu 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