{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T21:03:38Z","timestamp":1784667818368,"version":"3.55.0"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","heartandlung.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Heart &amp; Lung"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.hrtlng.2026.102837","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:01:28Z","timestamp":1779188488000},"page":"102837","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Presenting symptom patterns of pulmonary arterial hypertension across adult age groups and etiologies: Implications for early recognition"],"prefix":"10.1016","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4423-4258","authenticated-orcid":false,"given":"Christine R.","family":"Hoch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Brewer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea Ann","family":"Matura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"38","key":"10.1016\/j.hrtlng.2026.102837_bib0001","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","year":"2022","journal-title":"Eur Heart J"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0002","doi-asserted-by":"crossref","DOI":"10.1136\/bmjmed-2022-000137","article-title":"Pathophysiology and new advances in pulmonary hypertension","volume":"2","author":"Bousseau","year":"2023","journal-title":"BMJ Med"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0003","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S2213-2600(24)00295-9","article-title":"Global, regional, and national burden of pulmonary arterial hypertension, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"13","year":"2025","journal-title":"Lancet Respir Med"},{"issue":"7","key":"10.1016\/j.hrtlng.2026.102837_bib0004","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1136\/jim-2021-002027","article-title":"Advances in the management of pulmonary arterial hypertension","volume":"69","author":"Deshwal","year":"2021","journal-title":"J Investig Med"},{"issue":"14","key":"10.1016\/j.hrtlng.2026.102837_bib0005","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1001\/jama.2022.4402","article-title":"Diagnosis and treatment of pulmonary arterial hypertension: a review","volume":"327","author":"Ruopp","year":"2022","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0006","doi-asserted-by":"crossref","DOI":"10.1002\/pul2.12188","article-title":"Time to diagnosis of pulmonary hypertension and diagnostic burden: a retrospective analysis of nationwide US healthcare data","volume":"13","author":"Didden","year":"2023","journal-title":"Pulm Circ"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0007","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1378\/chest.12-2417","article-title":"Functional class improvement and 3-year survival outcomes in patients with pulmonary arterial hypertension in the REVEAL registry","volume":"144","author":"Barst","year":"2013","journal-title":"CHEST"},{"issue":"9","key":"10.1016\/j.hrtlng.2026.102837_bib0008","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1164\/rccm.200510-1668OC","article-title":"Pulmonary arterial hypertension in France: results from a national registry","volume":"173","author":"Humbert","year":"2006","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"10.1016\/j.hrtlng.2026.102837_bib0009","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1007\/s00408-020-00402-w","article-title":"Follow-up functional class and 6-minute walk distance identify long-term survival in pulmonary arterial hypertension","volume":"198","author":"Heresi","year":"2020","journal-title":"Lung"},{"issue":"Suppl K","key":"10.1016\/j.hrtlng.2026.102837_bib0010","article-title":"The burden of comorbidities in pulmonary arterial hypertension","volume":"21","author":"Lang","year":"2019","journal-title":"Eur Heart J Suppl"},{"issue":"2","key":"10.1016\/j.hrtlng.2026.102837_bib0011","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1378\/chest.09-1140","article-title":"Pulmonary arterial hypertension: baseline characteristics from the REVEAL registry","volume":"137","author":"Badesch","year":"2010","journal-title":"Chest"},{"issue":"2","key":"10.1016\/j.hrtlng.2026.102837_bib0012","doi-asserted-by":"crossref","first-page":"216","DOI":"10.7326\/0003-4819-107-2-216","article-title":"Primary pulmonary hypertension","volume":"107","author":"Rich","year":"1987","journal-title":"Ann Intern Med"},{"issue":"2","key":"10.1016\/j.hrtlng.2026.102837_bib0013","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1378\/chest.06-2913","article-title":"Registry and survival study in Chinese patients with idiopathic and familial pulmonary arterial hypertension","volume":"132","author":"Jing","year":"2007","journal-title":"Chest"},{"issue":"2","key":"10.1016\/j.hrtlng.2026.102837_bib0014","doi-asserted-by":"crossref","DOI":"10.1177\/2045894019851696","article-title":"United States pulmonary hypertension scientific registry (USPHSR): rationale, design, and clinical implications","volume":"9","author":"Elliott","year":"2019","journal-title":"Pulm Circ"},{"issue":"4","key":"10.1016\/j.hrtlng.2026.102837_bib0015","doi-asserted-by":"crossref","DOI":"10.7196\/AJTCCM.2018.v24i4.218","article-title":"The aetiology, clinical presentation and treatment of patients with pulmonary hypertension in Cape Town: a preliminary report from the Groote Schuur hospital pulmonary hypertension registry","volume":"24","author":"Davies-van Es","year":"2018","journal-title":"Afr J Thorac Crit Care Med"},{"issue":"4","key":"10.1016\/j.hrtlng.2026.102837_bib0016","doi-asserted-by":"crossref","first-page":"185","DOI":"10.21693\/1933-088X-16.4.185","article-title":"The pulmonary hypertension association registry: rationale, design, and role in quality improvement","volume":"16","author":"Gray","year":"2018","journal-title":"Adv Pulm Hypertens"},{"issue":"2","key":"10.1016\/j.hrtlng.2026.102837_bib0017","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.ijcard.2012.10.026","article-title":"Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the Compera registry","volume":"168","author":"Hoeper","year":"2013","journal-title":"Int J Cardiol"},{"issue":"3","key":"10.1016\/j.hrtlng.2026.102837_bib0018","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1183\/09031936.00056110","article-title":"Pulmonary arterial hypertension: a comparison between children and adults","volume":"37","author":"Barst","year":"2011","journal-title":"Eur Respir J"},{"issue":"6","key":"10.1016\/j.hrtlng.2026.102837_bib0019","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1053\/j.jvca.2021.06.036","article-title":"Pulmonary hypertension in 2021: part I-definition, classification, pathophysiology, and presentation","volume":"36","author":"Gelzinis","year":"2022","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0020","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.chest.2020.07.088","article-title":"United States Pulmonary Hypertension Scientific Registry: baseline characteristics","volume":"159","author":"Badlam","year":"2021","journal-title":"Chest"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0021","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jpainsymman.2015.07.012","article-title":"Symptom interference severity and health-related quality of life in pulmonary arterial hypertension","volume":"51","author":"Matura","year":"2016","journal-title":"J Pain Symptom Manage"},{"issue":"8_Supplement","key":"10.1016\/j.hrtlng.2026.102837_bib0022","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/S0735-1097(23)01048-3","article-title":"Demographic disparities in heart failure mortality: insights from a nationwide database","volume":"81","author":"Agrawal","year":"2023","journal-title":"JACC"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0023","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.apnr.2014.04.001","article-title":"Development and initial psychometric properties of the pulmonary arterial hypertension symptom scale (PAHSS)","volume":"28","author":"Matura","year":"2015","journal-title":"Appl Nurs Res"},{"key":"10.1016\/j.hrtlng.2026.102837_bib0024","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6836973","article-title":"Clinical and instrumental characteristics of newly diagnosed patients with various forms of pulmonary hypertension according to the Russian national registry","volume":"2020","author":"Chazova","year":"2020","journal-title":"Biomed Res Int"},{"issue":"21","key":"10.1016\/j.hrtlng.2026.102837_bib0025","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","article-title":"2018 ESC guidelines for the diagnosis and management of syncope","volume":"39","author":"Brignole","year":"2018","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrtlng.2026.102837_bib0026","doi-asserted-by":"crossref","DOI":"10.2174\/0118743064359315250210080743","article-title":"Revisiting acute decompensated right ventricle failure in pulmonary arterial hypertension","volume":"19","author":"Masih","year":"2025","journal-title":"Open Respir Med J"},{"key":"10.1016\/j.hrtlng.2026.102837_bib0027","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3389\/fped.2020.00106","article-title":"Idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease in Chinese children: similarities, differences, and prognostic factors","volume":"8","author":"Gu","year":"2020","journal-title":"Front Pediatr"},{"issue":"4","key":"10.1016\/j.hrtlng.2026.102837_bib0028","doi-asserted-by":"crossref","DOI":"10.1183\/23120541.00223-2022","article-title":"Vasoreactive phenotype in children with pulmonary arterial hypertension and syncope","volume":"8","author":"Linder","year":"2022","journal-title":"ERJ Open Res"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0029","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s00246-018-1996-3","article-title":"Clinical effects of syncope on disease severity and adverse outcomes in children with idiopathic and heritable pulmonary arterial hypertension","volume":"40","author":"Takatsuki","year":"2019","journal-title":"Pediatr Cardiol"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0030","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1378\/chest.10-1166","article-title":"Delay in recognition of pulmonary arterial hypertension: factors identified from the REVEAL registry","volume":"140","author":"Brown","year":"2011","journal-title":"Chest"},{"issue":"5","key":"10.1016\/j.hrtlng.2026.102837_bib0031","article-title":"2017 ACC\/AHA\/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society","volume":"136","author":"Shen","year":"2017","journal-title":"Circulation"},{"issue":"6","key":"10.1016\/j.hrtlng.2026.102837_bib0032","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1378\/chest.12-0150","article-title":"Physical activity limitation as measured by accelerometry in pulmonary arterial hypertension","volume":"142","author":"Pugh","year":"2012","journal-title":"Chest"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0033","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1183\/20734735.003416","article-title":"Pulmonary hypertension in the elderly: a different disease?","volume":"12","author":"Berra","year":"2016","journal-title":"Breathe"},{"issue":"9","key":"10.1016\/j.hrtlng.2026.102837_bib0034","first-page":"401","article-title":"Pulmonary arterial hypertension in the elderly: peculiar features and challenges for a proper phenotyping approach","volume":"10","author":"Scagliola","year":"2023","journal-title":"J Cardiovasc Dev Dis"},{"issue":"6","key":"10.1016\/j.hrtlng.2026.102837_bib0035","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.02024-2021","article-title":"Temporal trends in pulmonary arterial hypertension: results from the Compera registry","volume":"59","author":"Hoeper","year":"2022","journal-title":"Eur Respir J"},{"issue":"4","key":"10.1016\/j.hrtlng.2026.102837_bib0036","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1183\/09031936.00078411","article-title":"Aspire registry: assessing the spectrum of pulmonary hypertension identified at a referral centre","volume":"39","author":"Hurdman","year":"2012","journal-title":"Eur Respir J"},{"issue":"1","key":"10.1016\/j.hrtlng.2026.102837_bib0037","article-title":"Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study","volume":"5","author":"Yorke","year":"2018","journal-title":"BMJ Open Respir Res"},{"key":"10.1016\/j.hrtlng.2026.102837_bib0038","article-title":"Impact of pulmonary arterial hypertension on employment, work productivity, and quality of life: results of a cross-sectional multi-center study","volume":"12","author":"Fuge","year":"2021","journal-title":"Front Psychiatry"}],"container-title":["Heart &amp; Lung"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0147956326001214?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0147956326001214?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:42:15Z","timestamp":1784666535000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0147956326001214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":38,"alternative-id":["S0147956326001214"],"URL":"https:\/\/doi.org\/10.1016\/j.hrtlng.2026.102837","relation":{},"ISSN":["0147-9563"],"issn-type":[{"value":"0147-9563","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Presenting symptom patterns of pulmonary arterial hypertension across adult age groups and etiologies: Implications for early recognition","name":"articletitle","label":"Article Title"},{"value":"Heart & Lung","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.hrtlng.2026.102837","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"102837"}}