{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:48:40Z","timestamp":1793148520742,"version":"4.5.0"},"reference-count":33,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pulmonary arterial hypertension (PAH), caused by pulmonary artery remodelling and increased pulmonary vascular resistance (PVR) due to an unknown mechanism, is an intractable disease with a poor prognosis. The recent development of PAH-specific treatment medications may allow for higher PVR reduction than previously achieved. This study aimed to identify the prognostic significance of follow-up PVR levels achieved shortly after the initiation of targeted treatment in patients with idiopathic\/heritable pulmonary arterial hypertension (I\/H-PAH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed the data of all patients with I\/H-PAH admitted to our hospital between 1998 and 2019. We collected data at baseline and during the first invasive haemodynamic evaluation. The primary outcome was death or lung transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 133 treatment-na\u00efve patients enrolled in this study, 47 experienced adverse events during a median follow-up period of 6.4 (IQR 3.5\u201311.5) years. The median time interval to first follow-up from diagnosis was 162 (IQR 117\u2013253) days. Incidence of the primary outcome was significantly lower in patients who achieved low PVR at follow-up. Of risk factors evaluated at follow-up, the multivariate Cox regression analysis revealed PVR as an independent predictor of the primary outcome (HR 1.103, 95% CI 1.029 to 1.183; p=0.006). The results were consistent across risk profiles according to the simplified risk stratification recommended by the European Society of Cardiology and European Respiratory Society guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Follow-up PVR was an independent predictor of transplant-free survival in patients with I\/H-PAH. Evaluation of haemodynamic status shortly after initiating treatment may help predict long-term prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2022-002054","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T11:06:27Z","timestamp":1654686387000},"page":"e002054","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Prognostic impact of follow-up pulmonary vascular resistance in pulmonary arterial hypertension"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9058-9258","authenticated-orcid":false,"given":"Sho","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryotaro","family":"Asano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayuri","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Ueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-4932","authenticated-orcid":false,"given":"Teruo","family":"Noguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Ogo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,6,8]]},"reference":[{"key":"2022060808051380000_9.1.e002054.1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.chest.2019.02.004","article-title":"Predicting survival in patients with pulmonary arterial hypertension: the reveal risk score calculator 2.0 and comparison with ESC\/ERS-Based risk assessment strategies","volume":"156","author":"Benza","year":"2019","journal-title":"Chest"},{"key":"2022060808051380000_9.1.e002054.2","doi-asserted-by":"crossref","first-page":"4175","DOI":"10.1093\/eurheartj\/ehx257","article-title":"A comprehensive risk stratification at early follow-up determines prognosis in pulmonary arterial hypertension","volume":"39","author":"Kylhammar","year":"2018","journal-title":"Eur Heart J"},{"key":"2022060808051380000_9.1.e002054.3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00740-2017"},{"key":"2022060808051380000_9.1.e002054.4","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00889-2017"},{"key":"2022060808051380000_9.1.e002054.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.01.015"},{"key":"2022060808051380000_9.1.e002054.6","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1164\/rccm.201806-1160ST","article-title":"Assessment of right ventricular function in the research setting: knowledge gaps and pathways forward. 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