{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:30:20Z","timestamp":1793413820892,"version":"4.5.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Normative changes in right ventricular (RV) structure and function have not been characterized in the context of treatment-associated functional recovery (RV functional recovery [RVFnRec]). The aim of this study is to assess the clinical relevance of a proposed RVFnRec definition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We evaluated 63 incident patients with pulmonary arterial hypertension by right heart catheterization and cardiac magnetic resonance imaging at diagnosis and cardiac magnetic resonance imaging and invasive cardiopulmonary exercise testing following treatment (\u224811 months). Sex, age, ethnicity matched healthy control subjects (n=62) with 1-time cardiac magnetic resonance imaging and noninvasive cardiopulmonary exercise testing were recruited from the PVDOMICS (Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics) project. We examined therapeutic cardiac magnetic resonance imaging changes relative to the evidence-based peak oxygen consumption (VO\n                      <jats:sub>2peak<\/jats:sub>\n                      )&gt;15 mL\/(kg\u00b7min) to define RVFnRec by receiver operating curve analysis. Afterload was measured as mean pulmonary artery pressure, resistance, compliance, and elastance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A drop in RV end-diastolic volume of \u221215 mL best defined RVFnRec (area under the curve, 0.87;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.0001) and neared upper 95% CI RV end-diastolic volume of controls. This cutoff was met by 22 out of 63 (35%) patients which was reinforced by freedom from clinical worsening, RVFnRec 1 out of 21 (5%) versus no RVFnRec 17 out of 42, 40% (log-rank\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.006). A therapy-associated increase of 0.8 mL\/mm\u2009Hg in compliance had the best predictive value of RVFnRec (area under the curve, 0.76; [95% CI, 0.64\u20130.88];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001). RVFnRec patients had greater increases in stroke volume, and cardiac output at exercise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>RVFnRec defined by RV end-diastolic volume therapeutic decrease of \u221215 mL predicts exercise capacity, freedom from clinical worsening, and nears normalization. A therapeutic improvement of compliance is superior to other measures of afterload in predicting RVFnRec. RVFnRec is also associated with increased RV output reserve at exercise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.010555","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T05:01:40Z","timestamp":1693803700000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Classification and Predictors of Right Ventricular Functional Recovery in Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6861-8304","authenticated-orcid":true,"given":"Franz P.","family":"Rischard","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine (F.P.R., M.I.), University of Arizona, Tuscon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6882-997X","authenticated-orcid":true,"given":"Roberto J.","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, University of Oklahoma Health Sciences Center, Oklahoma City (R.J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6038-0568","authenticated-orcid":true,"given":"Rebecca R.","family":"Vanderpool","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, The Ohio State University, Columbus (R.R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2191-4111","authenticated-orcid":true,"given":"Deborah H.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (D.H.K., M.M.P., W.H.W.T.), Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tushar","family":"Acharya","sequence":"additional","affiliation":[{"name":"Divison of Cardiology (T.A., S.K.), University of Arizona, Tuscon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4074-8630","authenticated-orcid":true,"given":"Margaret M.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (D.H.K., M.M.P., W.H.W.T.), Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Katrynuik","sequence":"additional","affiliation":[{"name":"Department of Medicine (A.K., J.G.N.G.), University of Arizona, Tuscon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Insel","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine (F.P.R., M.I.), University of Arizona, Tuscon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Kubba","sequence":"additional","affiliation":[{"name":"Divison of Cardiology (T.A., S.K.), University of Arizona, Tuscon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7887-5961","authenticated-orcid":true,"given":"Roberto","family":"Badagliacca","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Respiratory Science, Sapienza University of Rome, Italy (R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Brett","family":"Larive","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences (A.B.L., G.J.B.), Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Naeije","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Free University of Brussels, Belgium (R.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6934-0420","authenticated-orcid":true,"given":"Joe G.N.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Medicine (A.K., J.G.N.G.), University of Arizona, Tuscon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald J.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences (A.B.L., G.J.B.), Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serpil C.","family":"Erzurum","sequence":"additional","affiliation":[{"name":"Lerner Research Institute (S.C.E.), Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4128-3978","authenticated-orcid":true,"given":"Robert P.","family":"Frantz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (R.P.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Hassoun","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD (P.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2755-5845","authenticated-orcid":true,"given":"Anna R.","family":"Hemnes","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN (A.R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8242-8339","authenticated-orcid":true,"given":"Nicholas S.","family":"Hill","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, Boston, MA (N.S.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-9415","authenticated-orcid":true,"given":"Evelyn M.","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Perkin Heart Failure Center, Weill Cornell Medicine, New York, NY (E.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0598-8882","authenticated-orcid":true,"given":"Jane A.","family":"Leopold","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4849-214X","authenticated-orcid":true,"given":"Erika B.","family":"Rosenzweig","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Medicine, Columbia University, Vegelos College of Physicians and Surgeons, New York, NY (E.B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8335-735X","authenticated-orcid":true,"given":"W.H. 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