{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:48:57Z","timestamp":1791298137142,"version":"4.1.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Patients with lung disease, sleep apnea, and chronic thromboemboli can develop pulmonary hypertension, currently classified as group 3 or 4. Many of these patients also have risk factors for heart failure with preserved ejection fraction (HFpEF), but the optimal approach to identify the disease overlap remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Pretest probability for HFpEF was determined using the HFpEF-ABA (age, body mass index, atrial fibrillation) algorithm among adjudicated group 3 or 4 patients at risk for pulmonary hypertension in the PVDOMICS study (Redefining Pulmonary Hypertension Through Pulmonary Vascular Disease Phenomics). Patients were stratified by current resting right heart catheterization criteria, and in a separate analysis, stratified only by HFpEF-ABA probability into low (&lt;25%), intermediate, and high (\u226575%) HFpEF probability groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Among 598 patients with group 3 disease, 27% (n=161) had elevated pulmonary capillary wedge pressure (PCWP) with postcapillary pulmonary hypertension even at rest, which was associated with the highest exercise PCWP. However, regardless of this resting PCWP-based classification, a larger subset had intermediate-to-high HFpEF-ABA probabilities (32% [n=197] high and 57% [n=358] intermediate HFpEF probability). High HFpEF probability in group 3 disease was associated with higher resting and dynamic PCWP response to NO, fluid, and exercise (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001 for all). These changes were comparable with more traditionally defined HFpEF without pulmonary vascular disease (n=61) but less severe than those with combined precapillary and postcapillary pulmonary hypertension HFpEF (n=31; interaction\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.006). Increasing HFpEF probability in group 3 disease was associated with worse left heart remodeling, quality of life, 6-minute walk distance, and peak VO\n              <jats:sub>2<\/jats:sub>\n              (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001 for all). Findings were replicated in group 4 disease (n=102).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Quantifying pretest probability for HFpEF in patients with sleep apnea, lung disease, or chronic thromboemboli identifies a progressive gradient for dynamic PCWP abnormalities with worse functional status and quality of life. These subclinical left heart abnormalities are not universally detectable by resting right heart catheterization alone and call for further study of whether strategies to prevent or treat HFpEF might improve functional status in these patients with high risk of occult HFpEF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.012912","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T05:00:15Z","timestamp":1748494815000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Left Heart Abnormalities in Patients With Lung Disease, OSA, and Chronic Thromboemboli at Risk for or With Known Pulmonary Hypertension"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5322-0902","authenticated-orcid":true,"given":"Yogesh N.V.","family":"Reddy","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (Y.N.V.R., R.P.F., B.A.B.)."}],"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 (Y.N.V.R., R.P.F., B.A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0601-4975","authenticated-orcid":true,"given":"Paul M.","family":"Hassoun","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD (P.M.H., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2755-5845","authenticated-orcid":true,"given":"Anna","family":"Hemnes","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN (A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-9415","authenticated-orcid":true,"given":"Evelyn","family":"Horn","sequence":"additional","affiliation":[{"name":"Perkin Heart Failure Center, Division of Cardiology, Weill Cornell Medicine, New York, NY (E.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\/0000-0002-6861-8304","authenticated-orcid":true,"given":"Franz","family":"Rischard","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson (F.R.)."}],"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":"Maria Fareri Children\u2019s Hospital and Department of Pediatrics of New York Medical College, Valhalla (E.B.R.)."}],"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"}]},{"given":"Serpil C.","family":"Erzurum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lerner Research Institute (S.C.E.), Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8876-5045","authenticated-orcid":true,"given":"Gerald J.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences (G.J.B.), Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0156-6757","authenticated-orcid":true,"given":"J. Emanuel","family":"Finet","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (J.E.F., C.L.J., W.H.W.T.), Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8610-0533","authenticated-orcid":true,"given":"Christine L.","family":"Jellis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (J.E.F., C.L.J., W.H.W.T.), Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-7209","authenticated-orcid":true,"given":"Stephen C.","family":"Mathai","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD (P.M.H., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-2675","authenticated-orcid":true,"given":"Reena","family":"Mehra","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, University of Washington, Seattle (R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8335-735X","authenticated-orcid":true,"given":"W.H. Wilson","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (J.E.F., C.L.J., W.H.W.T.), Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-0596","authenticated-orcid":true,"given":"Barry A.","family":"Borlaug","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (Y.N.V.R., R.P.F., B.A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PVDOMICS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.026807"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.05.029"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.07.009"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.047"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.09.010"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202306-1072OC"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae049"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.11.049"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(68)90041-7"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.157.21.2483"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034646"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.930701"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.1916"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03140-1"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.311737"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01344-2024"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202402-0359VP"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.08.061"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006363"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.03.021"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1100-z"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.045810"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.11.037"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00469-0"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2410027"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02526-x"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.123.011366"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.95.08040537"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.2.8306039"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi807"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(81)90050-4"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.06.048"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.95.2.338"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201906-1122OC"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2404881"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.08.738"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.04.019"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.08.021"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae534"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.124.069479"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.065134"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.1914"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf027"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy268"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz713"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2024.09.005"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.125.012912","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T18:00:24Z","timestamp":1755626424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.125.012912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":47,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.125.012912"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.125.012912","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}