{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:12:26Z","timestamp":1788667946353,"version":"build-2803163510"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82270057"],"award-info":[{"award-number":["82270057"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Clinical Research Award of the First Affiliated Hospital of Xi\u2019an Jiaotong University, China","award":["XJTU1AF-CRF-2019-010"],"award-info":[{"award-number":["XJTU1AF-CRF-2019-010"]}]},{"name":"Fundamental Project Plan in Shaanxi Province, China","award":["2020JM-364"],"award-info":[{"award-number":["2020JM-364"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sodium\u2212glucose cotransporter\u22122 inhibitors (SGLT2 inhibitors) confer broad cardiovascular benefits, but their role in pulmonary arterial hypertension (PAH) remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the potential therapeutic role of SGLT2 inhibitors in PAH by evaluating their longitudinal association, including improvement in risk profile, functional status, and ventricular coupling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicenter retrospective longitudinal pilot study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with Group 1 PAH confirmed by right heart catheterization were followed and categorized by exposure to SGLT2 inhibitors. Time-to-clinical improvement was assessed using Cox proportional hazard models adjusted for age, gender, PAH etiology, pulmonary vascular resistance, and baseline risk profile. Two predefined endpoints were evaluated: (1) improvement by \u2265 1 category in a four-level risk stratification, and (2) achievement of a low-risk profile. Longitudinal changes in functional, biomarkers, and echocardiographic measures were analyzed using linear mixed-effects models adjusting for relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 83 patients with PAH, 43 received SGLT2 inhibitors. SGLT2 inhibitor use was independently associated with a higher rate of improvement by \u2265 1 risk category (hazard ratio [HR] 2.21, 95%CI 1.06\u22124.63; p = 0.034) and a higher likelihood of achieving a low risk profile (HR 2.62, 95% CI 1.02\u22126.76; p = 0.045). Longitudinal improvement was observed across the cohort in six-minute walk distance, Borg dyspnea score, B-type natriuretic peptide (BNP) levels, and composite risk score (all p &lt;0.001), with SGLT2 inhibitor use associated with greater improvement in persistently lower log-BNP levels during follow-up (p = 0.007). Echocardiographic demonstrated reductions in pulmonary artery systolic pressure and improvement in RV-pulmonary artery coupling over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this real-world cohort, SGLT2 inhibitor use was associated with a higher likelihood of clinical improvement and achieving a low-risk profile in PAH, alongside favorable longitudinal changes in biomarkers and hemodynamics. Prospective randomized trials are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261479969","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:06:26Z","timestamp":1788339986000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Repurposing SGLT2 inhibitors in pulmonary arterial hypertension: A multi-center longitudinal pilot study demonstrating favorable effects on risk profile and ventricular coupling"],"prefix":"10.1177","volume":"20","author":[{"given":"Yifan","family":"Zou","sequence":"first","affiliation":[{"name":"Xi\u2019an Jiaotong University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6032-7641","authenticated-orcid":false,"given":"Ashfaq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital"},{"name":"of Xi\u2019an Jiaotong 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