{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:40:48Z","timestamp":1783640448966,"version":"3.55.0"},"reference-count":49,"publisher":"European Respiratory Society (ERS)","issue":"1","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["200.000"],"award-info":[{"award-number":["200.000"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2025,9,2]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypersensitivity pneumonitis (HP) is an immune-mediated condition triggered by inhaled antigens in susceptible individuals. Patients with HP often present with exercise limitation due to multiple mechanisms, including ventilatory and cardiocirculatory impairments, particularly pulmonary hypertension (PH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, patients with HP of varying severity underwent clinical assessment, including quality-of-life questionnaires, incremental treadmill cardiopulmonary exercise testing (CPET), pulmonary function testing, 6-min walk test and transthoracic echocardiography (TTE). Patients with a diffusing capacity of the lung for carbon monoxide (\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>LCO<\/jats:sub>\n                      ) below 40% of predicted and\/or a tricuspid regurgitation velocity &gt;2.5\u2005m\u00b7s\n                      <jats:sup>\u22121<\/jats:sup>\n                      or pulmonary artery systolic pressure &gt;35\u2005mmHg on TTE were referred for right heart catheterisation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 90 patients, 65% were female, with a median age of 65.5\u2005years, and 85% had fibrotic HP. CPET was performed in 51 patients (56%), with a mean peak oxygen consumption of 58\u00b113% of predicted. Exercise capacity was reduced in 98% of patients, with multifactorial limitation in 88%, primarily due to cardiocirculatory impairment (76%) and impaired gas exchange (66%). The mean 6-min walk distance was 334\u00b1116\u2005m. Mean forced vital capacity and\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>LCO<\/jats:sub>\n                      were 56\u00b120% and 42\u00b122% predicted, respectively. PH was identified in 59% of patients (95% CI 48\u201372%), predominantly with combined post- and pre-capillary involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced exercise capacity is highly prevalent in patients with HP and is typically multifactorial. PH is also common, with a predominance of combined post- and pre-capillary patterns. These findings underscore the need for a comprehensive evaluation strategy in symptomatic HP patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.00656-2025","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T16:55:25Z","timestamp":1757609725000},"page":"00656-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanisms of exercise limitation and prevalence of pulmonary hypertension in hypersensitivity pneumonitis"],"prefix":"10.1183","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0771-3703","authenticated-orcid":false,"given":"Guilherme das Posses","family":"Bridi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-4649","authenticated-orcid":false,"given":"Bianca","family":"Freire da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Barbosa","family":"Sobral-Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3046-3412","authenticated-orcid":false,"given":"Celso R. 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