{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:36:02Z","timestamp":1755225362947,"version":"3.43.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000327","name":"Heart Research UK","doi-asserted-by":"publisher","award":["NET31\/19"],"award-info":[{"award-number":["NET31\/19"]}],"id":[{"id":"10.13039\/501100000327","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The consistent relationship between pulmonary artery systolic (PASP), diastolic (PADP), mean (mPAP), and pulse (PP) pressures has led to the proposal of the golden ratio (\u03a6) hypothesis. This study tested the \u03a6 hypothesis in the pulmonary circulation of patients with advanced heart failure (HF) and cardiogenic shock (CS). PASP:mPAP, mPAP:PADP, and PP:mPAP ratios were evaluated in 20 patients with advanced HF (high\u2010fidelity measurements) and 93 patients with CS (fluid\u2010filled system). Twelve of 20 patients with advanced HF had PASP:mPAP and mPAP:PADP ratios from high\u2010fidelity measurements that were consistent with the \u03a6 hypothesis. The eight patients with low PASP:mPAP and mPAP:PADP ratios had lower PP: mPAP ratio (0.72 (0.71\u20130.73) vs. 0.94 (0.92\u20130.99), <jats:italic>p<\/jats:italic>\u2009=\u20090.002). In patients with CS, 76 patients (82%) had PASP:mPAP and mPAP:PADP ratios that were consistent with the \u03a6 hypothesis. The 17 patients with CS and \u201clow ratios\u201d also had lower PP:mPAP (0.53 (0.48\u20130.57) vs. 0.74 (0.68\u20130.87), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Lower PP:mPAP ratio was related to higher filling pressures and lower cardiac power output. The pulmonary circulation deviated from the \u03a6 hypothesis in patients with more severe HF and CS. Low PP:mPAP ratio identifies patients with HF and CS with more severe hemodynamic compromise.<\/jats:p>","DOI":"10.14814\/phy2.70287","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T01:13:20Z","timestamp":1743383600000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock"],"prefix":"10.14814","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6569-1805","authenticated-orcid":false,"given":"Hoong Sern","family":"Lim","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"},{"name":"Institute of Cardiovascular Sciences University of Birmingham  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-4600","authenticated-orcid":false,"given":"Ivan H. W.","family":"Yim","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.01.013"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14093"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.12.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.4.1313"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0904"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-1755"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.49.1.165"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.007393"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2022.07.045"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/02676591221140744"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166463"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1998.84.1.303"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200910-1643OC"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00002210"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-1367"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.051540"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4745"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-016-0350-7"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029254"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-024-00360-x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12345"}],"container-title":["Physiological Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.14814\/phy2.70287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T09:49:09Z","timestamp":1755078549000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.14814\/phy2.70287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.14814\/phy2.70287"],"URL":"https:\/\/doi.org\/10.14814\/phy2.70287","archive":["Portico"],"relation":{},"ISSN":["2051-817X","2051-817X"],"issn-type":[{"type":"print","value":"2051-817X"},{"type":"electronic","value":"2051-817X"}],"subject":[],"published":{"date-parts":[[2025,3,28]]},"assertion":[{"value":"2025-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70287"}}