{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:37:27Z","timestamp":1780108647769,"version":"3.54.0"},"reference-count":26,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Pulmonary arterial hypertension (PAH) in the elderly is often associated with left heart disease (LHD), prompting concerns about the use of pulmonary vasodilators. The PATRIARCA registry enrolled \u226570 year-old PAH or chronic thromboembolic pulmonary hypertension (CTEPH) patients at 11 Italian centers from 1 December 2019 through 15 September 2022. After excluding those with CTEPH, post-capillary PH at the diagnostic right heart catheterization (RHC), and\/or incomplete data, 23 (33%) of a total of 69 subjects met the criteria proposed in the AMBITION trial to suspect LHD. Diabetes [9 (39%) vs. 6 (13%), p = 0.01] and chronic kidney disease [14 (61%) vs. 12 (26%), p = 0.003] were more common, and the last RHC pulmonary artery wedge pressure [14 \u00b1 5 vs. 10 \u00b1 3 mmHg, p &lt; 0.001] was higher and pulmonary vascular resistance [5.56 \u00b1 3.31 vs. 8.30 \u00b1 4.80, p = 0.02] was lower in LHD than non-LHD patients. However, PAH therapy was similar, with 13 (57%) and 23 (50%) subjects, respectively, taking two oral drugs. PAH medication patterns remained comparable between LHD and non-LHD patients also when the former [37, 54%] were identified by atrial fibrillation and echocardiographic features of LHD, in addition to the AMBITION criteria. In this real-world snapshot, elderly PAH patients were treated with pulmonary vasodilators, including combinations, despite a remarkable prevalence of a LHD phenotype.<\/jats:p>","DOI":"10.3390\/jcm11237136","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T02:24:46Z","timestamp":1669861486000},"page":"7136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1361-9609","authenticated-orcid":false,"given":"Matteo","family":"Toma","sequence":"first","affiliation":[{"name":"Cardiovascular Disease Unit, Cardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Miceli","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, Ente Ospedaliero Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Bonsante","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Ospedale di Bolzano, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6034-6335","authenticated-orcid":false,"given":"Davide","family":"Colombo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione IRCCS Policlinico San Matteo Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-768X","authenticated-orcid":false,"given":"Marco","family":"Confalonieri","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University Hospital of Cattinara, Strada di Fiume 447, 34149 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Garascia","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Ghio","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione IRCCS Policlinico San Matteo Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Lattanzio","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Heart and Vessels, Ospedale di Circolo & Fondazione Macchi, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Maria","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, ASST Spedali Civili di Brescia, 25123 Brescia, Italy"},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Paciocco","sequence":"additional","affiliation":[{"name":"Pulmonary Unit, Cardio-Thoracic and Vascular Department, Milano Bicocca University, San Gerardo Hospital, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Piccinino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, \u201cMaggiore della Carit\u00e0\u201d Hospital, Corso Mazzini 18, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Rota","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, Internal Medicine Department, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Santolamazza","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Scelsi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione IRCCS Policlinico San Matteo Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piermario","family":"Scuri","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiovascular Department, ASST- Ospedale Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Stolfo","sequence":"additional","affiliation":[{"name":"Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina and University Hospital of Trieste, 34129 Trieste, Italy"},{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet, 17177 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Vincenzi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, San Gerardo Hospital, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Volpiano","sequence":"additional","affiliation":[{"name":"Pulmonary Unit, Cardio-Thoracic and Vascular Department, Milano Bicocca University, San Gerardo Hospital, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vicenzi","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, Internal Medicine Department, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7167-7287","authenticated-orcid":false,"given":"Pietro","family":"Ameri","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, Cardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy"},{"name":"Department of Internal Medicine, University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/eurheartj\/ehv317","article-title":"2015 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: 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