{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T19:09:52Z","timestamp":1785611392408,"version":"3.56.0"},"reference-count":106,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"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>Background: Pulmonary hypertension (PH) is characterized by elevated pulmonary artery pressure, often leading to right heart failure and poor prognosis. Depression, a common comorbidity in PH, significantly affects the quality of life. However, mechanistic insights into the bidirectional relationship between PH and depression and specific treatment interactions remain scarce. Objective: The object was to examine the clinical and therapeutic implications of depression in PH, focusing on its impact on patient outcomes and cost efficiency. Methods: A systematic review of Medline and Google Scholar was conducted to identify studies on depression in PH, emphasizing evidence-based interventions, clinical outcomes, and cost efficiency. Special consideration was given to potential drug interactions between PH medications and depression treatments and to the role of emerging technologies in managing PH-related depression. Results: While depression reduces the quality of life and exacerbates disease severity in PH, depression treatment improves outcomes, particularly when tailored to PH-targeted therapies, considering potential drug\u2013drug interactions. Emerging technologies, including telemedicine, offer innovative approaches to manage depression in PH, enhancing access to care and improving adherence to treatment regimens. Conclusions: Depression in PH must no longer be neglected and should be acknowledged as both a critical comorbidity and a significant driver of disease progression. Interdisciplinary treatment approaches are necessary, considering potential pharmacological interactions and incorporating emerging technologies like telemedicine to improve patient care. Further research is needed to assess the long-term outcomes of depression treatment in different groups of PH.<\/jats:p>","DOI":"10.3390\/jcm14030982","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:55:22Z","timestamp":1738648522000},"page":"982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Depression in Pulmonary Hypertension: A Systematic Review of Clinical Outcomes, Treatment Interactions, and Emerging Technologies"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3464-0802","authenticated-orcid":false,"given":"Mira","family":"Kramer","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Cologne-Merheim Medical Center, University of Witten Herdecke, Ostmerheimer Str. 200, D-51109 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Rosenkranz","sequence":"additional","affiliation":[{"name":"Clinic III for Internal Medicine, Heart Center of the University of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0265-7607","authenticated-orcid":false,"given":"Tilmann","family":"Kramer","sequence":"additional","affiliation":[{"name":"Clinic III for Internal Medicine, Heart Center of the University of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the 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 the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG)","volume":"43","author":"Humbert","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/S2213-2600(15)00543-3","article-title":"A global view of pulmonary hypertension","volume":"4","author":"Hoeper","year":"2016","journal-title":"Lancet Respir. Med."},{"key":"ref_3","first-page":"3124","article-title":"Anxiety and depression in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: Results from a Chinese survey","volume":"19","author":"Zhou","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s00408-017-0052-z","article-title":"Anxiety, Depression, and Health-Related QOL in Patients Diagnosed with PAH or CTEPH","volume":"195","author":"Pfeuffer","year":"2017","journal-title":"Lung"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Olsson, K.M., Meltendorf, T., Fuge, J., Kamp, J.C., Park, D.-H., Richter, M.J., Gall, H., Ghofrani, H.A., Ferrari, P., and Schmiedel, R. (2021). Prevalence of mental disorders and impact on quality of life in patients with pulmonary arterial hypertension. Front. Psychiatry, 12.","DOI":"10.3389\/fpsyt.2021.667602"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e000876","DOI":"10.1136\/bmjresp-2021-000876","article-title":"Depression, anxiety and psychological distress in patients with pulmonary hypertension: A mixed-methods study","volume":"8","author":"Takita","year":"2021","journal-title":"BMJ Open Respir. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1159\/000524369","article-title":"Anxiety, Depression and Quality of Life in Pulmonary Hypertension: A Comparison of Incident and Prevalent Cases","volume":"101","author":"Joa","year":"2022","journal-title":"Respiration"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"349","DOI":"10.2147\/VHRM.S147173","article-title":"Anxiety and depression in patients with pulmonary hypertension: Impact and management challenges","volume":"14","author":"Bussotti","year":"2018","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s11606-011-1704-y","article-title":"Depression and medication adherence in the treatment of chronic diseases in the United States: A meta-analysis","volume":"26","author":"Grenard","year":"2011","journal-title":"J. Gen. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Zhang, J., Yin, Y., Wen, Y., Shi, F., and Wang, J. (2021). Anxiety and Depression in Patients With Pulmonary Arterial Hypertension in Northwest China: A Cross-Sectional Study. Front. Psychiatry, 12.","DOI":"10.3389\/fpsyt.2021.758120"},{"key":"ref_11","first-page":"384","article-title":"Mental distress and wish for psychosomatic treatment of patients with pulmonary hypertension","volume":"64","author":"Larisch","year":"2014","journal-title":"Psychother. Psychosom. Med. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1183\/16000617.0063-2015","article-title":"Pulmonary arterial hypertension: The burden of disease and impact on quality of life","volume":"24","author":"Delcroix","year":"2015","journal-title":"Eur. Respir. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e12114","DOI":"10.1002\/pul2.12114","article-title":"Prevalence of potential drug-drug interactions with disease-specific treatments in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: A registry study","volume":"12","author":"Norell","year":"2022","journal-title":"Pulm. Circ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.chest.2022.06.042","article-title":"Drug-Drug Interactions in the Management of Patients With Pulmonary Arterial Hypertension","volume":"162","author":"Wu","year":"2022","journal-title":"Chest"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1080\/07853890.2023.2187078","article-title":"The effects of treatment via telemedicine interventions for patients with depression on depressive symptoms and quality of life: A systematic review and meta-ranalysis","volume":"55","author":"Shih","year":"2023","journal-title":"Ann. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.genhosppsych.2019.11.004","article-title":"Telemedicine interventions for medication adherence in mental illness: A systematic review","volume":"62","author":"Basit","year":"2020","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_17","unstructured":"eHealth, WHOGOF (2010). Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on eHealth, World Health Organization."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1158\/1078-0432.CCR-20-3758","article-title":"Optimizing the Use of Telemedicine in Oncology Care: Postpandemic OpportunitiesTelehealth in Cancer Care","volume":"27","author":"Knudsen","year":"2021","journal-title":"Clin. Cancer Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e2253788","DOI":"10.1001\/jamanetworkopen.2022.53788","article-title":"Estimated Carbon Emissions Savings with Shifts From In-Person Visits to Telemedicine for Patients with Cancer","volume":"6","author":"Patel","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.7861\/fhj.2020-0080","article-title":"Does telemedicine reduce the carbon footprint of healthcare? A systematic review","volume":"8","author":"Purohit","year":"2021","journal-title":"Future Healthc. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7861\/fhj.2021-0148","article-title":"The environmental impacts of telemedicine in place of face-to-face patient care: A systematic review","volume":"9","author":"Ravindrane","year":"2022","journal-title":"Future Healthc. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100006","DOI":"10.1016\/j.joclim.2021.100006","article-title":"Using telemedicine for a lower carbon footprint in healthcare: A twofold tale of healing","volume":"1","author":"Tsagkaris","year":"2021","journal-title":"J. Clim. Change Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41746-023-00818-7","article-title":"Telemedicine and the environment: Life cycle environmental emissions from in-person and virtual clinic visits","volume":"6","author":"Thiel","year":"2023","journal-title":"NPJ Digit. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1089\/tmj.2009.0105","article-title":"Telemedicine can make healthcare greener","volume":"16","author":"Yellowlees","year":"2010","journal-title":"Telemed. J. E-Health"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Morcillo Serra, C., Aroca Tanarro, A., Cummings, C.M., Jimenez Fuertes, A., and Tom\u00e1s Mart\u00ednez, J.F. (2022). Impact on the reduction of CO2 emissions due to the use of telemedicine. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-16864-2"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"339.e338","DOI":"10.1016\/S0033-3182(10)70706-4","article-title":"Depressive symptoms in pulmonary arterial hypertension: Prevalence and association with functional status","volume":"51","author":"McCollister","year":"2010","journal-title":"Psychosomatics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/01.psy.0000145593.37594.39","article-title":"Anxiety and depression in patients with pulmonary hypertension","volume":"66","author":"Ufer","year":"2004","journal-title":"Psychosom. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mai, A.S., Lim, O.Z.H., Ho, Y.J., Kong, G., Lim, G.E.H., Ng, C.H., Ho, C., Ho, R., Lim, Y., and Kuntjoro, I. (2022). Prevalence, Risk Factors and Intervention for Depression and Anxiety in Pulmonary Hypertension: A Systematic Review and Meta-analysis. Front. Med., 9.","DOI":"10.3389\/fmed.2022.765461"},{"key":"ref_29","first-page":"4983","article-title":"Quality of life of patients with pulmonary arterial hypertension: A meta-analysis","volume":"25","author":"Dudek","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Dering, M.-R., Lepsy, N., Fuge, J., Meltendorf, T., Hoeper, M.M., Heitland, I., Kamp, J.C., Park, D.-H., Richter, M.J., and Gall, H. (2022). Prevalence of Mental Disorders in Patients With Chronic Thromboembolic Pulmonary Hypertension. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.821466"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/0970-2113.173072","article-title":"Depression in pulmonary arterial hypertension: An undertreated comorbidity","volume":"33","author":"Verma","year":"2016","journal-title":"Lung India"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e6783","DOI":"10.1097\/MD.0000000000006783","article-title":"The impact and financial burden of pulmonary arterial hypertension on patients and caregivers: Results from a national survey","volume":"96","author":"Zhai","year":"2017","journal-title":"Medicine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s40273-024-01427-2","article-title":"Economic Burden Associated with Pulmonary Arterial Hypertension in the United States","volume":"43","author":"Watzker","year":"2025","journal-title":"Pharmacoeconomics"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sikirica, M., Iorga, S.R., Bancroft, T., and Potash, J. (2014). The economic burden of pulmonary arterial hypertension (PAH) in the US on payers and patients. BMC Health Serv. Res., 14.","DOI":"10.1186\/s12913-014-0676-0"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Helgeson, S.A., Menon, D., Helmi, H., Vadlamudi, C., Moss, J.E., Zeiger, T.K., and Burger, C.D. (2020). Psychosocial and Financial Burden of Therapy in USA Patients with Pulmonary Arterial Hypertension. Diseases, 8.","DOI":"10.3390\/diseases8020022"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1183\/23120541.00617-2020","article-title":"Health-related quality of life and disease progression in pulmonary arterial hypertension patients: A 3-year study","volume":"7","author":"Halimi","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e062564","DOI":"10.1136\/bmjopen-2022-062564","article-title":"Coping styles associated with depression, health anxiety and health-related quality of life in pulmonary hypertension: Cross-sectional analysis","volume":"12","author":"Rawlings","year":"2022","journal-title":"BMJ Open"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1016\/j.chest.2024.02.009","article-title":"Health-Related Quality of Life Across the Spectrum of Pulmonary Hypertension","volume":"165","author":"Balasubramanian","year":"2024","journal-title":"Chest"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/1465-9921-14-104","article-title":"Anxiety and depression disorders in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension","volume":"14","author":"Harzheim","year":"2013","journal-title":"Respir. Res."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Fuge, J., Park, D.H., von Lengerke, T., Richter, M.J., Gall, H., Ghofrani, H.A., Kamp, J.C., Hoeper, M.M., and Olsson, K.M. (2021). Impact of Pulmonary Arterial Hypertension on Employment, Work Productivity, and Quality of Life - Results of a Cross-Sectional Multi-Center Study. Front. Psychiatry, 12.","DOI":"10.3389\/fpsyt.2021.781532"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00408-010-9277-9","article-title":"Sleep quality, depression, and quality of life in patients with pulmonary hypertension","volume":"189","author":"Batal","year":"2011","journal-title":"Lung"},{"key":"ref_42","first-page":"240","article-title":"Depression in pulmonary arterial hypertension and interstitial lung diseases","volume":"6","author":"Verma","year":"2014","journal-title":"N. Am. J. Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10253890802046281","article-title":"Stress, depression and cardiovascular dysregulation: A review of neurobiological mechanisms and the integration of research from preclinical disease models","volume":"12","author":"Grippo","year":"2009","journal-title":"Stress"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1161\/01.CIR.0000140724.90898.D3","article-title":"Increased sympathetic nerve activity in pulmonary artery hypertension","volume":"110","author":"Ciarka","year":"2004","journal-title":"Circulation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1056\/NEJMra073096","article-title":"Major depressive disorder","volume":"358","author":"Belmaker","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/1465-9921-15-47","article-title":"Inflammatory cytokines in pulmonary hypertension","volume":"15","author":"Groth","year":"2014","journal-title":"Respir. Res."},{"key":"ref_47","first-page":"794","article-title":"Cardiac baroreflex dysfunction in patients with pulmonary arterial hypertension at rest and during orthostatic stress: Role of the peripheral chemoreflex","volume":"131","author":"Ribeiro","year":"2021","journal-title":"J. Appl. Physiol. 1985"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Shah, A.J., Vorla, M., and Kalra, D.K. (2022). Molecular Pathways in Pulmonary Arterial Hypertension. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231710001"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.chest.2016.02.633","article-title":"Physical Activity and Symptoms in Pulmonary Arterial Hypertension","volume":"150","author":"Matura","year":"2016","journal-title":"Chest"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pupt.2014.01.004","article-title":"The impact of drug-drug interactions on pulmonary arterial hypertension therapy","volume":"28","author":"Tirone","year":"2014","journal-title":"Pulm. Pharmacol. Ther."},{"key":"ref_51","first-page":"263","article-title":"Basic review of the cytochrome p450 system","volume":"4","author":"McDonnell","year":"2013","journal-title":"J. Adv. Pract. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1161\/CIRCULATIONAHA.110.944603","article-title":"Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension","volume":"122","author":"Schwartz","year":"2010","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1177\/0091270011423662","article-title":"Clinical pharmacokinetics and drug-drug interactions of endothelin receptor antagonists in pulmonary arterial hypertension","volume":"52","author":"Venitz","year":"2012","journal-title":"J. Clin. Pharmacol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"10","DOI":"10.18773\/austprescr.2001.007","article-title":"Cytochrome P450 drug interactions: Are they clinically relevant?","volume":"24","author":"Martin","year":"2001","journal-title":"Aust. Prescr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1177\/0091270004270642","article-title":"Examination of 209 drugs for inhibition of cytochrome P450 2C8","volume":"45","author":"Walsky","year":"2005","journal-title":"J. Clin. Pharmacol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/87551225221114001","article-title":"Drug Interactions Associated With Therapies for Pulmonary Arterial Hypertension","volume":"38","author":"Narechania","year":"2022","journal-title":"J. Pharm. Technol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11920-019-1017-0","article-title":"Community Interventions to Promote Mental Health and Social Equity","volume":"21","author":"Castillo","year":"2019","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"5212","DOI":"10.19082\/5212","article-title":"The correlation of social support with mental health: A meta-analysis","volume":"9","author":"Harandi","year":"2017","journal-title":"Electron. Physician"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Singh, V., Kumar, A., and Gupta, S. (2022). Mental Health Prevention and Promotion-A Narrative Review. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.898009"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00127-003-0627-2","article-title":"Social inequalities and the common mental disorders: A systematic review of the evidence","volume":"38","author":"Fryers","year":"2003","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1017\/S0033291707002516","article-title":"Debt, income and mental disorder in the general population","volume":"38","author":"Jenkins","year":"2008","journal-title":"Psychol. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.socscimed.2010.04.027","article-title":"Poverty and common mental disorders in low and middle income countries: A systematic review","volume":"71","author":"Lund","year":"2010","journal-title":"Soc. Sci. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s41030-022-00213-9","article-title":"Why Living with Pulmonary Arterial Hypertension Requires a Holistic Approach: A Patient and Clinician Perspective","volume":"9","author":"Lynn","year":"2023","journal-title":"Pulm. Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1056\/NEJMoa1413687","article-title":"Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension","volume":"373","author":"Frost","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1056\/NEJMoa1213917","article-title":"Macitentan and morbidity and mortality in pulmonary arterial hypertension","volume":"369","author":"Pulido","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2522","DOI":"10.1056\/NEJMoa1503184","article-title":"Selexipag for the Treatment of Pulmonary Arterial Hypertension","volume":"373","author":"Sitbon","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1056\/NEJMoa2213558","article-title":"Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension","volume":"388","author":"Hoeper","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.psym.2018.04.002","article-title":"Depression and Anxiety in Patients With Pulmonary Hypertension: The Role of Life Satisfaction and Optimism","volume":"59","year":"2018","journal-title":"Psychosomatics"},{"key":"ref_69","first-page":"792895","article-title":"Progressive muscle relaxation improves anxiety and depression of pulmonary arterial hypertension patients","volume":"2015","author":"Li","year":"2015","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1089\/jpm.2019.0359","article-title":"The Impact of Urban Zen Integrative Therapy on Symptoms and Health-Related Quality of Life for Patients with Pulmonary Hypertension","volume":"23","author":"Thrane","year":"2020","journal-title":"J. Palliat. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.hrtlng.2016.11.001","article-title":"Slow-paced respiration therapy to treat symptoms in pulmonary arterial hypertension","volume":"46","author":"Matura","year":"2017","journal-title":"Heart Lung"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1183\/09031936.00109607","article-title":"Slow breathing reduces sympathoexcitation in COPD","volume":"32","author":"Raupach","year":"2008","journal-title":"Eur. Respir. J."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Bilo, G., Revera, M., Bussotti, M., Bonacina, D., Styczkiewicz, K., Caldara, G., Giglio, A., Faini, A., Giuliano, A., and Lombardi, C. (2012). Effects of slow deep breathing at high altitude on oxygen saturation, pulmonary and systemic hemodynamics. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0049074"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4187\/respcare.02565","article-title":"Effectiveness of controlled breathing techniques on anxiety and depression in hospitalized patients with COPD: A randomized clinical Trial","volume":"59","author":"Valenza","year":"2014","journal-title":"Respir. Care"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1161\/hc0202.103311","article-title":"Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure","volume":"105","author":"Bernardi","year":"2002","journal-title":"Circulation"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1136\/bjsports-2022-106497","article-title":"Yoga-based interventions may reduce anxiety symptoms in anxiety disorders and depression symptoms in depressive disorders: A systematic review with meta-analysis and meta-regression","volume":"57","year":"2023","journal-title":"Br. J. Sports Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e29635","DOI":"10.2196\/29635","article-title":"Health Care Providers\u2019 and Professionals\u2019 Experiences with Telehealth Oncology Implementation During the COVID-19 Pandemic: A Qualitative Study","volume":"24","author":"Turner","year":"2022","journal-title":"J. Med. Internet Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"107024","DOI":"10.1016\/j.vph.2022.107024","article-title":"Telehealth: A winning weapon to face the COVID-19 outbreak for patients with pulmonary arterial hypertension","volume":"145","author":"Manzi","year":"2022","journal-title":"Vasc. Pharmacol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"107061","DOI":"10.1016\/j.rmed.2022.107061","article-title":"Effects of COVID-19 pandemic on the management of pulmonary hypertension","volume":"206","author":"Zhou","year":"2023","journal-title":"Respir. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1253\/circrep.CR-20-0088","article-title":"How COVID-19 Affected the Introduction of Telemedicine and Patient Reported Outcomes Among Patients With Pulmonary Hypertension\u2015A Report From a Referral Center in Japan\u2015","volume":"2","author":"Tamura","year":"2020","journal-title":"Circ. Rep."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.healun.2020.12.005","article-title":"Risk assessment in patients with pulmonary arterial hypertension in the era of COVID 19 pandemic and the telehealth revolution: State of the art review","volume":"40","author":"Sahay","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_82","unstructured":"Telematics, WHOGCoH (1998). A Health Telematics Policy in Support of WHO\u2019s Health-for-All Strategy for Global Health Development: Report of the WHO Group Consultation on Health Telematics, 11\u201316 December, Geneva, 1997, World Health Organization."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.jad.2022.12.015","article-title":"Telehealth treatment of patients with major depressive disorder during the COVID-19 pandemic: Comparative safety, patient satisfaction, and effectiveness to prepandemic in-person treatment","volume":"323","author":"Zimmerman","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1017\/S0033291722002331","article-title":"Telehealth v. face-to-face provision of care to patients with depression: A systematic review and meta-analysis","volume":"52","author":"Scott","year":"2022","journal-title":"Psychol. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.jpsychires.2021.11.003","article-title":"Comparing efficacy of telehealth to in-person mental health care in intensive-treatment-seeking adults","volume":"145","author":"Bulkes","year":"2022","journal-title":"J. Psychiatr. Res."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2045894019880086","DOI":"10.1177\/2045894019880086","article-title":"Medication adherence, hospitalization, and healthcare resource utilization and costs in patients with pulmonary arterial hypertension treated with endothelin receptor antagonists or phosphodiesterase type-5 inhibitors","volume":"10","author":"Frantz","year":"2020","journal-title":"Pulm. Circ."},{"key":"ref_87","first-page":"00299","article-title":"Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension","volume":"6","author":"Sandqvist","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e026620","DOI":"10.1161\/JAHA.122.026620","article-title":"Association Between Copayment and Adherence to Medications for Pulmonary Arterial Hypertension","volume":"11","author":"Schikowski","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.2196\/jmir.7.1.e9","article-title":"What is eHealth (4): A scoping exercise to map the field","volume":"7","author":"Pagliari","year":"2005","journal-title":"J. Med. Internet Res."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e100176","DOI":"10.1136\/bmjhci-2020-100176","article-title":"Use of eHealth in the management of pulmonary arterial hypertension: Review of the literature","volume":"27","author":"Fatehi","year":"2020","journal-title":"BMJ Health Care Inform."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.2196\/jmir.6571","article-title":"Remote monitoring of patients with heart failure: An overview of systematic reviews","volume":"19","author":"Bashi","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.chest.2019.06.010","article-title":"Monitoring Pulmonary Arterial Hypertension Using an Implantable Hemodynamic Sensor","volume":"156","author":"Benza","year":"2019","journal-title":"Chest"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Thangavel, S., Kanwar, M., Benza, R., and Raina, A. (2022). Long Term Safety and Outcomes Utilizing the CardioMEMS Device in Patients with Pulmonary Arterial Hypertension. J. Heart Lung Transplant., 41.","DOI":"10.1016\/j.healun.2022.01.330"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/1460458211420089","article-title":"An empowerment-based approach to developing innovative e-health tools for self-management","volume":"17","author":"Alpay","year":"2011","journal-title":"Health Inform. J."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1089\/pop.2014.0120","article-title":"Disease management: The need for a focus on broader self-management abilities and quality of life","volume":"18","author":"Cramm","year":"2015","journal-title":"Popul. Health Manag."},{"key":"ref_96","unstructured":"Kay, M., Santos, J., and Takane, M. (2011). mHealth: New Horizons for Health Through Mobile Technologies, World Health Organization."},{"key":"ref_97","first-page":"1770","article-title":"Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: Results from a randomised controlled trial","volume":"100","author":"Varnfield","year":"2014","journal-title":"Heart Br. Card. Soc."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/j.chest.2021.04.012","article-title":"A Mobile Health Intervention to Increase Physical Activity in Pulmonary Arterial Hypertension","volume":"160","author":"Hemnes","year":"2021","journal-title":"Chest"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e12144","DOI":"10.1002\/pul2.12144","article-title":"Towards telemedicine in pulmonary hypertension: Assessing the feasibility of remote quality of life and exercise capacity assessment","volume":"12","author":"Stubbs","year":"2022","journal-title":"Pulm. Circ."},{"key":"ref_100","first-page":"608","article-title":"The direct and indirect health care costs associated with pulmonary arterial hypertension among commercially insured patients in the United States","volume":"28","author":"Ogbomo","year":"2022","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.37765\/ajmc.2021.88611","article-title":"Reducing economic burden and improving quality of life in pulmonary arterial hypertension","volume":"27","author":"Burgoyne","year":"2021","journal-title":"Am. J. Manag. Care"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.jagp.2013.01.058","article-title":"Improving the Cost-Effectiveness of a Healthcare System for Depressive Disorders by Implementing Telemedicine: A Health Economic Modeling Study","volume":"22","author":"Lokkerbol","year":"2013","journal-title":"Am. J. Geriatr. Psychiatry Off. J. Am. Assoc. Geriatr. Psychiatry"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s40274-018-5298-z","article-title":"Telehealth intervention for depression reduces costs","volume":"812","author":"Egede","year":"2018","journal-title":"PharmacoEconomics Outcomes News"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s10597-020-00724-2","article-title":"A Systematic Review of the Use of Telepsychiatry in Depression","volume":"57","author":"Guaiana","year":"2021","journal-title":"Community Ment. Health J."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Clark, A., Appleton, R., Kalocsanyiova, E., Gkaintatzi, E., and McCrone, P. (2022). Are remote mental healthcare interventions cost-effective? A systematic review of economic evaluations of remote mental healthcare. medRxiv.","DOI":"10.1101\/2022.12.01.22282817"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1192\/bjb.2021.17","article-title":"What mental health professionals and organisations should do to address climate change","volume":"45","author":"Monsell","year":"2021","journal-title":"BJPsych Bull."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/982\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:26:29Z","timestamp":1760027189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":106,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030982"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030982","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]}}}