{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:03:14Z","timestamp":1785488594251,"version":"3.56.0"},"reference-count":46,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy Timi\u0219oara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Amb a 1 is the major allergenic component of Ambrosia artemisiifolia pollen and a clinically relevant marker of genuine ragweed sensitization. Heart failure is increasingly recognized as a systemic syndrome shaped by immune activation, endothelial dysfunction, fibrosis, neurohormonal imbalance, pulmonary comorbidity, and environmental exposures. This narrative review aims to synthesize the translational evidence linking Amb a 1-specific IgE, IgE-mediated inflammation, allergic airway disease, and cardiovascular remodeling in heart failure. Methods: A targeted narrative review was performed, integrating evidence on component-resolved ragweed diagnosis, IgE-Fc\u03b5RI signaling, mast cell and eosinophil biology, pollen exposure, cardiovascular inflammation, and heart failure pathophysiology. Results: No dedicated clinical studies have validated Amb a 1-specific IgE as a diagnostic, prognostic, or therapeutic biomarker in heart failure. However, adjacent evidence supports biologically plausible links between allergen-specific IgE responses and cardiovascular dysfunction, including mast cell activation, cytokine release, endothelial perturbation, oxidative stress, microvascular dysfunction, pulmonary-cardiac interaction, and myocardial fibrosis. Amb a 1-specific IgE may therefore identify a seasonally vulnerable heart failure phenotype, particularly in patients with allergic rhinitis, asthma, eosinophilic inflammation, or recurrent symptom worsening during ragweed season. A systemic\/indirect pathway operating through allergic airway disease is distinguished from a postulated direct cardiac pathway; the latter remains strictly speculative, as no direct evidence demonstrates that inhaled Amb a 1 reaches or activates cardiac mast cells in vivo. Conclusions: Amb a 1-specific IgE should not currently be used to infer cardiac causality or modify heart failure therapy. Prospective, phenotype-rich, exposure-informed studies are needed to determine whether ragweed sensitization has clinically meaningful implications for heart failure endotyping, seasonal risk assessment, and cardio-allergology care. These findings may inform patient-centered heart failure management by improving the interpretation of seasonal dyspnea, allergic comorbidity, and symptom fluctuations in ragweed-endemic regions.<\/jats:p>","DOI":"10.3390\/jcm15155971","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:20:18Z","timestamp":1785486018000},"page":"5971","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Amb a 1-Specific IgE in Heart Failure: A Translational Framework for Seasonal Risk, Endotyping, and Patient-Centered Management"],"prefix":"10.3390","volume":"15","author":[{"given":"Camelia-Felicia","family":"B\u0103n\u0103rescu","sequence":"first","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Department of General Medicine, Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavia","family":"Harich","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Physiology Discipline, Department of Functional Sciences, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"U\u021ba","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Department of General Medicine, Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Clinical Hospital \u201cPius Brinzeu\u201d, 156 Liviu Rebreanu Bd., 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5703-2578","authenticated-orcid":false,"given":"Laura","family":"Haidar","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Physiology Discipline, Department of Functional Sciences, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5030-3235","authenticated-orcid":false,"given":"Roxana Maria","family":"Buzan","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Research Center for Gene and Cellular Therapies in the Treatment of Cancer\u2014OncoGen, Timi\u0219 County Emergency Clinical Hospital \u201cPius Brinzeu\u201d, 156 Liviu Rebreanu Bd., 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena-Larisa","family":"Zimbru","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Physiology Discipline, Department of Functional Sciences, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Research Center for Gene and Cellular Therapies in the Treatment of Cancer\u2014OncoGen, Timi\u0219 County Emergency Clinical Hospital \u201cPius Brinzeu\u201d, 156 Liviu Rebreanu Bd., 300723 Timisoara, Romania"},{"name":"Cardiovascular Disease Institute Timisoara, Gheorghe Adam St., No. 13A, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra Iulia","family":"Moldovan","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Department of General Medicine, Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Emergency Clinical Hospital \u201cPius Brinzeu\u201d, 156 Liviu Rebreanu Bd., 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9972","authenticated-orcid":false,"given":"Carmen","family":"Panaitescu","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Physiology Discipline, Department of Functional Sciences, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Research Center for Gene and Cellular Therapies in the Treatment of Cancer\u2014OncoGen, Timi\u0219 County Emergency Clinical Hospital \u201cPius Brinzeu\u201d, 156 Liviu Rebreanu Bd., 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Andreea","family":"Tischer","sequence":"additional","affiliation":[{"name":"Ear-Nose-Throat Department, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Daniela","family":"Jurj","sequence":"additional","affiliation":[{"name":"Center for Drug Data Analysis, Cheminformatics, and the Internet of Medical Things, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4951-1702","authenticated-orcid":false,"given":"Diana-Maria","family":"Mateescu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Timisoara Clinical Railway Hospital, 1 G\u0103rii Street, 300166 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip-Alin","family":"Banarescu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cVictor Babe\u0219\u201d Clinical Hospital for Infectious Diseases and Pneumophthisiology, 13 Gheorghe Adam Street, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgil","family":"P\u0103unescu","sequence":"additional","affiliation":[{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Physiology Discipline, Department of Functional Sciences, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Research Center for Gene and Cellular Therapies in the Treatment of Cancer\u2014OncoGen, Timi\u0219 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Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1093\/eurheartj\/ehad195","article-title":"2023 Focused Update of the 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure","volume":"44","author":"McDonagh","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_3","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.cardfail.2021.01.022","article-title":"Universal Definition and Classification of Heart Failure","volume":"27","author":"Bozkurt","year":"2021","journal-title":"J. Card. Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1161\/CIRCRESAHA.121.318159","article-title":"From Systemic Inflammation to Myocardial Fibrosis: The Heart Failure with Preserved Ejection Fraction Paradigm Revisited","volume":"128","author":"Paulus","year":"2021","journal-title":"Circ. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1161\/CIRCRESAHA.116.302317","article-title":"Innate Immunity and the Failing Heart: The Cytokine Hypothesis Revisited","volume":"116","author":"Mann","year":"2015","journal-title":"Circ. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1038\/nrcardio.2014.28","article-title":"The Inflammatory Response in Myocardial Injury, Repair, and Remodelling","volume":"11","author":"Frangogiannis","year":"2014","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1038\/nrcardio.2017.57","article-title":"Redefining the Identity of Cardiac Fibroblasts","volume":"14","author":"Tallquist","year":"2017","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1002\/ejhf.1406","article-title":"Towards Better Definition, Quantification and Treatment of Fibrosis in Heart Failure","volume":"21","author":"Bauersachs","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1016\/j.jacc.2018.02.021","article-title":"Myocardial Interstitial Fibrosis in Heart Failure: Biological and Translational Perspectives","volume":"71","author":"Gonzalez","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1161\/CIRCULATIONAHA.120.047852","article-title":"Role of IgE-Fc epsilon R1 in Pathological Cardiac Remodeling and Dysfunction","volume":"143","author":"Zhao","year":"2021","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7600","DOI":"10.7150\/thno.47845","article-title":"Elevated IgE Promotes Cardiac Fibrosis by Suppressing miR-486a-5p","volume":"11","author":"Zhao","year":"2021","journal-title":"Theranostics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1161\/CIRCRESAHA.124.325813","article-title":"Spleen-Heart Cross-Talk Through CD23-Mediated Signal Promotes Cardiac Remodeling","volume":"137","author":"Feng","year":"2025","journal-title":"Circ. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e14281","DOI":"10.1111\/apha.14281","article-title":"IgE and Cardiac Disease","volume":"241","author":"Levick","year":"2025","journal-title":"Acta Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3564","DOI":"10.1172\/JCI46028","article-title":"IgE Stimulates Human and Mouse Arterial Cell Apoptosis and Cytokine Expression and Promotes Atherogenesis in Apoe\u2212\/\u2212 Mice","volume":"121","author":"Wang","year":"2011","journal-title":"J. Clin. Investig."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Min, K.B., and Min, J.Y. (2019). Risk of Cardiovascular Mortality in Relation to Increased Total Serum IgE Levels in Older Adults: A Population-Based Cohort Study. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16224350"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.jaci.2023.09.038","article-title":"IgE to Common Food Allergens Is Associated with Cardiovascular Mortality in the National Health and Examination Survey and the Multi-Ethnic Study of Atherosclerosis","volume":"153","author":"Keet","year":"2024","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.it.2020.06.006","article-title":"Cardiac Mast Cells: Underappreciated Immune Cells in Cardiovascular Homeostasis and Disease","volume":"41","author":"Varricchi","year":"2020","journal-title":"Trends Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Legere, S.A., Haidl, I.D., Legare, J.F., and Marshall, J.S. (2019). Mast Cells in Cardiac Fibrosis: New Insights Suggest Opportunities for Intervention. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.00580"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/cvr\/cvae066","article-title":"Mast Cells: A Novel Therapeutic Avenue for Cardiovascular Diseases?","volume":"120","author":"Poto","year":"2024","journal-title":"Cardiovasc. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mamazhakypov, A., Viswanathan, G., Imhof, A., Babicheva, A., Rodriguez, M., Ghofrani, H.A., Weissmann, N., Seeger, W., Grimminger, F., and Savai, R. (2024). Mast Cells in Cardiac Remodeling: Focus on the Right Ventricle. J. Cardiovasc. Dev. Dis., 11.","DOI":"10.20944\/preprints202312.1272.v1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e13854","DOI":"10.1111\/pai.13854","article-title":"EAACI Molecular Allergology User\u2019s Guide 2.0","volume":"34","author":"Dramburg","year":"2023","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3642","DOI":"10.1111\/all.14969","article-title":"Molecular Allergology and Its Impact in Specific Allergy Diagnosis and Therapy","volume":"76","author":"Barber","year":"2021","journal-title":"Allergy"},{"key":"ref_24","first-page":"1","article-title":"EAACI Allergen Immunotherapy User\u2019s Guide","volume":"31","author":"Akdis","year":"2020","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.envint.2013.08.005","article-title":"Common Ragweed: A Threat to Environmental Health in Europe","volume":"61","author":"Smith","year":"2013","journal-title":"Environ. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1289\/EHP173","article-title":"Climate Change and Future Pollen Allergy in Europe","volume":"125","author":"Lake","year":"2017","journal-title":"Environ. Health Perspect."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1038\/nclimate2652","article-title":"Effects of Climate Change and Seed Dispersal on Airborne Ragweed Pollen Loads in Europe","volume":"5","author":"Vautard","year":"2015","journal-title":"Nat. Clim. Change"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1111\/j.1365-2222.2006.02477.x","article-title":"Artemisia and Ambrosia Hypersensitivity: Co-Sensitization or Co-Recognition?","volume":"36","author":"Asero","year":"2006","journal-title":"Clin. Exp. Allergy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1111\/j.1398-9995.2008.01780.x","article-title":"Array-Based Profiling of Ragweed and Mugwort Pollen Allergens","volume":"63","author":"Gadermaier","year":"2008","journal-title":"Allergy"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Bordas-Le Floch, V., Le Mignon, M., Bouley, J., Groeme, R., Jain, K., Baron-Bodo, V., Nony, E., Mascarell, L., and Moingeon, P. (2015). Identification of Novel Short Ragweed Pollen Allergens Using Combined Transcriptomic and Immunoproteomic Approaches. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0136258"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1111\/all.13196","article-title":"Amb a 1 Isoforms: Unequal Siblings with Distinct Immunological Features","volume":"72","author":"Wolf","year":"2017","journal-title":"Allergy"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2500\/ajra.2012.26.3698","article-title":"IgE Reactivity Patterns in Patients with Allergic Rhinoconjunctivitis to Ragweed and Mugwort Pollens","volume":"26","author":"Canis","year":"2012","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Bocsan, I.C., Muntean, I.A., Ureche, C., Pop, R.M., Neag, M.A., Sabin, O., Deleanu, D., and Buzoianu, A.D. (2019). Characterization of Patients with Allergic Rhinitis to Ragweed Pollen in Two Distinct Regions of Romania. Medicina, 55.","DOI":"10.3390\/medicina55110712"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"15921","DOI":"10.1038\/s41598-022-20069-y","article-title":"Ragweed Pollen Concentration Predicts Seasonal Rhino-Conjunctivitis and Asthma Severity in Patients Allergic to Ragweed","volume":"12","author":"Bonini","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"15447","DOI":"10.1074\/jbc.M116.733659","article-title":"Structural, Functional, and Immunological Characterization of Profilin Panallergens Amb a 8, Art v 4, and Bet v 2","volume":"291","author":"Offermann","year":"2016","journal-title":"J. Biol. Chem."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1111\/all.14177","article-title":"The Need for Clean Air: The Way Air Pollution and Climate Change Affect Allergic Rhinitis and Asthma","volume":"75","author":"Mathioudakis","year":"2020","journal-title":"Allergy"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e023036","DOI":"10.1161\/JAHA.121.023036","article-title":"Temporal Changes in Pollen Concentration Predict Short-Term Clinical Outcomes in Acute Coronary Syndromes","volume":"11","author":"Vogrin","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e296","DOI":"10.1097\/EE9.0000000000000296","article-title":"Associations of Pollen and Cardiovascular Disease Morbidity in Atlanta During 1993-2018","volume":"8","author":"Lappe","year":"2024","journal-title":"Environ. Epidemiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"109517","DOI":"10.1016\/j.envint.2025.109517","article-title":"Associations Between Airborne Pollen, Pollen-Related Allergic Rhinitis and Blood Pressure: A Systematic Review and Meta-Analysis","volume":"200","author":"Burgler","year":"2025","journal-title":"Environ. Int."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Nitschke, M., Davies, J.M., Beggs, P.J., Koplin, J.J., Newbigin, E., Katelaris, C.H., Girgis, S.T., Prescott, S.L., and Erbas, B. (2022). Pollen Exposure and Cardiopulmonary Health Impacts in Adelaide, South Australia. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19159093"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.anai.2016.08.021","article-title":"Association of Allergic Rhinitis, Coronary Heart Disease, Cerebrovascular Disease, and All-Cause Mortality","volume":"117","author":"Yoon","year":"2016","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1093\/aje\/kws181","article-title":"Adult Asthma and Risk of Coronary Heart Disease, Cerebrovascular Disease, and Heart Failure: A Prospective Study of 2 Matched Cohorts","volume":"176","author":"Iribarren","year":"2012","journal-title":"Am. J. Epidemiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bocsan, I.C., Muntean, I.A., Miron, N., Pintea, I., Dobrican, C.T., Ureche, C., Buzoianu, A.D., and Deleanu, D. (2022). Are Markers of Allergic Inflammation in Grass Pollen Allergy Influenced by H1 Antihistamines?. J. Clin. Med., 11.","DOI":"10.3390\/jcm11010113"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.jacc.2018.06.050","article-title":"Identifying Pathophysiological Mechanisms in Heart Failure with Reduced Versus Preserved Ejection Fraction","volume":"72","author":"Tromp","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101","DOI":"10.18087\/cardio.2025.10.n3021","article-title":"Phenotypes of Chronic Heart Failure in Patients with Preserved Ejection Fraction","volume":"65","author":"Plotnikova","year":"2025","journal-title":"Kardiologiia"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e70263","DOI":"10.1002\/pul2.70263","article-title":"Association of Immunoglobulin E with Right Ventricular Dysfunction in Pulmonary Arterial Hypertension","volume":"16","author":"Wu","year":"2026","journal-title":"Pulm. Circ."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5971\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:48:43Z","timestamp":1785487723000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":46,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15155971"],"URL":"https:\/\/doi.org\/10.3390\/jcm15155971","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}