{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:33:33Z","timestamp":1787150013670,"version":"build-2736575974"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Pulmonary vascular diseases have undergone a profound transformation over the past two decades [...]<\/jats:p>","DOI":"10.3390\/life16081364","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:07:34Z","timestamp":1787148454000},"page":"1364","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Evolving Landscape of Pulmonary Vascular Disease: Current Advances and Future Directions in Pulmonary Hypertension and Pulmonary Embolism"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-4433","authenticated-orcid":false,"given":"Michele Antonio","family":"Cacia","sequence":"first","affiliation":[{"name":"Cardiology Unit, \u201cRenato Dulbecco\u201d University Hospital, \u201cPugliese\u201d Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egidio","family":"Imbalzano","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1469-1714","authenticated-orcid":false,"given":"Marco","family":"Vatrano","sequence":"additional","affiliation":[{"name":"Cardiology Unit, \u201cRenato Dulbecco\u201d University Hospital, \u201cPugliese\u201d Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1801913","DOI":"10.1183\/13993003.01913-2018","article-title":"Haemodynamic definitions and updated clinical classification of pulmonary hypertension","volume":"53","author":"Simonneau","year":"2019","journal-title":"Eur. Respir. 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","doi-asserted-by":"crossref","unstructured":"Cacia, M., Imbalzano, E., Ciconte, V.A., and Vatrano, M. (2025). Pulmonary Hypertension: Let\u2019s Take Stock!. Life, 15.","DOI":"10.3390\/life15071137"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_5","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","volume":"43","author":"Humbert","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.tips.2025.05.004","article-title":"Anti-remodeling therapies in pulmonary arterial hypertension","volume":"46","author":"Boucherat","year":"2025","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1801899","DOI":"10.1183\/13993003.01899-2018","article-title":"Genetics and genomics of pulmonary arterial hypertension","volume":"53","author":"Morrell","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2401294","DOI":"10.1183\/13993003.01294-2024","article-title":"Chronic thromboembolic pulmonary disease","volume":"64","author":"Kim","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sharma, M., Paudyal, V., Syed, S.K., Thapa, R., Kassam, N., and Surani, S. (2025). Management of Pulmonary Arterial Hypertension: Current Strategies and Future Prospects. Life, 15.","DOI":"10.20944\/preprints202501.1187.v1"},{"key":"ref_10","first-page":"832","article-title":"Cellular and molecular pathobiology of pulmonary arterial hypertension","volume":"74","author":"Humbert","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1161\/CIRCULATIONAHA.109.933762","article-title":"Elevated levels of inflammatory cytokines predict survival in idiopathic and familial pulmonary arterial hypertension","volume":"122","author":"Soon","year":"2010","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/S0140-6736(01)06250-X","article-title":"Effects of the dual endothelin receptor antagonist bosentan in patients with pulmonary arterial hypertension: A randomized placebo-controlled study","volume":"358","author":"Channick","year":"2001","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3010","DOI":"10.1161\/CIRCULATIONAHA.107.742510","article-title":"Ambrisentan for the treatment of pulmonary arterial hypertension: Results of the Ambrisentan in Pulmonary Arterial Hypertension, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Efficacy (ARIES) study 1 and 2","volume":"117","author":"Olschewski","year":"2008","journal-title":"Circulation"},{"key":"ref_14","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_15","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1056\/NEJMc051946","article-title":"Sildenafil citrate therapy for pulmonary arterial hypertension","volume":"353","author":"Ghofrani","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2894","DOI":"10.1161\/CIRCULATIONAHA.108.839274","article-title":"Tadalafil therapy for pulmonary arterial hypertension (PHIRST study)","volume":"119","author":"Brundage","year":"2009","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1056\/NEJMoa1209657","article-title":"Riociguat for the treatment of chronic thromboembolic pulmonary hypertension","volume":"369","author":"Ghofrani","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1056\/NEJM199602013340504","article-title":"A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension","volume":"334","author":"Barst","year":"1996","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1164\/ajrccm.165.6.2106079","article-title":"Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension: A double-blind, randomized, placebo-controlled trial","volume":"165","author":"Simonneau","year":"2002","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1056\/NEJMoa020204","article-title":"Inhaled iloprost for severe pulmonary arterial hypertension","volume":"347","author":"Olschewski","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_21","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_22","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.jacbts.2024.04.005","article-title":"Targeting soluble TGF-\u03b2 factors: Advances in precision therapy for pulmonary arterial hypertension","volume":"9","author":"Becher","year":"2024","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1056\/NEJMoa2024277","article-title":"Sotatercept for the Treatment of Pulmonary Arterial Hypertension","volume":"384","author":"Humbert","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_24","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_25","first-page":"3738","article-title":"Treatment goals in pulmonary arterial hypertension","volume":"37","author":"Hoeper","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_26","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_27","doi-asserted-by":"crossref","first-page":"1700889","DOI":"10.1183\/13993003.00889-2017","article-title":"Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension","volume":"50","author":"Boucly","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4175","DOI":"10.1093\/eurheartj\/ehx257","article-title":"A comprehensive risk stratification at early follow-up determines prognosis in pulmonary arterial hypertension","volume":"39","author":"Kylhammar","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Baccelli, A., Gopalan, D., Davies, R.J., Haji, G., Gin-Sing, W., Howard, L.S., and Lo Giudice, F. (2025). How to Reliably Measure Stroke Volume Index in Pulmonary Arterial Hypertension: A Comparison of Thermodilution, Direct and Indirect Fick, and Cardiac MRI. Life, 15.","DOI":"10.3390\/life15010054"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2301633","DOI":"10.1183\/13993003.01633-2023","article-title":"Phenotypes in pulmonary hypertension","volume":"64","author":"Weatherald","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2401370","DOI":"10.1183\/13993003.01370-2024","article-title":"Genetics and precision genomics approaches to pulmonary hypertension","volume":"64","author":"Austin","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Dima, E., Orfanos, S.E., Grigoropoulos, V., Fasfali, D., Mpatsouli, A., Zimpounoumi-Keratsa, N.P., Niarchou, P., Megarisiotou, A., Prappa, E., and Xydonas, S. (2025). Low DLCO Can Provide Insights into Treatment Response in PAH Patients Irrespective of the Reason for Its Decrease. Life, 15.","DOI":"10.20944\/preprints202508.2220.v1"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1164\/rccm.201909-1771OC","article-title":"Identification of cardiac magnetic resonance imaging thresholds for risk stratification in pulmonary arterial hypertension","volume":"201","author":"Lewis","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"106191","DOI":"10.1016\/j.ebiom.2026.106191","article-title":"Harnessing metabolomics and proteomics in a clinical trial for pulmonary arterial hypertension: Insights from post-hoc analysis of the REHAB-PH trial","volume":"126","author":"Pi","year":"2026","journal-title":"eBioMedicine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2002828","DOI":"10.1183\/13993003.02828-2020","article-title":"ERS statement on chronic thromboembolic pulmonary hypertension","volume":"57","author":"Delcroix","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"160112","DOI":"10.1183\/16000617.0112-2016","article-title":"The pathophysiology of chronic thromboembolic pulmonary hypertension","volume":"26","author":"Simonneau","year":"2017","journal-title":"Eur. Respir. Rev."},{"key":"ref_37","first-page":"2696","article-title":"Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension: Long-term results","volume":"33","author":"Jenkins","year":"2012","journal-title":"Eur. Heart J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/20458940211007372","article-title":"Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: State-of-the-art 2020","volume":"11","author":"Madani","year":"2021","journal-title":"Pulm. Circ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.jtcvs.2010.11.024","article-title":"Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: Results from an international prospective registry","volume":"141","author":"Mayer","year":"2011","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1093\/eurheartj\/ehad413","article-title":"Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: A clinical consensus statement","volume":"44","author":"Lang","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/S2213-2600(22)00214-4","article-title":"Balloon pulmonary angioplasty versus riociguat in inoperable chronic thromboembolic pulmonary hypertension (RACE-2): A multicentre, open-label, randomised controlled trial","volume":"10","author":"Brenot","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1183\/09031936.00087114","article-title":"Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: A long-term extension study (CHEST-2)","volume":"45","author":"Simonneau","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Abdulaal, L., Maiter, A., Salehi, M., Sharkey, M., Alnasser, T., Garg, P., Rajaram, S., Hill, C., Johns, C., and Rothman, A.M.K. (2024). A systematic review of artificial intelligence tools for chronic pulmonary embolism on CT pulmonary angiography. Front. Radiol., 4.","DOI":"10.3389\/fradi.2024.1335349"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1161\/CIRCRESAHA.115.306841","article-title":"Global burden of thrombosis: Epidemiologic aspects","volume":"118","author":"Wendelboe","year":"2016","journal-title":"Circ. Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Keskin, H.V., Ozcelik, N., Senturk Topaloglu, E., Ozyurt, S., Gumus, A., and Sahin, U. (2025). Which Is More Valuable in the Diagnosis of Pulmonary Thromboembolism? The Wells Score, the Revised Geneva Score, or the Padua Score?. Life, 15.","DOI":"10.3390\/life15071115"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Diaz-Lorenzo, I., Alonso-Burgos, A., Friera Reyes, A., Pacios Blanco, R.E., de Benavides Bernaldo de Quiros, M.D.C., and Gallardo Madue\u00f1o, G. (2024). Current Role of CT Pulmonary Angiography in Pulmonary Embolism: A State-of-the-Art Review. J. Imaging, 10.","DOI":"10.20944\/preprints202408.0042.v1"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1016\/j.jacc.2025.11.005","article-title":"2026 AHA\/ACC\/ACCP\/ACEP\/CHEST\/SCAI\/SHM\/SIR\/SVM\/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"87","author":"Creager","year":"2026","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/j.jcin.2018.04.008","article-title":"A randomized trial of the optimum duration of acoustic pulse thrombolysis procedure and alteplase dose for submassive pulmonary embolism: The OPTALYSE PE trial","volume":"11","author":"Tapson","year":"2018","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e623","DOI":"10.4244\/EIJ-D-22-00246","article-title":"Percutaneous treatment options for acute pulmonary embolism: A clinical consensus statement by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function and the European Association of Percutaneous Cardiovascular Interventions","volume":"18","author":"Pruszczyk","year":"2022","journal-title":"EuroIntervention"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e013406","DOI":"10.1161\/CIRCINTERVENTIONS.123.013406","article-title":"Outcomes in high-risk pulmonary embolism patients undergoing FlowTriever mechanical thrombectomy or other contemporary therapies: Results from the FLAME study","volume":"16","author":"Silver","year":"2023","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.jcin.2020.09.053","article-title":"Indigo aspiration system for treatment of pulmonary embolism: Results of the EXTRACT-PE trial","volume":"14","author":"Sista","year":"2021","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_52","first-page":"746","article-title":"Changes in treatment and outcomes after creation of a multidisciplinary pulmonary embolism response team (PERT)","volume":"139","author":"Rosovsky","year":"2019","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ahj.2022.05.011","article-title":"Ultrasound-facilitated, catheter-directed thrombolysis vs anticoagulation alone for acute intermediate-high-risk pulmonary embolism: Rationale and design of the HI-PEITHO study","volume":"251","author":"Klok","year":"2022","journal-title":"Am. Heart J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1076029619853037","DOI":"10.1177\/1076029619853037","article-title":"Diagnosis, treatment and follow-up of acute pulmonary embolism: Consensus practice from the PERT Consortium","volume":"25","author":"McDaniel","year":"2019","journal-title":"Clin. Appl. Thromb. Hemost."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/8\/1364\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:12:53Z","timestamp":1787148773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/8\/1364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":54,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["life16081364"],"URL":"https:\/\/doi.org\/10.3390\/life16081364","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}