{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:53:25Z","timestamp":1760147605098,"version":"build-2065373602"},"reference-count":9,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Combined cases of hypertrophic obstructive cardiomyopathy (HOCM) and pulmonary arterial hypertension (PAH) are rare and have a management dilemma. Although preload is crucial in the management of HOCM, anti-PAH agents dramatically change the preload, leading to improving or worsening heart failure in patients with HOCM. We had a 74-year-old woman with Sjogren-syndrome-associated PAH. Her heart failure worsened following the initiation of anti-PAH agents due to an incremental preload on the left ventricle, whereas HOCM clinically developed following the termination of anti-PAH agents and progressing anorexia due to the progression of the left ventricular outflow obstruction. Careful monitoring of the left ventricular outflow obstruction during initiation\/termination of anti-PAH agents and medical intervention to the HOCM are highly recommended.<\/jats:p>","DOI":"10.3390\/medicina59020401","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T03:56:07Z","timestamp":1676865367000},"page":"401","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Therapeutic Strategy for Patients with Concomitant Pulmonary Artery Hypertension and Hypertrophic Obstructive Cardiomyopathy: A Rare Case Report"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2703-2523","authenticated-orcid":false,"given":"Toshihide","family":"Izumida","sequence":"first","affiliation":[{"name":"Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-7637","authenticated-orcid":false,"given":"Teruhiko","family":"Imamura","sequence":"additional","affiliation":[{"name":"Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7551-3431","authenticated-orcid":false,"given":"Shuhei","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuji","family":"Joho","sequence":"additional","affiliation":[{"name":"Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Kinugawa","sequence":"additional","affiliation":[{"name":"Second Department of Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ytab354","DOI":"10.1093\/ehjcr\/ytab354","article-title":"A haemodynamic conundrum: A case report of a patient with concurrent pulmonary arterial hypertension and hypertrophic obstructive cardiomyopathy","volume":"5","author":"Hassanin","year":"2021","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e003689","DOI":"10.1161\/CIRCHEARTFAILURE.116.003689","article-title":"Mechanism of Progressive Heart Failure and Significance of Pulmonary Hypertension in Obstructive Hypertrophic Cardiomyopathy","volume":"10","author":"Covella","year":"2017","journal-title":"Circ. Heart Fail."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.echo.2016.03.003","article-title":"Abnormalities of the Mitral Apparatus in Hypertrophic Cardiomyopathy: Echocardiographic, Pathophysiologic, and Surgical Insights","volume":"29","author":"Silbiger","year":"2016","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Sato, T., Hatano, M., Iwasaki, Y., Maki, H., Saito, A., Minatsuki, S., Inaba, T., Amiya, E., Fujio, K., and Watanabe, M. (2018). Prevalence of primary Sj\u00f6gren\u2019s syndrome in patients undergoing evaluation for pulmonary arterial hypertension. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197297"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1902157","DOI":"10.1183\/13993003.02157-2019","article-title":"Pulmonary arterial hypertension associated with primary Sj\u00f6gren\u2019s syndrome: A multicentre cohort study from China","volume":"56","author":"Wang","year":"2020","journal-title":"Eur. Respir. 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Cardiol."},{"key":"ref_9","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. 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