Predictive Power of Pulmonary Artery Stiffness—Right Ventricular Interplay, But Not Pulmonary Vascular Resistance, in Mild Pulmonary Hypertension
Year: 2026
Type: article
Abstract: BACKGROUND: ) capture complementary aspects of pulmonary vascular load, whereas stroke volume index (SVI) reflects RV functional adaptation. The prognostic significance of these integrated parameters remains incompletely understood, particularly in early-stage disease. RESEARCH QUESTION: , and SVI predict mortality independently of PVR in patients with mild pulmonary hypertension (PH) and across the full spectrum of PH? STUDY DESIGN AND METHODS: as end-systolic pressure divided by stroke volume. RESULTS: , PAC, SVI, and heart rate demonstrated independent prognostic value. Expanding the analysis to 16,899 patients across PH groups 1-5, these parameters remained significantly associated with survival, independent of PVR/total pulmonary resistance and after adjustment for multiple potential confounders. Consistent findings were observed across etiological subgroups and idiopathic pulmonary arterial hypertension/heritable pulmonary arterial hypertension. INTERPRETATION: Parameters integrating pulsatile vascular load and interdependent RV function possess predictive power independent of PVR/total pulmonary resistance across the full spectrum of PH. Moreover, they allow meaningful risk stratification in patients with mild PH, for whom conventional parameters lack discriminative prognostic power. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT05329714; URL: www. CLINICALTRIALS: gov.
Source: CHEST Journal
Authors: Athiththan Yogeswaran, Meike Fünderich, David G. Kiely, Jeffrey S. Annis, Evan Brittain, Harm Jan Bogaard, Aparna Balasubramanian, Paul M. Hassoun, Luke Howard, Allan Lawrie, Martin R. Wilkins, Thenappan Thenappan, Jean Elwing, Arun Jose, Mona Lichtblau, Silvia Ulrich, Lars Harbaum, Hans Klose, Andrew J. Sweatt, Roham T. Zamanian, Edmund M. Lau, Keiichiro Kuronuma, Hiromi Matsubara, Nathan Dwyer, Yuriy Sirenko, Olena Torbas, Christina A. Eichstaedt, Ekkehard Grünig, Melanie Lavender, Alexandra Arvanitaki, George Giannakoulas, Marlize Frauendorf, Paul G. Williams, Zhenguo Zhai, Zhu Zhang, Anastasia Anthi, Effrosyni Dima, Hani Sabbour, Khaled Saleh, Stefano Ghio, Laura Scelsi, Juliana De Luque Figueroa, Mauricio Orozco-Levi, Alba Ramirez-Sarmiento, Siva Sivakumaran, James Anderson, Stephen Y. Chan, Ingrid King, Horst Olschewski, Hossein-Ardeschir Ghofrani, Friedrich Grimminger, Raphael W. Majeed, Jochen Wilhelm, Khodr Tello, Werner Seeger, Imad Al Ghouleh, Felix Ballmann, Joan Albert Barbera, Hector R. Cajigas, John Cannon, Ceren Demircan, Alejandro Cruz Utrilla, Victoria Damonte, Eckart De Bie, Philipp Douschan, Diego Echazarreta, Pilar Escribano Subias, Kai Förster, Robert Frantz, Melanie Heberling, Anne Hilgendorff, Patrick Janetzko, Ernesto Junaeda, Cihangir Kaymaz, Ingrid King, Grzegorz Kopec, Gabor Kovacs, Philipp Krieb, Kurt Marquardt, Farhan Mubashir, Karen Osborn, Joanna Pepke-Zaba, Timo Rosenbach, Stephan Rosenkranz, Sandeep Sahay, Ioan Tilea, Mark Toshner, Andrea Varga, Katharina Wendlandt, Helen M. Whitford, Christoph B. Wiedenroth, Shaun Yo, Nayeli Zayas
Institutions: Justus-Liebig-Universität Gießen, Universitätsklinikum Gießen und Marburg, German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Cardio-Pulmonary Institute, Royal Hallamshire Hospital, National Institute for Health and Care Research, NIHR Sheffield Biomedical Research Centre, University of Sheffield, Vanderbilt University Medical Center, Amsterdam University Medical Centers, Johns Hopkins University, Johns Hopkins Medicine, Imperial College London, University of Minnesota, University of Cincinnati, University Hospital Zurich, University Medical Center Hamburg-Eppendorf, Pulmonary and Allergy Associates, Royal Prince Alfred Hospital, Okayama Medical Center, Royal Hobart Hospital, Shupyk National Healthcare University of Ukraine, National Scientific Center "M.D. Strazhesko Institute of Cardiology", Heidelberg University, University Hospital Heidelberg, Fiona Stanley Hospital, Aristotle University of Thessaloniki, Milpark Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China-Japan Friendship Hospital, National and Kapodistrian University of Athens, Evangelismos Hospital, Cleveland Clinic Abu Dhabi, Policlinico San Matteo Fondazione, Fundación Cardiovascular de Colombia, Gold Coast Hospital, Sunshine Coast University Hospital, University of Pittsburgh, The University of Melbourne, Murdoch Children's Research Institute, Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,160
OpenAlex ID: W7204220199
FWCI:
Cites:
Cited by:
Related to: