Evidence map›Paper›PMID 31853950›Full record

ReviewComprehensive Physiology2019

Sex, Gender, and Sex Hormones in Pulmonary Hypertension and Right Ventricular Failure.

James Hester, Corey Ventetuolo, Tim Lahm

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Comprehensive Physiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
118citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

118 citing papers in PubMed, 1 synthesis or guideline pooled it, 155 citations in OpenAlex.

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  6. Large animal models of right heart failure due to pulmonary hypertension: a bridge to translational success.European respiratory review : an official journal of the European Respiratory Society · 2026
    Review
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58 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

James HesterDepartment of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Corey VentetuoloDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Tim LahmDepartment of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Brown University · USIndiana University – Purdue University Indianapolis · USIndiana University School of Medicine

Funding

Mechanisms of Right Ventricle Adaptation to Pulmonary HypertensionR01HL144727 · NHLBI · NATIONAL JEWISH HEALTH · PI Tim Lahm · 2019 to 2026
$4.7M
Mechanisms of right ventricle adaptation to pulmonary hypertensionR56HL134736 · NHLBI · INDIANA UNIVERSITY INDIANAPOLIS · PI LAHM, TIM · 2017 to 2017
$615k
BLRD VA I01 BX002042NHLBI NIH HHS R01 HL144727NHLBI NIH HHS R56 HL134736
6 · The paper itself

Abstract

Pulmonary hypertension (PH) encompasses a syndrome of diseases that are characterized by elevated pulmonary artery pressure and pulmonary vascular remodeling and that frequently lead to right ventricular (RV) failure and death. Several types of PH exhibit sexually dimorphic features in disease penetrance, presentation, and progression. Most sexually dimorphic features in PH have been described in pulmonary arterial hypertension (PAH), a devastating and progressive pulmonary vasculopathy with a 3-year survival rate <60%. While patient registries show that women are more susceptible to development of PAH, female PAH patients display better RV function and increased survival compared to their male counterparts, a phenomenon referred to as the "estrogen paradox" or "estrogen puzzle" of PAH. Recent advances in the field have demonstrated that multiple sex hormones, receptors, and metabolites play a role in the estrogen puzzle and that the effects of hormone signaling may be time and compartment specific. While the underlying physiological mechanisms are complex, unraveling the estrogen puzzle may reveal novel therapeutic strategies to treat and reverse the effects of PAH/PH. In this article, we (i) review PH classification and pathophysiology; (ii) discuss sex/gender differences observed in patients and animal models; (iii) review sex hormone synthesis and metabolism; (iv) review in detail the scientific literature of sex hormone signaling in PAH/PH, particularly estrogen-, testosterone-, progesterone-, and dehydroepiandrosterone (DHEA)-mediated effects in the pulmonary vasculature and RV; (v) discuss hormone-independent variables contributing to sexually dimorphic disease presentation; and (vi) identify knowledge gaps and pathways forward. © 2020 American Physiological Society. Compr Physiol 10:125-170, 2020.

Indexed as

AnimalsGender IdentityGonadal Steroid HormonesHumansHypertension, PulmonarySex CharacteristicsVentricular Dysfunction, RightGonadal Steroid Hormones

Identifiers

PMID31853950
PMCPMC7338988
OpenAlexW2995489031

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.