ArticleChest2022
The Right Ventricular-Pulmonary Arterial Coupling and Diastolic Function Response to Therapy in Pulmonary Arterial Hypertension.
Article in Chest, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Prognostic Value of Serial Risk Stratification in Adult and Pediatric Pulmonary Arterial Hypertension: A Systematic Review.Journal of the American Heart Association · 2024Pooled it
- From Snapshot to Trajectory: The RV-3 Check for Pulmonary Arterial Hypertension Follow-up.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Right Heart Diastology, Where Are We Now?Circulation research · 2026Review
- Broiler Ascites Syndrome as a Potential Spontaneous Animal Model for Human Pulmonary Arterial Hypertension: A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Sex Differences in Echocardiographic Measures of Right Ventricular Function and RV-PA Coupling.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Knowledge Gaps and Controversies on Cardiopulmonary Exercise Testing in the Assessment of Pulmonary Vascular Disease: An Official Statement of the Pulmonary Vascular Research Institute Exercise and Right Ventricular Function Task Force.Pulmonary circulation · 2026Article
- Ovarian hormones attenuate right ventricular remodeling in a rat model of pulmonary arterial hypertension.Biomechanics and modeling in mechanobiology · 2025Article
- Treatment Response and Survival in Methamphetamine-Associated Pulmonary Arterial Hypertension.Journal of the American Heart Association · 2025Article
- Right Ventricular Dysfunction in Lung Disease/Hypoxia-Associated Pulmonary Hypertension.Journal of the American Heart Association · 2025Article
- Right Ventricular Function, Inflammation, and the Gut Microbiome in Pulmonary Hypertension: A Translational Frontier.Circulation. Heart failure · 2025Article
- Emerging Mechanistic Insights and Therapeutic Strategies for Pulmonary Arterial Hypertension: A Focus on Right Ventricular Dysfunction and Novel Treatment Pathways.Biomedicines · 2025Review
- Right ventricular-pulmonary arterial coupling predicts mortality in precapillary pulmonary hypertension.ERJ open research · 2025Article
- PET/CT Imaging of the Right Heart Perfusion and Glucose Metabolism Depending on a Risk Status in Patients With Idiopathic Pulmonary Arterial Hypertension.Pulmonary circulation · 2025Article
- A PrOsPective Cohort Study on Interstitial Lung Disease-Associated Pulmonary Hypertension with a ParticulaR Focus on the Subset with Pulmonary Arterial Hypertension Features (POPLAR Study).Pulmonary therapy · 2024Article
- Sex-dependent remodeling of right ventricular function in a rat model of pulmonary arterial hypertension.American journal of physiology. Heart and circulatory physiology · 2024Article
- Right ventricular diastolic adaptation to pressure overload in different rat strains.Physiological reports · 2024Article
- Insights Into Differences in Pulmonary Hemodynamics in Hispanic Patients With Pulmonary Arterial Hypertension.Cardiology research · 2024Article
- Contribution of pressure and flow changes to resistance reduction after pulmonary arterial hypertension treatment: a meta-analysis of 3898 patients.ERJ open research · 2024Article
- Classification and Predictors of Right Ventricular Functional Recovery in Pulmonary Arterial Hypertension.Circulation. Heart failure · 2023Article
- Echocardiographic evaluation of right ventricular diastolic function in pulmonary hypertension.ERJ open research · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMultiparametric risk assessment is used in pulmonary arterial hypertension (PAH) to target therapy. However, this strategy is imperfect because most patients remain at intermediate or high risk after initial treatment, with low risk being the goal. Metrics of right ventricular (RV) adaptation are promising tools that may help refine our therapeutic strategy. RESEARCH QUESTION: Does RV adaptation predict therapeutic response over time? STUDY DESIGN AND
methodsWe evaluated 52 incident treatment-naive patients with advanced PAH by catheterization and cardiac imaging longitudinally at baseline, follow-up 1 (∼3 months), and follow-up 2 (∼18 months). All patients received goal-directed therapy with parenteral treprostinil and/or combination therapy with treatment escalation if functional class I or II was not achieved. On the basis of their therapeutic response, patients were evaluated at follow-up 1 as nonresponders (died) or as responders, and again at follow-up 2 as super-responders (low risk) or partial responders (high/intermediate risk). Multiparametric risk was based on a simplified European Respiratory Society/European Society of Cardiology guideline score. RV adaptation was evaluated with the single-beat coupling ratio (Ees/Ea) and diastolic function with diastolic elastance (Eed). Data are expressed as mean ± SD or as OR (95% CI).
resultsNine patients (17%) were nonresponders. PAH-directed therapy improved the European Respiratory Society low-risk score from 1 (2%) at baseline to 23 (55%) at follow-up 2. Ees/Ea at presentation was nonsignificantly higher in responders (0.9 ± 0.4) vs nonresponders (0.6 ± 0.4; P = .09) but could not be used to predict super-responder status at follow-up 2 (OR, 1.40 [95% CI, 0.28-7.0]; P = .84). Baseline RV ejection fraction and change in Eed were successfully used to predict super-responder status at follow-up 2 (OR, 1.15 [95% CI, 1.0-1.27]; P = .009 and OR, 0.29 [95% CI, 0.86-0.96]; P = .04, respectively).
interpretationIn patients with advanced PAH, RV-pulmonary arterial coupling could not discriminate irreversible RV failure (nonresponders) at presentation but showed a late trend to improvement by follow-up 2. Early change in Eed and baseline RV ejection fraction were the best predictors of therapeutic response.
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Registered trials
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