ArticleOpen heart2025
Phenotyping of patients with mild pulmonary hypertension.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- An unexpected therapeutic overlap: long-term control of KCNK3-associated pulmonary arterial hypertension during treatment of systemic hypertension-a case report.European heart journal. Case reports · 2026Article
- Article
- Advancing the diagnosis of pulmonary arterial hypertension-a Brazilian perspective aligned with global standards.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2026Article
- Global burden and epidemiological determinants of pulmonary arterial hypertension among women aged 55 years and older: a GBD 2023 analysis.Frontiers in medicine · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRevised haemodynamic criteria for pulmonary hypertension (PH)-mean pulmonary artery pressure (mPAP) >20 mm Hg and pulmonary vascular resistance (PVR) >2 Wood Units (WU)-have defined new subsets of patients with mild PH. We aimed to characterise their clinical profile and prognosis.
methodsWe included consecutive incident, treatment-naïve patients undergoing right heart catheterisation at a PH referral centre. Patients with mPAP 21-24 mm Hg and pulmonary artery wedge pressure (PAWP) ≤15 mm Hg were stratified by PVR values to identify those with unclassified PH (PVR≤2 WU) and mild precapillary PH (PVR>2 WU). Patients with mild precapillary PH were compared with matched controls with normal haemodynamics and with patients meeting previous pulmonary arterial hypertension (PAH) haemodynamic criteria (mPAP≥25 mm Hg, PAWP≤15 mm Hg, PVR>3 WU).
resultsAmong 259 patients with mPAP 21-24 mm Hg and PAWP≤15 mm Hg, 76% had left heart or lung disease. In unclassified PH, mPAP elevation was mainly due to high stroke volume index (SVI) or backward transmission from borderline PAWP. In mild precapillary PH, SVI was the only independent haemodynamic predictor of survival. Survival was similar between mild precapillary PH and PAH patients. A limited number of patients with PAH risk factors progressed to overt PAH and, in the absence of comorbidities, appeared to benefit from PAH therapies.
conclusionsUnclassified PH is mainly related to pulmonary overflow or backward transmission from borderline PAWP. Mild precapillary PH is typically associated with comorbidities and not necessarily an early PAH stage. SVI is a key prognostic marker. Careful clinical phenotyping is essential to identify the small subset who may benefit from targeted therapies.
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