ArticleCHEST pulmonary2025
Incidence and Clinical Associations With Phenotypic Drift From Pulmonary Arterial Hypertension to Combined Precapillary and Postcapillary Pulmonary Hypertension.
Article in CHEST pulmonary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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Who cites it
1 citing paper in PubMed.
- Sotatercept Improves Small Airway Disease and Hyperinflation in Patients with Pulmonary Hypertension.medRxiv : the preprint server for health sciences · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pulmonary hypertension (PH) diagnosis relies on hemodynamic measurements from right heart catheterization (RHC). Pulmonary arterial hypertension (PAH) (group 1) is differentiated from group 2 PH (due to left-sided heart disease) by pulmonary capillary wedge pressure (PCWP), with group 2 requiring PCWP > 15 mm Hg. Contemporary PAH cohorts are older with more cardiovascular comorbidities compared with early descriptions, making it harder to distinguish between PAH and group 2 PH. It is unclear whether hemodynamic shifts between PH classifications occur over time or how these shifts impact outcomes. Research Question: How frequently do patients with PAH develop combined precapillary and postcapillary PH (CpcPH), marked by elevated PCWP on follow-up RHC? What baseline characteristics are associated with this change, and does it affect outcomes? Study Design and Methods: This retrospective cohort analysis at a single academic institution examined demographic, clinical, and RHC data from diagnostic and most recent RHCs. The primary outcome was the incidence of phenotypic drift from PAH to CpcPH. Secondary objectives included identifying clinical features associated with phenotypic drift and its impact on all-cause mortality and hospitalizations. Results: Of 257 patients with PAH, 58 (22.6%; 95% CI, 17.6%-28.2%) experienced phenotypic drift, whereas 199 (77.4%; 95% CI, 72%-83%) retained PAH hemodynamics. Those with drift were more likely to be Black (29.3% vs 14.1%), have atrial fibrillation (12.1% vs 3.5%), have diabetes (22.4% vs 10.5%), and have higher BMI (30.2 vs 28.1 kg/m Interpretation: Our results indicate that phenotypic drift from PAH to CpcPH is common and associated with features of metabolic syndrome and atrial fibrillation, but not predicted by baseline RHC or imaging features. Phenotypic drift was now shown to affect survival or hospitalization outcomes and should not routinely influence initial PAH treatment decisions.
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