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Ørbæk Andersen M, Carlsen J. Continuous heart monitoring in patients with pulmonary hypertension smartwatches and direct transmission to their electronic health records: A trial design. Contemp Clin Trials 2024; 142:107548. [PMID: 38679139 DOI: 10.1016/j.cct.2024.107548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Pulmonary hypertension is a progressive disease for which early treatment interventions are essential. Traditionally, patients undergo periodic clinical assessments. However, recent advances in wearable technology could improve the quality and efficiency of follow-up monitoring in patients with pulmonary hypertension. TRIAL DESIGN To our knowledge, this is the first study describing direct data transmission from a smartwatch to patients' electronic health records. It implements a novel update and customised program to continuously and automatically transmit data from a smartwatch to the patient's electronic healthcare records. It will evaluate continuous monitoring in patients with pulmonary hypertension and monitor their physical activity time, heart rate variability, and heart rate at rest and during physical activity via a smartwatch. It will also evaluate the data transmission method, and its data will be assessed by the treating physicians supplemental to clinical practice. Smartwatch integration promises numerous advantages: comprehensive cardiovascular monitoring and improved patient experience. Our continuous smartwatch monitoring approach offers a solution for earlier detection of clinical worsening and could be included as a combined endpoint in future clinical trials. It could improve patient empowerment, enhance precision medicine, and reduce hospitalisations. The user-friendly smartwatch is designed to minimise disruption in daily life. CONCLUSION The ability to transfer real-time data from wearable devices to electronic health records could help to transform the treatment of patients with pulmonary hypertension and their follow-up monitoring outside a clinical setting, enhancing the efficiency of healthcare delivery.
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Affiliation(s)
- Mads Ørbæk Andersen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Jørn Carlsen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.
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Le Bozec A, Korb-Savoldelli V, Boiteau C, Dechartres A, Al Kahf S, Sitbon O, Montani D, Jaïs X, Guignabert C, Humbert M, Savale L, Chaumais MC. Medication adherence, related factors and outcomes among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: a systematic review. Eur Respir Rev 2024; 33:240006. [PMID: 38960611 PMCID: PMC11220621 DOI: 10.1183/16000617.0006-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/04/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are life-threatening conditions that can progress to death without treatment. Although strong medication adherence (MA) is known to enhance outcomes in chronic illnesses, its association with PAH and CTEPH was sporadically explored. This study aims to examine the MA of patients with PAH or CTEPH, identify factors associated with low adherence and explore the resulting outcomes. METHODS A systematic review was conducted by searching multiple databases (Medline, Embase, Cochrane Central, ClinicalTrials.gov, Scopus, Web of Science and Google Scholar) from 6 March 1998 to 6 July 2023. We included studies reporting MA as primary or secondary end-points. Study selection, data extraction and methodological quality assessment were performed in duplicate. RESULTS 20 studies involving 22 675 patients met the inclusion criteria. Heterogeneity was observed, particularly in the methods employed. MA means ranged from 0.62 to 0.96, with the proportion of patients exhibiting high MA varying from 40% (95% CI 35-45%) to 94% (95% CI 88-97%). Factors associated with low adherence included increased treatment frequency, time since diagnosis and co-payment. High MA seems to be associated with reduced hospitalisation rates, inpatient stays, outpatient visits and healthcare costs. CONCLUSIONS This systematic review underscores the heterogeneity of MA across studies. Nevertheless, the findings suggest that high MA could improve patients' clinical outcomes and alleviate the economic burden. Identifying factors consistently associated with poor MA could strengthen educational efforts for these patients, ultimately contributing to improved outcomes.
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Affiliation(s)
- Antoine Le Bozec
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay, Service de Pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Université Paris Saclay, Orsay, France
| | - Virginie Korb-Savoldelli
- Université Paris Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Université Paris Saclay, Orsay, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Cité, Service de Pharmacie, Hôpital Européen Georges Pompidou, Paris, France
| | - Claire Boiteau
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay, Service de Pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1421, Paris, France
| | - Salma Al Kahf
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - David Montani
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Christophe Guignabert
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Marie-Camille Chaumais
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay, Service de Pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Université Paris Saclay, Orsay, France
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Pitre T, Weatherald J, Humbert M. Treatments for pulmonary arterial hypertension: navigating through a network of choices. Eur Heart J 2024; 45:1953-1955. [PMID: 38442135 DOI: 10.1093/eurheartj/ehae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Affiliation(s)
- Tyler Pitre
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Jason Weatherald
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Marc Humbert
- Université Paris-Saclay, INSERM UMR_S 999, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre (Assistance Publique-Hôpitaux de Paris), European Reference Network for rare lung diseases (ERN-LUNG), 78 rue du général Leclerc, 94270 Le Kremlin-Bicêtre, France
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Lemay SE, Montesinos MS, Grobs Y, Yokokawa T, Shimauchi T, Romanet C, Sauvaget M, Breuils-Bonnet S, Bourgeois A, Théberge C, Pelletier A, El Kabbout R, Martineau S, Yamamoto K, Ray AS, Lippa B, Goodwin B, Lin FY, Wang H, Dowling JE, Lu M, Qiao Q, McTeague TA, Moy TI, Potus F, Provencher S, Boucherat O, Bonnet S. Exploring Integrin α5β1 as a Potential Therapeutic Target for Pulmonary Arterial Hypertension: Insights from Comprehensive Multicenter Preclinical Studies. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.27.596052. [PMID: 38854025 PMCID: PMC11160677 DOI: 10.1101/2024.05.27.596052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Pulmonary arterial hypertension (PAH) is characterized by obliterative vascular remodeling of the small pulmonary arteries (PA) and progressive increase in pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Although several drugs are approved for the treatment of PAH, mortality remains high. Accumulating evidence supports a pathological function of integrins in vessel remodeling, which are gaining renewed interest as drug targets. However, their role in PAH remains largely unexplored. We found that the arginine-glycine-aspartate (RGD)-binding integrin α5β1 is upregulated in PA endothelial cells (PAEC) and PA smooth muscle cells (PASMC) from PAH patients and remodeled PAs from animal models. Blockade of the integrin α5β1 or depletion of the α5 subunit resulted in mitotic defects and inhibition of the pro-proliferative and apoptosis-resistant phenotype of PAH cells. Using a novel small molecule integrin inhibitor and neutralizing antibodies, we demonstrated that α5β1 integrin blockade attenuates pulmonary vascular remodeling and improves hemodynamics and RV function in multiple preclinical models. Our results provide converging evidence to consider α5β1 integrin inhibition as a promising therapy for pulmonary hypertension. One sentence summary The α5β1 integrin plays a crucial role in pulmonary vascular remodeling.
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Shen T, Shi J, Zhao X, Fu L, Wang N, Zheng X, Chen Y, Li M, Ma C, Liu P, Zhu D. Presenilin 1 Is a Therapeutic Target in Pulmonary Hypertension and Promotes Vascular Remodeling. Am J Respir Cell Mol Biol 2024; 70:468-481. [PMID: 38381098 DOI: 10.1165/rcmb.2022-0426oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/20/2024] [Indexed: 02/22/2024] Open
Abstract
Small muscular pulmonary artery remodeling is a dominant feature of pulmonary arterial hypertension (PAH). PSEN1 affects angiogenesis, cancer, and Alzheimer's disease. We aimed to determine the role of PSEN1 in the pathogenesis of vascular remodeling in pulmonary hypertension (PH). Hemodynamics and vascular remodeling in the Psen1-knockin and smooth muscle-specific Psen1-knockout mice were assessed. The functional partners of PSEN1 were predicted by bioinformatics analysis and biochemical experiments. The therapeutic effect of PH was evaluated by administration of the PSEN1-specific inhibitor ELN318463. We discovered that both the mRNA and protein levels of PSEN1 were increased over time in hypoxic rats, monocrotaline rats, and Su5416/hypoxia mice. Psen1 transgenic mice were highly susceptible to PH, whereas smooth muscle-specific Psen1-knockout mice were resistant to hypoxic PH. STRING analysis showed that Notch1/2/3, β-catenin, Cadherin-1, DNER (delta/notch-like epidermal growth factor-related receptor), TMP10, and ERBB4 appeared to be highly correlated with PSEN1. Immunoprecipitation confirmed that PSEN1 interacts with β-catenin and DNER, and these interactions were suppressed by the catalytic PSEN1 mutations D257A, D385A, and C410Y. PSEN1 was found to mediate the nuclear translocation of the Notch1 intracellular domains and activated RBP-Jκ. Octaarginine-coated liposome-mediated pharmacological inhibition of PSEN1 significantly prevented and reversed the pathological process in hypoxic and monocrotaline-induced PH. PSEN1 essentially drives the pathogenesis of PAH and interacted with the noncanonical Notch ligand DNER. PSEN1 can be used as a promising molecular target for treating PAH. PSEN1 inhibitor ELN318463 can prevent and reverse the progression of PH and can be developed as a potential anti-PAH drug.
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Affiliation(s)
- TingTing Shen
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - JiuCheng Shi
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - XiJuan Zhao
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - Li Fu
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - Na Wang
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - XiaoDong Zheng
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - YingLi Chen
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - MingHui Li
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - Cui Ma
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
| | - PiXu Liu
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - DaLing Zhu
- Central Laboratory of Harbin Medical University-Daqing, College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China; and
- College of Pharmacy, Harbin Medical University, Harbin, China
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Yang Q, Lai B, Xie H, Deng M, Li J, Yang Y, Wan J, Liao B, Liu F. Identification of differentially expressed ER stress-related genes and their association with pulmonary arterial hypertension. Respir Res 2024; 25:220. [PMID: 38789967 PMCID: PMC11127292 DOI: 10.1186/s12931-024-02849-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a complex and progressive illness that has a multifaceted origin, significant fatality rates, and profound effects on health. The pathogenesis of PAH is poorly defined due to the insufficient understanding of the combined impact of endoplasmic reticulum (ER) stress and immune infiltration, both of which play vital roles in PAH development. This study aims to identify potential ER stress-related biomarkers in PAH and investigate their involvement in immune infiltration. METHODS The GEO database was used to download gene expression profiles. Genes associated with ER stress were obtained from the MSigDB database. Weighted gene co-expression network analysis (WGCNA), GO, KEGG, and protein-protein interaction (PPI) were utilized to conduct screening of hub genes and explore potential molecular mechanisms. Furthermore, the investigation also delved into the presence of immune cells in PAH tissues and the correlation between hub genes and the immune system. Finally, we validated the diagnostic value and expression levels of the hub genes in PAH using subject-workup characterization curves and real-time quantitative PCR. RESULTS In the PAH and control groups, a total of 31 genes related to ER stress were found to be differentially expressed. The enrichment analysis revealed that these genes were primarily enriched in reacting to stress in the endoplasmic reticulum, dealing with unfolded proteins, transporting proteins, and processing proteins within the endoplasmic reticulum. EIF2S1, NPLOC4, SEC61B, SYVN1, and DERL1 were identified as the top 5 hub genes in the PPI network. Immune infiltration analysis revealed that these hub genes were closely related to immune cells. The receiver operating characteristic (ROC) curves revealed that the hub genes exhibited excellent diagnostic efficacy for PAH. The levels of SEC61B, NPLOC4, and EIF2S1 expression were in agreement with the findings of bioinformatics analysis in the PAH group. CONCLUSIONS Potential biomarkers that could be utilized are SEC61B, NPLOC4, and EIF2S1, as identified in this study. The infiltration of immune cells was crucial to the development and advancement of PAH. This study provided new potential therapeutic targets for PAH.
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Affiliation(s)
- Qi Yang
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Banghui Lai
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Hao Xie
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Mingbin Deng
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Jun Li
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Yan Yang
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Juyi Wan
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China
| | - Bin Liao
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.
| | - Feng Liu
- Department of Cardiovascular Surgery, The Affiliated Hospital, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.
- Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.
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Weinstein N, Carlsen J, Schulz S, Stapleton T, Henriksen HH, Travnik E, Johansson PI. A Lifelike guided journey through the pathophysiology of pulmonary hypertension-from measured metabolites to the mechanism of action of drugs. Front Cardiovasc Med 2024; 11:1341145. [PMID: 38845688 PMCID: PMC11153715 DOI: 10.3389/fcvm.2024.1341145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/12/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Pulmonary hypertension (PH) is a pathological condition that affects approximately 1% of the population. The prognosis for many patients is poor, even after treatment. Our knowledge about the pathophysiological mechanisms that cause or are involved in the progression of PH is incomplete. Additionally, the mechanism of action of many drugs used to treat pulmonary hypertension, including sotatercept, requires elucidation. Methods Using our graph-powered knowledge mining software Lifelike in combination with a very small patient metabolite data set, we demonstrate how we derive detailed mechanistic hypotheses on the mechanisms of PH pathophysiology and clinical drugs. Results In PH patients, the concentration of hypoxanthine, 12(S)-HETE, glutamic acid, and sphingosine 1 phosphate is significantly higher, while the concentration of L-arginine and L-histidine is lower than in healthy controls. Using the graph-based data analysis, gene ontology, and semantic association capabilities of Lifelike, led us to connect the differentially expressed metabolites with G-protein signaling and SRC. Then, we associated SRC with IL6 signaling. Subsequently, we found associations that connect SRC, and IL6 to activin and BMP signaling. Lastly, we analyzed the mechanisms of action of several existing and novel pharmacological treatments for PH. Lifelike elucidated the interplay between G-protein, IL6, activin, and BMP signaling. Those pathways regulate hallmark pathophysiological processes of PH, including vasoconstriction, endothelial barrier function, cell proliferation, and apoptosis. Discussion The results highlight the importance of SRC, ERK1, AKT, and MLC activity in PH. The molecular pathways affected by existing and novel treatments for PH also converge on these molecules. Importantly, sotatercept affects SRC, ERK1, AKT, and MLC simultaneously. The present study shows the power of mining knowledge graphs using Lifelike's diverse set of data analytics functionalities for developing knowledge-driven hypotheses on PH pathophysiological and drug mechanisms and their interactions. We believe that Lifelike and our presented approach will be valuable for future mechanistic studies of PH, other diseases, and drugs.
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Affiliation(s)
- Nathan Weinstein
- CAG Center for Endotheliomics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jørn Carlsen
- CAG Center for Endotheliomics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Sebastian Schulz
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Timothy Stapleton
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Hanne H. Henriksen
- CAG Center for Endotheliomics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Evelyn Travnik
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Pär Ingemar Johansson
- CAG Center for Endotheliomics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Zhang L, Gu X. 4-hydroxysesamin protects rat with right ventricular failure due to pulmonary hypertension by inhibiting JNK/p38 MAPK signaling. Aging (Albany NY) 2024; 16:8142-8154. [PMID: 38728253 PMCID: PMC11131979 DOI: 10.18632/aging.205808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024]
Abstract
The specific mechanism of 4-hydroxysesamin (4-HS), a modification of Sesamin, on right ventricular failure due to pulmonary hypertension (PH) is ominous. By creating a rat model of PH in vivo and a model of pulmonary artery smooth muscle cell (PASMC) hypoxia and inflammation in vitro, the current work aimed to investigate in depth the molecular mechanism of the protective effect of 4-HS. In an in vitro model of hypoxia PASMC, changes in cell proliferation and inflammatory factors were detected after treatment with 4-HS, followed by changes in the JNK/p38 MAPK signaling pathway as detected by Western blot signaling pathway. The findings demonstrated that 4-HS was able to minimize PASMC cell death, block the JNK/p38 MAPK signaling pathway, and resist the promoting effect of hypoxia on PASMC cell proliferation. Following that, we found that 4-HS could both mitigate the right ventricular damage brought on by MCT and had a protective impact on rats Monocrotaline (MCT)-induced PH in in vivo investigations. The key finding of this study is that 4-HS may protect against PH by inhibiting the JNK/p38 MAPK signaling pathway.
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Affiliation(s)
- Lingnan Zhang
- Department of Cardiovascular, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China
- Department of Cardiovascular Sciences, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Xinshun Gu
- Department of Cardiovascular, The Second Hospital of Hebei Medicine University, Shijiazhuang 050000, Hebei, China
- Department of Cardiovascular Sciences, Hebei Medical University, Shijiazhuang 050017, Hebei, China
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Cardouat G, Douard M, Bouchet C, Roubenne L, Kmecová Z, Esteves P, Brette F, Guignabert C, Tu L, Campagnac M, Robillard P, Coste F, Delcambre F, Thumerel M, Begueret H, Maurac A, Belaroussi Y, Klimas J, Ducret T, Quignard JF, Vacher P, Baudrimont I, Marthan R, Berger P, Guibert C, Freund-Michel V. NGF increases Connexin-43 expression and function in pulmonary arterial smooth muscle cells to induce pulmonary artery hyperreactivity. Biomed Pharmacother 2024; 174:116552. [PMID: 38599061 DOI: 10.1016/j.biopha.2024.116552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024] Open
Abstract
AIMS Pulmonary hypertension (PH) is characterised by an increase in pulmonary arterial pressure, ultimately leading to right ventricular failure and death. We have previously shown that nerve growth factor (NGF) plays a critical role in PH. Our objectives here were to determine whether NGF controls Connexin-43 (Cx43) expression and function in the pulmonary arterial smooth muscle, and whether this mechanism contributes to NGF-induced pulmonary artery hyperreactivity. METHODS AND RESULTS NGF activates its TrkA receptor to increase Cx43 expression, phosphorylation, and localization at the plasma membrane in human pulmonary arterial smooth muscle cells, thus leading to enhanced activity of Cx43-dependent GAP junctions as shown by Lucifer Yellow dye assay transfer and fluorescence recovery after photobleaching -FRAP- experiments. Using both in vitro pharmacological and in vivo SiRNA approaches, we demonstrate that NGF-dependent increase in Cx43 expression and activity in the rat pulmonary circulation causes pulmonary artery hyperreactivity. We also show that, in a rat model of PH induced by chronic hypoxia, in vivo blockade of NGF or of its TrkA receptor significantly reduces Cx43 increased pulmonary arterial expression induced by chronic hypoxia and displays preventive effects on pulmonary arterial pressure increase and right heart hypertrophy. CONCLUSIONS Modulation of Cx43 by NGF in pulmonary arterial smooth muscle cells contributes to NGF-induced alterations of pulmonary artery reactivity. Since NGF and its TrkA receptor play a role in vivo in Cx43 increased expression in PH induced by chronic hypoxia, these NGF/Cx43-dependent mechanisms may therefore play a significant role in human PH pathophysiology.
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MESH Headings
- Animals
- Humans
- Male
- Rats
- Cells, Cultured
- Connexin 43/metabolism
- Gap Junctions/metabolism
- Gap Junctions/drug effects
- Hypertension, Pulmonary/metabolism
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/drug effects
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/drug effects
- Nerve Growth Factor/metabolism
- Phosphorylation
- Pulmonary Artery/drug effects
- Pulmonary Artery/metabolism
- Pulmonary Artery/pathology
- Rats, Sprague-Dawley
- Rats, Wistar
- Receptor, trkA/metabolism
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Affiliation(s)
| | - Matthieu Douard
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux F-33000, France
| | - Clément Bouchet
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France
| | - Lukas Roubenne
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France
| | - Zuzana Kmecová
- Department of Pharmacology and Toxicology, Comenius University, Bratislava, Slovakia
| | - Pauline Esteves
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France
| | - Fabien Brette
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux F-33000, France
| | - Christophe Guignabert
- INSERM UMR_S 999, « Pulmonary Hypertension: Pathophysiology and Novel Therapies », Hôpital Marie Lannelongue, Le Plessis-Robinson 92350, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre 94270, France
| | - Ly Tu
- INSERM UMR_S 999, « Pulmonary Hypertension: Pathophysiology and Novel Therapies », Hôpital Marie Lannelongue, Le Plessis-Robinson 92350, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre 94270, France
| | | | - Paul Robillard
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France
| | - Florence Coste
- Laboratoire de Pharm-écologie Cardiovasculaire (LaPEC-EA 4278), Université d'Avignon et des Pays du Vaucluse, Avignon 84000, France
| | | | - Matthieu Thumerel
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux 33000, France
| | | | | | | | - Jan Klimas
- Department of Pharmacology and Toxicology, Comenius University, Bratislava, Slovakia
| | - Thomas Ducret
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France
| | | | - Pierre Vacher
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France
| | | | - Roger Marthan
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux 33000, France
| | - Patrick Berger
- Univ. Bordeaux, INSERM, CRCTB, U 1045, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux 33000, France
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10
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Israël-Biet D, Pastré J, Nunes H. Sarcoidosis-Associated Pulmonary Hypertension. J Clin Med 2024; 13:2054. [PMID: 38610818 PMCID: PMC11012707 DOI: 10.3390/jcm13072054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/25/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Sarcoidosis-associated pulmonary hypertension (SAPH) is a very severe complication of the disease, largely impacting its morbidity and being one of its strongest predictors of mortality. With the recent modifications of the hemodynamic definition of pulmonary hypertension (mean arterial pulmonary pressure >20 instead of <25 mmHg,) its prevalence is presently not precisely known, but it affects from 3 to 20% of sarcoid patients; mostly, although not exclusively, those with an advanced, fibrotic pulmonary disease. Its gold-standard diagnostic tool remains right heart catheterization (RHC). The decision to perform it relies on an expert decision after a non-invasive work-up, in which echocardiography remains the screening tool of choice. The mechanisms underlying SAPH, very often entangled, are crucial to define, as appropriate and personalized therapeutic strategies will aim at targeting the most significant ones. There are no recommendations so far as to the indications and modalities of the medical treatment of SAPH, which is based upon the opinion of a multidisciplinary team of sarcoidosis, pulmonary hypertension and sometimes lung transplant experts.
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Affiliation(s)
| | - Jean Pastré
- Service de Pneumologie, Hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France;
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Avivenne, AP-HP, 93000 Bobigny, France;
- Inserm UMR 1272 “Hypoxie et Poumon”, UFR de Santé, Médecine et Biologie Humaine (SMBH), Université Sorbonne Paris-Nord, 93000 Bobigny, France
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11
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Ji XY, Lei CJ, Kong S, Li HF, Pan SY, Chen YJ, Zhao FR, Zhu TT. Hydroxy-Safflower Yellow A Mitigates Vascular Remodeling in Rat Pulmonary Arterial Hypertension. Drug Des Devel Ther 2024; 18:475-491. [PMID: 38405578 PMCID: PMC10893878 DOI: 10.2147/dddt.s439686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose The underlying causes of pulmonary arterial hypertension (PAH) often remain obscure. Addressing PAH with effective treatments presents a formidable challenge. Studies have shown that Hydroxysafflor yellow A (HSYA) has a potential role in PAH, While the mechanism underlies its protective role is still unclear. The study was conducted to investigate the potential mechanisms of the protective effects of HSYA. Methods Using databases such as PharmMapper and GeneCards, we identified active components of HSYA and associated PAH targets, pinpointed intersecting genes, and constructed a protein-protein interaction (PPI) network. Core targets were singled out using Cytoscape for the development of a model illustrating drug-component-target-disease interactions. Intersection targets underwent analysis for Gene Ontology (GO) functions and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Selected components were then modeled for target interaction using Autodock and Pymol. In vivo validation in a monocrotaline-induced PAH (MCT-PAH) animal model was utilized to substantiate the predictions made by network pharmacology. Results We associated HSYA with 113 targets, and PAH with 1737 targets, identifying 34 mutual targets for treatment by HSYA. HSYA predominantly affects 9 core targets. Molecular docking unveiled hydrogen bond interactions between HSYA and several PAH-related proteins such as ANXA5, EGFR, SRC, PPARG, PGR, and ESR1. Conclusion Utilizing network pharmacology and molecular docking approaches, we investigated potential targets and relevant human disease pathways implicating HSYA in PAH therapy, such as the chemical carcinogenesis receptor activation pathway and the cancer pathway. Our findings were corroborated by the efficacious use of HSYA in an MCT-induced rat PAH model, confirming its therapeutic potential.
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Affiliation(s)
- Xiang-Yu Ji
- Department of Pharmacy, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Cheng-Jing Lei
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Shuang Kong
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Han-Fei Li
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Si-Yu Pan
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Yu-Jing Chen
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Fan-Rong Zhao
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
| | - Tian-Tian Zhu
- Department of Pharmacy, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, Henan, People’s Republic of China
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12
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Farmakis IT, Baroutidou A, Patsiou V, Arvanitaki A, Doundoulakis I, Hobohm L, Zafeiropoulos S, Konstantinides SV, D'Alto M, Badagliacca R, Giannakoulas G. Contribution of pressure and flow changes to resistance reduction after pulmonary arterial hypertension treatment: a meta-analysis of 3898 patients. ERJ Open Res 2024; 10:00706-2023. [PMID: 38259812 PMCID: PMC10801731 DOI: 10.1183/23120541.00706-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/21/2023] [Indexed: 01/24/2024] Open
Abstract
Background Pulmonary arterial hypertension (PAH)-targeted therapies exert significant haemodynamic changes; however, systematic synthesis is currently lacking. Methods We searched PubMed, CENTRAL and Web of Science for studies evaluating mean pulmonary artery pressure (mPAP), cardiac index/cardiac output (CI/CO) and pulmonary vascular resistance (PVR) of PAH-targeted therapies either in monotherapy or combinations as assessed by right heart catheterisation in treatment-naïve PAH patients. We performed a random-effects meta-analysis with meta-regression. Results We included 68 studies (90 treatment groups) with 3898 patients (age 47.4±13.2 years, 74% women). In studies with small PVR reduction (<4 WU), CI/CO increase (R2=62%) and not mPAP reduction (R2=24%) was decisive for the PVR reduction (p<0.001 and p=0.36, respectively, in the multivariable meta-regression model); however, in studies with large PVR reduction (>4 WU), both CI/CO increase (R2=72%) and mPAP reduction (R2=35%) contributed significantly to the PVR reduction (p<0.001 and p=0.01, respectively). PVR reduction as a percentage of the pre-treatment value was more pronounced in the oral+prostanoid intravenous/subcutaneous combination therapy (mean difference -50.0%, 95% CI -60.8- -39.2%), compared to oral combination therapy (-41.7%, -47.6- -35.8%), prostanoid i.v./s.c. monotherapy (-31.8%, -37.6- -25.9%) and oral monotherapy (-21.6%, -25.4- -17.8%). Changes in haemodynamic parameters were significantly associated with changes in functional capacity of patients with PAH as expressed by the 6-min walking distance. Conclusion Combination therapies, especially with the inclusion of parenteral prostanoids, lead to remarkable haemodynamic improvement in treatment-naïve PAH patients and may unmask the contribution of mPAP reduction to the overall PVR reduction in addition to the increase in CO.
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Affiliation(s)
- Ioannis T. Farmakis
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Amalia Baroutidou
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Patsiou
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandra Arvanitaki
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Doundoulakis
- Athens Heart Center, Athens Medical Center, Athens, Greece
- First Department of Cardiology, National and Kapodistrian University, “Hippokration” Hospital, Athens, Greece
| | - Lukas Hobohm
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stefanos Zafeiropoulos
- Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA
- Feinstein Institutes for Medical Research at Northwell Health, Manhasset, NY
| | - Stavros V. Konstantinides
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Michele D'Alto
- Department of Cardiology, University “L. Vanvitelli”-Monaldi Hospital, Naples, Italy
| | - Roberto Badagliacca
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - George Giannakoulas
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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13
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Zelt JGE, Weatherald J, Mathai SC. Ambitions for Pulmonary Arterial Hypertension Composite End Points: A Chain Is Only as Strong as Its Weakest Link. Chest 2023; 164:1350-1353. [PMID: 38070956 DOI: 10.1016/j.chest.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Jason G E Zelt
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jason Weatherald
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Stephen C Mathai
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
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14
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Humbert M. Viewpoint: activin signalling inhibitors for the treatment of pulmonary arterial hypertension. Eur Respir J 2023; 62:2301726. [PMID: 37918877 DOI: 10.1183/13993003.01726-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Le Kremlin-Bicêtre, France
- Department of Respiratory and Intensive Care Medicine, Assistance Publique Hôpitaux de Paris, Hôpital Bicêtre, ERN-LUNG, Le Kremlin-Bicêtre, France
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15
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Newman J, Pepke-Zaba J. Illuminating the many faces of pulmonary hypertension. THE LANCET. RESPIRATORY MEDICINE 2023; 11:760-762. [PMID: 37591296 DOI: 10.1016/s2213-2600(23)00291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Joseph Newman
- Royal Papworth Hospital, Cambridge CB2 0AY, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Joanna Pepke-Zaba
- Royal Papworth Hospital, Cambridge CB2 0AY, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
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