Introduction: Pulmonary hypertension is a pathophysiological disorder with poor prognosis. Exercise intolerance and lower physical activity levels are common features of pulmonary hypertension and affect patients' quality of life. Exercise training effectively improves clinical outcomes in this population, but access to rehabilitation centres is often limited.
View Article and Find Full Text PDFArq Bras Cardiol
June 2025
Background: The most common clinical presentation of pulmonary hypertension (PH) includes exertional dyspnea, signs of systemic congestion, and syncope. Angina pectoris can also be a relevant manifestation, especially in cases where the left main coronary artery (LMCA) is externally compressed by a dilated pulmonary artery. However, significant gaps remain regarding the most appropriate diagnostic and therapeutic strategies for coronary obstruction in this clinical scenario.
View Article and Find Full Text PDFTo translate, cross-culturally adapt, and validate the Brazilian version of the Parkinson's Disease Sleep Scale-2 (PDSS-2/BR). This cross-sectional study addressed 80 patients with PD, and it was organized into two phases: 1) Translation and cross-cultural adaptation, which included 30 individuals in the scale's pretest stage and 2) Validation, when 50 individuals were assessed by the PDSS-2/BR, Pittsburgh Sleep Quality Index (PSQI), Parkinson's Disease Questionnaire-39 (PDQ-39), MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), and Hoehn and Yahr rating scale (HY); the PDSS-2/BR was retested 7 days later. The significance level was set at 5%.
View Article and Find Full Text PDFInt J Cardiol Congenit Heart Dis
September 2025
Pulmonary arterial hypertension (PAH) is a progressive and life-threatening condition characterized by elevated pulmonary vascular resistance, ultimately leading to right heart failure and death. Advances in the understanding of PAH pathophysiology have driven the development of targeted therapies that improve functional capacity, quality of life and survival. The current treatment paradigm emphasizes early and aggressive therapy, with combination therapy now considered standard of care, offering superior outcomes compared to monotherapy.
View Article and Find Full Text PDFAm J Respir Crit Care Med
June 2025
Background: Sotatercept improves exercise capacity and delays the time to clinical worsening in patients with World Health Organization (WHO) functional class II or III pulmonary arterial hypertension. The effects of add-on sotatercept in patients with advanced pulmonary arterial hypertension and a high risk of death are unclear.
Methods: In this phase 3 trial, we randomly assigned patients with pulmonary arterial hypertension (WHO functional class III or IV) and a high 1-year risk of death (Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management Lite 2 risk score, ≥9) who were receiving the maximum tolerated dose of background therapy to receive add-on sotatercept (starting dose, 0.
Background: Age affects disease severity and patient outcomes in pulmonary arterial hypertension. This post-hoc analysis identified prognostic age groups and associated macitentan/selexipag treatment effects.
Methods: Randomized trials evaluated macitentan (SERAPHIN; NCT00660179) and selexipag (GRIPHON; NCT01106014) versus placebo (primary endpoint: time to morbidity/mortality [M/M]).
Am J Respir Crit Care Med
June 2025
It is unclear whether carriers of pathogenic variants in PAH-associated genes have a distinct response to PAH treatment. To evaluate the effect of genetic variant status on the efficacy of sotatercept and the effect of sotatercept treatment on biomarkers in pulmonary arterial hypertension. PULSAR (A Study of Sotatercept for the Treatment of Pulmonary Arterial Hypertension; NCT03496207) was a phase II, randomized controlled study of sotatercept versus placebo added to background therapy for pulmonary arterial hypertension.
View Article and Find Full Text PDFBackground: SOTERIA (ClinicalTrials.gov: NCT04796337) is an ongoing open-label study evaluating long-term safety, tolerability and efficacy of sotatercept in participants with pulmonary arterial hypertension (PAH).
Methods: Eligible adults with PAH on stable background therapy who completed a prior sotatercept study without early discontinuation were enrolled.
Background: Schistosomiasis associated pulmonary arterial hypertension (Sch-PAH) is a highly relevant form of pulmonary hypertension, particularly in developing countries. Compared with idiopathic pulmonary arterial hypertension (IPAH), Sch-PAH has a better prognosis, though without identified mechanisms that justify this clinical course. Right ventricular-arterial pulmonary (RV-PA) coupling, expressed by the relationship between right ventricular contractility and afterload, has been studied as a potential marker of cardiac response to pulmonary vascular disease.
View Article and Find Full Text PDFIntroduction: Pulmonary arterial hypertension is a progressive disease associated with significant morbidity and mortality. Sotatercept is a first-in-class activin signalling inhibitor that acts to restore the balance between the growth-promoting and growth-inhibiting signalling pathways.
Methods: This , exploratory, pooled analysis combines data from the double-blind placebo periods of the phase 2 PULSAR (NCT03496207) and phase 3 STELLAR (NCT04576988) studies.
Objectives: To investigate clinical characteristics, symptom profile, testing practices, treatment patterns and quality of life (QoL) among patients with pulmonary arterial hypertension (PAH) in Latin America.
Design: Data from the Adelphi Real World PAH Disease Specific Programme, a cross-sectional survey with retrospective data collection.
Setting: University/teaching hospital, regional centres, private practices and government institutions in Argentina, Brazil, Colombia and Mexico.
J Heart Lung Transplant
April 2025
Background: This analysis examined the effects of the activin signaling inhibitor, sotatercept, in pulmonary arterial hypertension (PAH) subgroups stratified by baseline cardiac index (CI).
Methods: Pooled data from PULSAR (N = 106; NCT03496207) and STELLAR (N = 323; NCT04576988) were analyzed using 2 different CI thresholds, <2.0 and ≥2.
Background: Exercise pulmonary hypertension (PH) was defined by a mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope >3 mmHg·min·L between rest and exercise in the 2022 European Society of Cardiology/European Respiratory Society PH guidelines. However, large, multicentre studies on the prognostic relevance of exercise haemodynamics and its added value to resting haemodynamics are missing.
Patients And Methods: The PEX-NET (Pulmonary Haemodynamics during Exercise Network) registry enrolled patients who underwent clinically indicated right heart catheterisations both at rest and ergometer exercise from 23 PH centres worldwide.
Lupus
January 2025
Objective: To evaluate the possible reversibility of PAH to a normopressoric state in SLE after induction immunosuppressive (IS) and predictors of response.
Methods: We retrospectively evaluated all SLE-PAH patients who underwent IS therapy at our center. PAH reversion was defined as the normalization of pulmonary arterial pressure (PAP), either by the presence of systolic PAP <40 mmHg on echocardiogram or mean PAP <20 mmHg on right heart catheterization (RHC).
Mol Genet Genomics
October 2024
Care of pulmonary hypertension (PH) patients in special situations requires insightful knowledge of the pathophysiology of the cardiopulmonary system and close interaction with different specialists, depending on the situation. The role of this task force was to gather knowledge about five conditions that PH patients may be faced with. These conditions are 1) perioperative care; 2) management of pregnancy; 3) medication adherence; 4) palliative care; and 5) the influence of climate on PH.
View Article and Find Full Text PDFCommon beans ( L.), besides being an important source of nutrients such as iron, magnesium, and protein, are crucial for food security, especially in developing countries. Common bean cultivation areas commonly face production challenges due to drought occurrences, mainly during the reproductive period.
View Article and Find Full Text PDFIntroduction: To verify whether the COVID-19 pandemic has had an impact on the safety climate based on the perception of the multiprofessional team in the operating room and to analyze the domains of the safety climate during the pre-pandemic and pandemic period of COVID-19, demonstrating the intersections of quantitative and qualitative approaches.
Methods: Mixed-method research using a convergent approach strategy, carried out in the operating room of a university hospital, located in Rio de Janeiro, Brazil. The nature of the quantitative phase was cross-sectional, and the nature of the qualitative phase was descriptive.
J Heart Lung Transplant
October 2024
In Riociguat rEplacing PDE5i therapy evaLuated Against Continued PDE5i thErapy (REPLACE) (NCT02891850), improvements in risk status were observed in patients with pulmonary arterial hypertension (PAH) at intermediate risk switching to riociguat versus continuing phosphodiesterase-5 inhibitors (PDE5i). This post hoc study applied the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) Lite 2 and Comparative Prospective Registry of Newly Initiated Therapies for Pulmonary (COMPERA) 2.0 risk-assessment tools to REPLACE to investigate the impact of baseline risk status on clinical improvement.
View Article and Find Full Text PDFObjective: To implement a telerehabilitation prevention, treatment, and follow-up physical therapy protocol for monitoring individuals with Parkinson's disease (PD) and to verify its effectiveness in minimizing the deleterious effects of the COVID-19 pandemic.
Design: Prospective case series, involving 40 participants with mild to moderate PD recruited from a specialized neurorehabilitation group. The study was divided into four parts: (1) Phone calls to assess the feasibility of participating in remote physical therapy.
Mol Genet Genomics
November 2023
Transposable elements (TEs) are DNA sequences capable of moving within the genome. Their distribution is very dynamic among organisms, and despite advances, there are still gaps in the understanding of the diversity and evolution of TEs in many insect species. In the case of Euschistus heros, considered the main stink bug in the soybean crop in Brazil, little is known about the participation of these elements.
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