Pulmonary Arterial Hypertension Specific Therapy in Patients with Combined Post- and Precapillary Pulmonary Hypertension
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Bibliographic record
Abstract
Background . Specific therapy for patients with PAH is associated with good outcomes. Little is known about the effect of this treatment in patients with Cpc-PH (PAPm ≥ 25 mmHg, PAWP > 15 mmHg, DPG ≥ 7 mmHg, and/or PVR > 3 WU). This study evaluates the outcome of treating patients with Cpc-PH using PAH specific therapy. Methods . The primary outcome was survival. Secondary outcomes were WHO functional class and 6-minute walk distance (6-MWD). Results . Twenty-six patients with Cpc-PH (half with VHD and half with HF) received PAHST. Six patients did not tolerate treatment due to pulmonary edema. No predictors for treatment intolerance were identified. In twenty patients who tolerated the treatment, the mean WHO functional class improved from <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mn fontstyle="italic">2.70</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">0.21</mml:mn></mml:math> at initial assessment to <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mn fontstyle="italic">2.22</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">0.21</mml:mn></mml:math> (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn fontstyle="italic">0.04</mml:mn></mml:math>) and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mn fontstyle="italic">2.06</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">0.21</mml:mn></mml:math> (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn fontstyle="italic">0.03</mml:mn></mml:math>) at 6 and 9 months, respectively. Mean 6-MWD improved from <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mn fontstyle="italic">276.0</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">38.50</mml:mn></mml:math> meters at initial assessment to <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mn fontstyle="italic">343.9</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">22.99</mml:mn></mml:math> meters (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn fontstyle="italic">0.04</mml:mn></mml:math>) and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mn fontstyle="italic">364.6</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">34.85</mml:mn></mml:math> meters (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M10"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.07</mml:mn></mml:math>) at 6 and 9 months, respectively. Twelve patients died during the follow-up period. Mean survival for all patients was <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M11"><mml:mn fontstyle="italic">1279.7</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">193.60</mml:mn></mml:math> days. Conclusion . PAHST may be beneficial in the treatment of Cpc-PH (both short and long term). Prospective randomized controlled trials of PAHST in this population are needed to assess its potential efficacy.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it