Phenotypic Clustering of Idiopathic Pulmonary Arterial Hypertension: Insights Into Pulmonary Vascular and Cardiometabolic Co-Morbidity Trajectories
Abstract
Idiopathic pulmonary arterial hypertension (IPAH) exhibits significant clinical heterogeneity, necessitating a precision medicine approach. This study aimed to identify distinct IPAH phenotypes using machine learning-based clustering and to evaluate their longitudinal therapeutic responses and long-term survival. We analyzed 297 IPAH patients using hierarchical agglomerative clustering based on baseline demographics, hemodynamics, and comorbidities. The cohort was characterized by two distinctive yet overlapping phenotypic patterns: Cluster 1 (n = 198, "Pulmonary Vascular Phenotype"), comprising younger patients (median age: 40) with low comorbidity burden but severe hemodynamic impairment, and Cluster 2 (n = 99, "Cardiometabolic Phenotype"), consisting of older, predominantly female patients (median age: 65) with high prevalence of obesity (78%), diabetes (73%), and hypertension (57%). Despite comparable baseline multiparametric risk scores, Cluster 1 exhibited more impaired echocardiographic right ventricular-arterial coupling, lower left ventricular filling pressure and higher pulmonary vascular resistance (p p = 0.048). Linear mixed-effects modeling over 12 months demonstrated that Cluster 1 achieved superior functional recovery (6-min walk distance increase: 75 m vs. 42 m, p p = 0.017). However, during a median follow-up of 763 days, 5-year survival was similar between groups (Log-rank p = 0.452), and cluster membership was not associated with mortality in adjusted Cox…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 297 participants or records.
Read the paper
Related studies
- Protective effects of tadalafil and N-acetyl cysteine therapy on cisplatin-induced testicular toxicity
- The Use of Generative AI for Scientific Literature Searches for Systematic Reviews: ChatGPT and Microsoft Bing AI Performance Evaluation
- Sildenafil as a Candidate Drug for Alzheimer’s Disease: Real-World Patient Data Observation and Mechanistic Observations from Patient-Induced Pluripotent Stem Cell-Derived Neurons
- Ozone-modified properties of pumpkin seed oil as anti-H. pylori, anticancer, anti-diabetic and anti-obesity agent
- Effectiveness of Low-Intensity Extracorporeal Shock Wave Therapy in Erectile Dysfunction: An Analysis of Sexual Function and Penile Hardness at Erection: An Umbrella Review
- Molecular Docking of Silymarin as a Ligand for Aromatase Enzyme and HIV-1 Reverse Transcriptase Using Molegro Virtual Docker
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.