Publications by authors named "Chad M Kosanovich"

Heart failure with preserved ejection fraction can be complicated by pulmonary hypertension. We designed a retrospective study to provide supporting evidence for referral to specialty care centers. Specialty care centers improved hospitalizations but not mortality-in part due to more aggressive medication management and guideline-directed monitoring.

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Background: Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary arterial pressures and is managed by vasodilator therapies. Current guidelines encourage PAH management in specialty care centers (SCCs), but evidence is sparse regarding improvement in clinical outcomes and correlation to vasodilator use with referral.

Research Question: Is PAH management at SCCs associated with improved clinical outcomes?

Study Designand Methods: A single-center, retrospective study was performed at the University of Pittsburgh Medical Center (UPMC; overseeing 40 hospitals).

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Pulmonary hypertension (PH), a heterogeneous vascular disease, consists of subtypes with overlapping clinical phenotypes. MicroRNAs, small non-coding RNAs that negatively regulate gene expression, have emerged as regulators of PH pathogenesis. The muscle-specific micro RNA (miR)-204 is known to be depleted in diseased pulmonary artery smooth muscle cells (PASMCs), furthering proliferation and promoting PH.

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