The prevalence of LMCA compression in patients with PAH and angina is high. These results suggest that CTCA is indicated in patients with PAH and angina or angina-like symptoms. PCI was well tolerated, improved symptoms, and resulted in favorable long-term outcomes.

Patients with Ipc-PH have a better prognosis compared with patients with Cpc-PH and with patients with isolated increase of PVR or DPG. Pulmonary vascular resistance has a better predictive value than DPG in patients with PH-LHD.

No abstract

This paper reports about the gas-phase reduction of methyl levulinate to γ-valerolactone (GVL) via catalytic transfer hydrogenation using ethanol as the H-donor. In particular, high-surface-area, tetragonal zirconia has proven to be a suitable catalyst for the reaction. Under optimized conditions, the reaction is selective toward the formation of GVL (yield 70%). However, both the deposition of heavy oligomeric compounds over the catalytic surface and the progressive conversion from Lewis to Brønsted acidity, due to the reaction with the water formed in situ, led to a progressive change in the chemo-selectivity, promoting side reactions, e.g. the alcoholysis of angelica lactones to ethyl levulinate. However, the in situ regeneration of the catalyst performed by feeding air at 400 °C for 2 h permitted an almost total recovery of the initial catalytic behavior, proving that the deactivation is reversible. The reaction has been tested also using a true bioethanol, derived from agricultural waste.

Pulmonary arterial hypertension is a severe disease with a complex pathogenesis, for which combination therapy is an attractive option.This study aimed to assess the impact of sequential combination therapy on both short-term responses and long-term outcomes in a real-world setting.Patients with idiopathic/heritable pulmonary arterial hypertension, or pulmonary arterial hypertension associated with congenital heart disease or connective tissue disease and who were not meeting treatment goals on either first-line bosentan or sildenafil monotherapy, were given additional sildenafil or bosentan and assessed after 3-4 months. Double combination therapy significantly improved clinical and haemodynamic parameters, independent of aetiology or the order of drug administration. Significant improvements in functional class were observed in patients with idiopathic/heritable pulmonary arterial hypertension. The 1-, 3-and 5-year overall survival estimates were 91%, 69% and 59%, respectively. Patients with pulmonary arterial hypertension associated with connective tissue disease had significantly poorer survival rates compared to other aetiologies ( p<0.003).The favourable short-term haemodynamic results and good survival rates, observed in patients receiving both bosentan and sildenafil, supports the use of sequential combination therapy in patients failing on monotherapy in a real-world setting. @ERSpublications Bosentan and sildenafil combination therapy improved haemodynamics and exercise in PAH patients failing monotherapy