The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock

Abstract The consistent relationship between pulmonary artery systolic (PASP), diastolic (PADP), mean (mPAP), and pulse (PP) pressures has led to the proposal of the golden ratio (Φ) hypothesis. This study tested the Φ hypothesis in the pulmonary circulation of patients with advanced heart failure (...

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Main Authors: Hoong Sern Lim, Ivan H. W. Yim
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Physiological Reports
Subjects:
Online Access:https://doi.org/10.14814/phy2.70287
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author Hoong Sern Lim
Ivan H. W. Yim
author_facet Hoong Sern Lim
Ivan H. W. Yim
author_sort Hoong Sern Lim
collection DOAJ
description Abstract The consistent relationship between pulmonary artery systolic (PASP), diastolic (PADP), mean (mPAP), and pulse (PP) pressures has led to the proposal of the golden ratio (Φ) hypothesis. This study tested the Φ hypothesis in the pulmonary circulation of patients with advanced heart failure (HF) and cardiogenic shock (CS). PASP:mPAP, mPAP:PADP, and PP:mPAP ratios were evaluated in 20 patients with advanced HF (high‐fidelity measurements) and 93 patients with CS (fluid‐filled system). Twelve of 20 patients with advanced HF had PASP:mPAP and mPAP:PADP ratios from high‐fidelity measurements that were consistent with the Φ hypothesis. The eight patients with low PASP:mPAP and mPAP:PADP ratios had lower PP: mPAP ratio (0.72 (0.71–0.73) vs. 0.94 (0.92–0.99), p = 0.002). In patients with CS, 76 patients (82%) had PASP:mPAP and mPAP:PADP ratios that were consistent with the Φ hypothesis. The 17 patients with CS and “low ratios” also had lower PP:mPAP (0.53 (0.48–0.57) vs. 0.74 (0.68–0.87), p < 0.001). Lower PP:mPAP ratio was related to higher filling pressures and lower cardiac power output. The pulmonary circulation deviated from the Φ hypothesis in patients with more severe HF and CS. Low PP:mPAP ratio identifies patients with HF and CS with more severe hemodynamic compromise.
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spelling doaj-art-7a3d44607a014d559b917dda77e7ec6f2025-08-20T03:10:39ZengWileyPhysiological Reports2051-817X2025-04-01137n/an/a10.14814/phy2.70287The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shockHoong Sern Lim0Ivan H. W. Yim1University Hospitals Birmingham NHS Foundation Trust Birmingham UKUniversity Hospitals Birmingham NHS Foundation Trust Birmingham UKAbstract The consistent relationship between pulmonary artery systolic (PASP), diastolic (PADP), mean (mPAP), and pulse (PP) pressures has led to the proposal of the golden ratio (Φ) hypothesis. This study tested the Φ hypothesis in the pulmonary circulation of patients with advanced heart failure (HF) and cardiogenic shock (CS). PASP:mPAP, mPAP:PADP, and PP:mPAP ratios were evaluated in 20 patients with advanced HF (high‐fidelity measurements) and 93 patients with CS (fluid‐filled system). Twelve of 20 patients with advanced HF had PASP:mPAP and mPAP:PADP ratios from high‐fidelity measurements that were consistent with the Φ hypothesis. The eight patients with low PASP:mPAP and mPAP:PADP ratios had lower PP: mPAP ratio (0.72 (0.71–0.73) vs. 0.94 (0.92–0.99), p = 0.002). In patients with CS, 76 patients (82%) had PASP:mPAP and mPAP:PADP ratios that were consistent with the Φ hypothesis. The 17 patients with CS and “low ratios” also had lower PP:mPAP (0.53 (0.48–0.57) vs. 0.74 (0.68–0.87), p < 0.001). Lower PP:mPAP ratio was related to higher filling pressures and lower cardiac power output. The pulmonary circulation deviated from the Φ hypothesis in patients with more severe HF and CS. Low PP:mPAP ratio identifies patients with HF and CS with more severe hemodynamic compromise.https://doi.org/10.14814/phy2.70287cardiogenic shockheart failurehemodynamicspulmonary hypertension
spellingShingle Hoong Sern Lim
Ivan H. W. Yim
The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
Physiological Reports
cardiogenic shock
heart failure
hemodynamics
pulmonary hypertension
title The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
title_full The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
title_fullStr The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
title_full_unstemmed The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
title_short The golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
title_sort golden ratio in the pulmonary circulation in patients with heart failure and cardiogenic shock
topic cardiogenic shock
heart failure
hemodynamics
pulmonary hypertension
url https://doi.org/10.14814/phy2.70287
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