Clinical Research Directory

Inclusion Criteria: that the patients were diagnosed with pulmonary hypertension By Right heart cath OR suspected By Echocardiograghy according to the ESC guidelines for pulmonary hypertension that they were aged 18 years or older Exclusion Criteria: 1. symptomatic hypotension (systolic blood pressure \< 95 mmHg) 2. impaired renal function (eGFR \< 30 mL/min/1.73 m2 calculated according to the CKD-EPI formula) and serum potassium level \> 5.2 mmol/L 3. hepatic dysfunction (defined as liver parameters such as ALT, AST, and/or ALP, which are three times above the upper 99-th percentile of the reference range 4. biliary cirrhosis and cholestasis, active malignancies (regardless of the stage and type of malignancy)), 5. the current use of hormone replacement therapy, chemotherapy, or immunotherapy 6. Type 1 diabetes mellitus 7. Acute pulmonary embolism (15) 8. Signficant Primary valvular Heart disease 9. Ischemic heart disease