<b>Alterations in Plasma Metabolites in Pulmonary Arterial Hypertension Secondary to Congenital Left-to-Right Shunt Heart Disease</b>

Pulmonary arterial hypertension (PAH) secondary to congenital left-to-right shunt heart disease (CL-RSHD) involves vascular remodeling, metabolic dysregulation, chronic inflammation, immune dysfunction, and oxidative stress. This study explored plasma metabolomic profiles in CL-RSHD-induced PAH patients compared to those with CL-RSHD alone and healthy controls. A total of 87 participants were included: 47 with CL-RSHD, 27 with CL-RSHD+PAH, and 13 healthy individuals. Plasma metabolomics was assessed using untargeted LC-MS. Significant differences in microbial species and metabolites were observed in CL-RSHD+PAH patients compared to both CL-RSHD and healthy groups.