## 4 Discussion  
In this study, we demonstrate that PHT is associated with both hemodynamic and anatomic changes throughout the PA. Patients with PHT demonstrated multiple changes across a variety of hemodynamic parameters, including EL, WSS, vorticity, flow direction and flow velocity. In addition, pulmonary artery dilation was observed alongside changes in bifurcation geometry. Sex matching for women identified differences for several anatomical and advanced hemodynamic biomarkers. Taken together, these findings provide additional evidence that hemodynamic and anatomic biomarkers possess clinical relevance for diagnosis of the disease. \begin{table}
\begin{tabular}{l c c c} \hline \hline  & **Pulmonary Hypertension (\(n=10\))** & **Controls (\(n=10\))** & \(p\)**-Value** \\ \hline Age (years) & \(54\pm 17\) & \(39\pm 17\) & 0.063 \\ Height (m) & \(1.59\pm 0.12\) & \(1.63\pm 0.04\) & 0.503 \\ BSA (m\({}^{2}\)) & \(1.85\pm 0.30\) & \(1.59\pm 0.26\) & 0.050 \\ Weight (kg) & \(79\pm 21\) & \(61\pm 10\) & 0.027 \\ Heart Rate (bpm) & \(79\pm 19\) & \(67\pm 14\) & 0.124 \\ Systolic Blood Pressure (mmHg) & \(116\pm 18\) & \(104\pm 16\) & 0.171 \\ Distolic Blood Pressure & \(63\pm 11\) & \(60\pm 13\) & 0.596 \\ LVEF (\%) & \(64\pm 7\) & \(60\pm 7\) & 0.208 \\ LVDVD (ml) & \(118\pm 32\) & \(128\pm 24\) & 0.437 \\ LVESV (ml) & \(48\pm 20\) & \(61\pm 32\) & 0.317 \\ RVEF (\%) & \(66\pm 33\) & \(61\pm 4\) & 0.733 \\ RVEDV (ml) & \(163\pm 74\) & \(122\pm 35\) & 0.233 \\ RVESV (ml) & \(75\pm 49\) & \(49\pm 14\) & 0.197 \\ MPA-AP (mm) & \(35\pm 5\) & \(28\pm 3\) & 0.002 \\ MPA-RL (mm) & \(34\pm 7\) & \(27\pm 2\) & 0.007 \\ RPA-AP (mm) & \(21\pm 4\) & \(17\pm 3\) & 0.025 \\ RPA-CC (mm) & \(22\pm 4\) & \(20\pm 3\) & 0.123 \\ LPA-AP (mm) & \(20\pm 5\) & \(18\pm 3\) & 0.349 \\ LPA-CC (mm) & \(21\pm 4\) & \(18\pm 2\) & 0.087 \\ MPA-distance (mm) & \(33\pm 5\) & \(31\pm 7\) & 0.455 \\ RPA-distance (mm) & \(34\pm 6\) & \(27\pm 2\) & 0.001 \\ LPA-distance (mm) & \(33\pm 7\) & \(28\pm 7\) & 0.079 \\ Bifurcation Angle (deg) & \(91\pm 10\) & \(97\pm 10\) & 0.187 \\ Max EL MPA (iiW) & \(28\pm 10\) & \(3.1\pm 1.0\) & 0.517 \\ Mean EL MPA (iW) & \(1.4\pm 0.5\) & \(1.0\pm 0.1\) & 0.025 \\ MPA Max WSS (Pa) & \(1.02\pm 0.21\) & \(1.02\pm 0.15\) & 0.962 \\ MPA Mean WSS (Pa) & \(0.15\pm 0.02\) & \(0.16\pm 0.02\) & 0.473 \\ RPA Max WSS (Pa) & \(0.65\pm 0.26\) & \(1.09\pm 0.33\) & 0.003 \\ RPA Mean WSS (Pa) & \(0.13\pm 0.04\) & \(0.16\pm 0.04\) & 0.059 \\ LPA Max WSS (Pa) & \(0.77\pm 0.30\) & \(1.09\pm 0.27\) & 0.019 \\ LPA Mean WSS (Pa) & \(0.15\pm 0.05\) & \(0.17\pm 0.03\) & 0.296 \\ MPA Max Vortex (mm\({}^{3}\)) & \(28.40\pm 9.73\) & \(16.04\pm 5.53\) & 0.003 \\ MPA Mean Vortex (mm\({}^{3}\)) & \(20.25\pm 8.49\) & \(9.15\pm 3.38\) & 0.001 \\ RPA Max Vortex (mm\({}^{3}\)) & \(3.95\pm 1.95\) & \(2.78\pm 1.81\) & 0.181 \\ RPA Mean Vortex (mm\({}^{3}\)) & \(2.60\pm 1.35\) & \(1.46\pm 0.86\) & 0.037 \\ LPA Max Vortex (mm\({}^{3}\)) & \(6.50\pm 3.08\) & \(3.79\pm 1.07\) & 0.017 \\ LPA Mean Vortex (mm\({}^{3}\)) & \(4.33\pm 2.16\) & \(1.65\pm 0.53\) & 0.001 \\ MPA Max KE (m) & \(2.83\pm 0.93\) & \(3.20\pm 1.0\) & 0.413 \\ RPA Max KE (m) & \(0.67\pm 0.03\) & \(1.44\pm 0.67\) & 0.004 \\ LPA Max KE (m) & \(1.17\pm 0.66\) & \(1.74\pm 0.94\) & 0.131 \\ \hline \hline \end{tabular}  
* Data are expressed as mean \(\pm\) SD. BSA: body surface area. SBP: systolic blood pressure. DBP: diastolic blood pressure. LVEDV: left ventricle end-diastolic volume. LVESV: left ventricle end-systolic volume. LVEF: left ventricle ejection fraction. RVEDV: right ventricle end-diastolic volume. RVESV: right ventricle end-systolic volume. RVEF: right ventricle ejection fraction. RVEDV: right ventricular outflow track. LPA: left pulmonary artery. MPA: PA. RPA: right PA: AP: anterior-posterior. CC: cranio-caudal. RL: right Left. RF: regurgilant fraction. EL: energy loss. WSS: wall shear stress. KE: kinetic energy.  
\end{table} 
Table 5: Matching analysis for women. Although hemodynamic changes are emerging biomarkers of the disease, they remain poorly understood.