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Diagram of study hypothesis and integration of the clinical study and the basic science study. PE causes intracardiac hemolysis which disrupts NO signaling by scavenging NO and releasing arginase which depletes L-arginine, producing a negative feedback cycle of increased pulmonary VSM constriction, increased PVR, higher RV pressures and more hemolysis. Inhaled NO (iNO*) will break this cycle.
