Van der Bruggen et al. [23] demonstrated that individuals with PAH and BMPR2 mutations have worse right ventricular function than those with PAH and normal BMPR2. In addition, animal studies found that [24] BMPR2-mutant mice showed decreased exercise capacity and poor response to stress load and that myocardial hypertrophy in animals was accompanied by right ventricular energy metabolism disorder. This evidence concerns the gene BMPR2 and pulmonary arterial hypertension.