Rivaroxaban has also previously been shown to downregulate F2RL1 and associated pathways (ERK, JNK, NF-κB), thereby attenuating right ventricular remodeling in a PAH Sugen-Hypoxia rat model, indicating roles of F2RL1 in vascular remodeling by various mechanisms, fibrosis, and endothelial dysfunction in PAH 50, 51. This evidence concerns the gene MAPK8 and endothelial dysfunction.