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  The pulmonary vascular lumen is decrease in PAH as a result of vasoconstriction and vascular remodeling, resulting in increase pulmonary artery pressure and pulmonary vascular resistance. Cialis 30 tablets/20mg causes pulmonary artery vasodilation, and inhibits vascular remodeling, thus lowering pulmonary arterial pressure and resistance. Right heart failure is the principal consequence of severe pulmonary arterial hypertension.