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The passing of Natalie Cole on Dec. 31 stunned her longtime fans and supporters. On Thursday, the family of celebrated vocalist released details on what caused her untimely passing.

ABC News, which obtained the family’s statement originally, reports:

According to her family, Cole underwent a successful kidney transplant in 2009, after which she was diagnosed with IPAH.

“This is a very serious and progressive disorder,” her family said in the statement. “[Cole] responded well to PAH-specific agents over many years, during which she performed many concerts world-wide, but eventually succumbed to intractable right heart failure, an outcome that unfortunately commonly occurs in this progressive disorder, despite modern therapies.”

The singer cancelled many of her November and December performance dates last year for hospital visits, although it was never reported to be linked with IPAH. Earlier in 2015, Cole cancelled a run of concerts due to unspecified health reasons.

Cole, who was very candid about her past drug abuse, battled related conditions due to her drug use. However, she continued to perform and thrill audiences despite it all.

She was 65 at the time of her passing

Photo: Rob Rich/WENN