PURPOSE: To investigate causal coincidence of pulmonary hypertention(PH) serum NT-ProBNP levels with either cardiopulmonary functional and inflammatory factors and/or latent cellular damage quided cardiac remodeling.
METHODS: Fifty five pulmonary hypertention dyspnea patients(pts),34 males and 21 females,mean age 69 years,underwent 1.Echocardiography 2.Lung function tests and arterial blood gasses 3.Evaluation of serum NT-ProBNP levels by the ECL method and various biomarkers,including inflammatory cytokines TNF-a,IL-1a,IL-6 and CRP,cellular damage marker Troponin-I(Tr-I,) and Metalloproteinase-2(MMP-2),Metalloproteinase-9(MMP-9) and Erythropoeitin (EPO),expressing cardiovascular remodeling.
RESULTS: Examination results demonstrated 1)Echocardiographic right ventricular systolic pressure(RVSP)>35mm Hg in all patients(mean:52mm Hg),ejection fraction(EF)=57%,left atrial dimention(LAD)>4cm(mean:4,8cm) and asymmetric septal hypertrophy(ASH)=1,5 2) Respiratory function of restrictive or congestive type,hypoxemia and alveolar-arterial oxygen difference=49mm Hg 3)Abnormal serum NT-ProBNP values=4267 pg/ml,TNF-a=44 pg/ml,IL-1a=10 pg/ml,IL-6=42 pg/ml, CRP=7,8 mg/dl, Tr-I=1,2 ng/ml, MMP-2=236 ng/ml, MMP-9= 922 ng/ml, EPO=26m/U/ml andD-dimers=1,2ng/ml 4) Further primary significant correlations of a)NT-ProBNP to Tr- I, CRP, EF, LAD and PCO2 b) Tr- I to IL-1a ,TNF-a, EF and MMP-2 c) MMP-2 to EPO d) CRP to IL-1b, D-dimers and PCO2.
CONCLUSIONS: NT-ProBNP values and significant correlations could be highly suggestive that PH mainly coincides with either inflammatory cardiopulmonary dysfunction,apoptosis and latent cellular damage guided cardiovascular remodeling,compatible with PH of cardiac origin,differentiating cardiac from pulmonary dyspnea.
CLINICAL IMPLICATIONS: Further investigation is needed to set up clinical diagnostic,causal,critera of PH.
DISCLOSURE: The following authors have nothing to disclose: Ioannis Angomachalelis, George Kyriazis, Demosthenes Bouros, Nestor Angomachalelis
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