Elevated plasma Pim‐1 and its clinical significance in patients with pulmonary arterial hypertension

Abstract

This study was aimed to determine plasma Pim-1 levels in patients with pulmonary arterial hypertension (PAH) and to estimate the clinical value of Pim-1 as a biomarker of PAH. This was a single-centre retrospective study in 111 patients with congenital heart disease (CHD) and idiopathic PAH (IPAH). Those CHD patients were divided into two groups: PAH associated with CHD (PAH-CHD) and CHD without PAH (nPAH-CHD). Plasma Pim-1 levels were measured by enzyme-linked immunosorbent assay. (a) Plasma Pim-1 levels were significantly increased in patients with PAH-CHD and IPAH compared with the healthy control group (27.81±11.34ng/mL vs 13.02±5.30ng/mL; 32.81±12.28ng/mL vs 13.02±5.30ng/mL, P<0.05) and nPAH-CHD (27.81±11.34ng/mL vs 17.33±7.99ng/mL; 32.81±12.28ng/mL vs 17.33±7.99ng/mL, P<0.05). Pim-1 levels were substantially increased in patients with severe PAH-CHD compared with mild-to-moderate PAH-CHD (19.12±6.70ng/mL vs 8.54±3.71ng/mL, P<0.05). (b) Pim-1 levels were correlated positively with the mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) (r=0.582, 0.516; P<0.001, respectively), while negatively with tricuspid annular plane systolic excursion (TAPSE), tricuspid annular plane systolic velocity (S') and right ventricular fractional area changes (RVFAC) (r=-0.375, -0.354, -0.507; P<0.05, respectively). (c) PAH-CHD and severe PAH-CHD was identified by plasma Pim-1 with a cutoff value of 16.8ng/mL (P<0.001) with a sensitivity of 87.3% and a specificity of 65%, and a cutoff value of 20.53ng/mL (P<0.001) with a sensitivity of 87.3% and a specificity of 52%, respectively. Plasma Pim-1 levels were significantly higher in patients with PAH-CHD and IPAH. Plasma Pim-1 may represent an effectively biomarker in patients with PAH.