Abstract
BackgroundThe severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure (mPAP) levels. However, other markers have not been elucidated. Fibrinolytic markers, such as total plasminogen activator inhibitor-1 (tPAI-1) and thrombomodulin (TM), are known to reflect arterial endothelial function. However, the relationship between serum tPAI-1, TM and pulmonary circulation has not been completely determined.MethodsThis study included 100 consecutive patients (38 men), with a mean age of 68.9 ± 12.0 years, with cardiac diseases who underwent right heart catheterization. Serum coagulation and fibrinolytic marker levels were measured.ResultsThe average mPAP value was 25.1 ± 13.1 mmHg for all patients. The mPAP levels revealed a significant positive correlation with serum tPAI-1 (ρ = 0.24, p = 0.042) and uric acid (ρ = 0.29, p = 0.0031) levels. In the group with mPAP levels less than 25 mmHg (n = 58, ave. 17.3 ± 4.3 mmHg), mPAP levels showed a significant positive correlation with serum tPA-1 (ρ = 0.34, p = 0.034) and TM (ρ = 0.34, p = 0.043) values. The mean tPAI-1 (29.8 ± 23.3 ng/ml, p = 0.047) and uric acid (5.7 ± 1.8 mg/dl, p = 0.026) levels were significantly less in those with lower mPAP levels. A multivariate analysis revealed that tPAI-1 alone was a significant independent characteristic marker of PAH (odds ratio 1.02, 95%CI 1.000–1.036, p = 0.034).ConclusionsThese results indicate that serum tPAI-1 and TM may be useful predictors of severity, similar to mPAP in patients with PAH. They could be beneficial in predicting PAH among patients in the early stage of the disease.
Highlights
The severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure levels
The fibrinolytic marker, total plasminogen activator inhibitor-1 is a major inhibitor of plasminogen activator in plasma. It is stored in platelets and has several sources, including the vascular endothelium [5]. tPAI-1 is known to be associated with a proinflammatory atherosclerotic risk
We reviewed the medical records of 111 consecutive patients who underwent right heart catheterization (RHC)
Summary
The severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure (mPAP) levels. The severity of pulmonary artery hypertension (PAH) is classified based on the mean pulmonary artery pressure (mPAP) levels that are evaluated by right heart catheterization (RHC). The fibrinolytic marker, total plasminogen activator inhibitor-1 (tPAI-1) is a major inhibitor of plasminogen activator in plasma. It is stored in platelets and has several sources, including the vascular endothelium [5]. Thrombomodulin (TM) has an anticoagulant effect that is activating protein C, and this is corroborated by reports about elevated blood levels of TM in patients with acute pulmonary embolism [8, 9]. It is known that TM is metabolized by the liver and excreted through the kidneys, and its level is elevated in a variety of diseases [10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
