Abstract
The study aimed to evaluate mean platelet volume (MPV), platelet distribution width (PDW), and platecrit in children with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD), to assess the predictive value of these platelet activation markers for adverse outcomes, and to correlate their levels with various data in these patients. This prospective cohort study included 60 children with PAH-CHD as group I and 60 children with CHD and no PAH as group II. Another 60 healthy children of matched age and sex served as the control group. All included children were evaluated by echocardiography. MPV, PDW, and platecrit were also measured using an automated blood counter. All patients were followed up for death or readmission for 6 months. MPV, PDW, and platecrit were significantly higher in group I compared to group II and the control group and they correlated well with increasing severity of PAH. MPV, PDW, and platecrit positively correlated with right ventricular diameter and mean pulmonary artery pressure, however they correlated negatively with right ventricular systolic and diastolic function. The best cut-off of platelet activation markers levels to predict poor prognosis in group I was > 11.2 FL with 75% sensitivity and 96.6% specificity for MPV, > 12.7 FL with 75% sensitivity and 61.5% specificity for PDW, and > 0.505% with 75% sensitivity and 93.2% specificity for platecrit. MPV, PDW, and platecrit were elevated in children with PAH-CHD and found to be good predictive markers for poor prognosis in these children.
Highlights
Congenital heart disease (CHD) accounts for nearly onethird of all major congenital anomalies [1]
One of the most important types of Pulmonary hypertension (PH) in children is pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) [5]
respiratory rate (RR) and heart rate (HR) were significantly higher in children with CHD with or without PAH compared to the healthy control group
Summary
Congenital heart disease (CHD) accounts for nearly onethird of all major congenital anomalies [1]. Pulmonary hypertension (PH) is a hemodynamic and pathophysiological disorder that defined as an increase in mean pulmonary. Arterial pressure (mPAP) ≥ 20 mmHg at rest as assessed by right heart catheterization [2–4]. One of the most important types of PH in children is pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) [5]. PAH-CHD is usually the result of a large systemic to pulmonary shunt, and often leads to right ventricular failure and early death [6, 7]. Mean platelet volume (MPV), platelet distribution width (PDW), and platecrit (PCT) are simple hematological markers of assessing platelet function and activation. MPV increases during platelet activation and reflects platelet production [9]. PDW directly measures the variability in platelet size and is a marker of platelet activation. PDW and platecrit provide information on total platelet mass [10]
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