Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA.
Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont, USA.
Pulm Circ. 2014 Jun;4(2):250-9. doi: 10.1086/675988.
Pentraxin-3 (PTX3) is a protein mediator of innate immunity that is elevated in the setting of left heart disease and pulmonary arterial hypertension. The relationship between PTX3 and right ventricular (RV) structure and function is not known. We included men and women with magnetic resonance imaging assessment of RV structure and function and measurement of PTX3 from the Multi-Ethnic Study of Atherosclerosis, a study of individuals free of clinical cardiovascular disease. Multivariable linear regression estimated associations between PTX3 protein levels and RV measures after adjusting for demographic characteristics, anthropometrics, smoking status, diabetes mellitus, hypertension, and corresponding left ventricular (LV) parameters. Instrumental variable analysis exploiting Mendelian randomization was attempted using two-stage least squares regression. The study sample included 1,779 participants with available PTX3 levels, RV measures, and all covariables. Mean PTX3 level was 2.1 ng/mL. Higher PTX3 was independently associated with greater RV mass and larger RV end-diastolic volume with and without adjustment for the corresponding LV parameters or C-reactive protein (all P < .05). There was no association between PTX3 and RV ejection fraction or stroke volume. Single-nucleotide polymorphisms were not associated with PTX3 protein levels or RV measures after accounting for race. Instrumental variable analysis could not be reliably performed. Higher PTX3 protein levels were associated with greater RV mass and larger RV end-diastolic volume. These associations were independent of common cardiovascular risk factors and LV morphologic changes. Inflammation is associated with differences in the pulmonary circulation-RV axis in adults without clinical cardiovascular disease.
血清淀粉样蛋白 P 成分 3（PTX3）是先天免疫的蛋白介质，在左心疾病和肺动脉高压的情况下升高。PTX3 与右心室（RV）结构和功能之间的关系尚不清楚。我们纳入了磁共振成像评估 RV 结构和功能以及从动脉粥样硬化多民族研究中测量 PTX3 的男性和女性，该研究是针对无临床心血管疾病个体的研究。多变量线性回归在调整人口统计学特征、人体测量学、吸烟状况、糖尿病、高血压和相应的左心室（LV）参数后，估计了 PTX3 蛋白水平与 RV 测量值之间的关联。利用两阶段最小二乘法回归尝试了利用孟德尔随机化的工具变量分析。研究样本包括 1779 名有可用 PTX3 水平、RV 测量值和所有协变量的参与者。平均 PTX3 水平为 2.1ng/mL。较高的 PTX3 与 RV 质量增加和 RV 舒张末期容积增大独立相关，无论是否调整相应的 LV 参数或 C 反应蛋白（均 P<0.05）。PTX3 与 RV 射血分数或每搏输出量之间没有关联。在考虑种族因素后，单核苷酸多态性与 PTX3 蛋白水平或 RV 测量值无关。无法可靠地进行工具变量分析。较高的 PTX3 蛋白水平与更大的 RV 质量和更大的 RV 舒张末期容积相关。这些关联独立于常见的心血管危险因素和 LV 形态变化。在没有临床心血管疾病的成年人中，炎症与肺循环-RV 轴的差异有关。
