Dinarti Lucia Kris, Hartopo Anggoro Budi, Anggrahini Dyah Wulan, Sadewa Ahmad Hamim, Setianto Budi Yuli, Wahab Abdus Samik
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Department of Biochemistry, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Cardiol Res Pract. 2020 Jan 7;2020:7526508. doi: 10.1155/2020/7526508. eCollection 2020.
The study design was cross-sectional. The subjects were adult uncorrected secundum ASD with PAH. Pulmonary artery pressure was measured with right heart catheterization. Pulmonary venous blood was obtained during catheterization for measuring endothelin-1, prostacyclin, and nitric oxide. Correlation tests were performed to determine any association between biomarkers and mean pulmonary artery pressure (mPAP). The levels of biomarkers were compared based on the severity of PAH. Statistical significance was determined at < 0.05.
Forty-four subjects were enrolled in this study. Endothelin-1 level and mPAP had significant moderate positive correlation ( = 0.423 and value = 0.004). However, no significant correlation was observed between prostacyclin, nitric oxide levels, and mPAP. The pattern of endothelin-1, prostacyclin, and nitric oxide was distinctive. Levels of endothelin-1 were incrementally increased from mild, moderate, to severe PAH. The levels of prostacyclin and nitric oxide had similar pattern in association with the severity of PAH, which was increased in mild-to-moderate PAH but decreased in severe PAH.
There was a distinctive pattern of endothelin-1, prostacyclin, and nitric oxide based on severity of PAH in adult uncorrected ASD. Significant correlations existed between endothelin-1 and the severity of PAH and mPAP.
本研究设计为横断面研究。研究对象为患有肺动脉高压（PAH）的成年未矫正继发孔型房间隔缺损（ASD）患者。通过右心导管插入术测量肺动脉压力。在导管插入过程中获取肺静脉血，以测量内皮素 -1、前列环素和一氧化氮。进行相关性测试以确定生物标志物与平均肺动脉压（mPAP）之间的任何关联。根据PAH的严重程度比较生物标志物的水平。统计学显著性设定为<0.05。
本研究纳入了44名受试者。内皮素 -1水平与mPAP呈显著的中度正相关（= 0.423，P值 = 0.004）。然而，未观察到前列环素、一氧化氮水平与mPAP之间存在显著相关性。内皮素 -1、前列环素和一氧化氮的模式各不相同。内皮素 -1水平从轻度、中度到重度PAH逐渐升高。前列环素和一氧化氮水平与PAH严重程度的关联模式相似，在轻度至中度PAH中升高，但在重度PAH中降低。
在成年未矫正ASD患者中，基于PAH严重程度，内皮素 -1、前列环素和一氧化氮存在独特的模式。内皮素 -1与PAH严重程度和mPAP之间存在显著相关性。
