Adachi Shiro, Kikuchi Ryosuke, Shimokata Shigetake, Suzuki Atsuo, Yoshida Masahiro, Imai Ryo, Nakano Yoshihisa, Kondo Takahisa, Murohara Toyoaki
Department of Cardiology, Nagoya University Hospital Nagoya Japan.
Department of Medical Technique, Nagoya University Hospital Nagoya Japan.
Circ Rep. 2021 Feb 19;3(3):161-169. doi: 10.1253/circrep.CR-20-0096.
Pulmonary hypertension (PH) is characterized by dysregulation of small pulmonary arteries. In addition to endostatin (ES), placenta growth factor (PlGF), vascular endothelial growth factor-A (VEGF-A), and the anti-angiogenesis isoform of VEGF-A (VEGF-Ab) are associated with PH. However, the usefulness of these biomarkers in PH in unknown. We investigated whether these 4 biomarkers are related to PH classification. Between July 2015 and August 2017, 33 control patients and 107 PH patients were enrolled in the study. Among the PH patients, 48 had pulmonary arterial hypertension (PAH), 5 had left heart disease-associated PH (LHD-PH), 4 had lung disease-associated PH (LD-PH), and 50 had chronic thromboembolic PH (CTEPH). Among the PAH patients, 16 had idiopathic PAH (IPAH) and 17 had connective tissue disease-associated PAH (CTD-PAH). PlGF, total VEGF-A, and VEGF-Ab levels were measured in the control and PH groups. ES was only measured in the PH group. VEGF-Ab levels were significantly higher in the LD-PH group than in the PAH, LHD-PH, and CTEPH groups (all P<0.001). PlGF levels were significantly higher in the CTD-PAH group than in the IPAH and control groups. ES levels were significantly correlated with the 6-min walk distance (P<0.001), B-type natriuretic peptide (P<0.001), and pulmonary vascular resistance (P=0.008). ES could detect CTD-PAH in PAH and may be an indicator of PH severity. VEGF-Ab was useful in detecting LD-PH.
肺动脉高压（PH）的特征是小肺动脉调节异常。除内皮抑素（ES）外，胎盘生长因子（PlGF）、血管内皮生长因子-A（VEGF-A）以及VEGF-A的抗血管生成异构体（VEGF-Ab）也与PH相关。然而，这些生物标志物在PH中的作用尚不清楚。我们研究了这4种生物标志物是否与PH分类有关。2015年7月至2017年8月，33例对照患者和107例PH患者纳入本研究。在PH患者中，48例患有肺动脉高压（PAH），5例患有左心疾病相关性PH（LHD-PH），4例患有肺部疾病相关性PH（LD-PH），50例患有慢性血栓栓塞性PH（CTEPH）。在PAH患者中，16例患有特发性PAH（IPAH），17例患有结缔组织病相关性PAH（CTD-PAH）。在对照组和PH组中测量了PlGF、总VEGF-A和VEGF-Ab水平。ES仅在PH组中测量。LD-PH组的VEGF-Ab水平显著高于PAH、LHD-PH和CTEPH组（均P<0.001）。CTD-PAH组的PlGF水平显著高于IPAH组和对照组。ES水平与6分钟步行距离（P<0.001）、B型利钠肽（P<0.001）和肺血管阻力（P=0.008）显著相关。ES可在PAH中检测出CTD-PAH，可能是PH严重程度的一个指标。VEGF-Ab有助于检测LD-PH。
