Cardiothoracic Department, Ospedali Riuniti University Hospital, 71100 Foggia, Italy.
Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy.
Biomolecules. 2024 May 3;14(5):552. doi: 10.3390/biom14050552.
Pulmonary arterial hypertension (PAH) is a rare subtype of group 1 pulmonary hypertension (PH) diseases, characterized by high pulmonary artery pressure leading to right ventricular dysfunction and potential life-threatening consequences. PAH involves complex mechanisms: vasoconstriction, vascular remodeling, endothelial dysfunction, inflammation, oxidative stress, fibrosis, RV remodeling, cellular hypoxia, metabolic imbalance, and thrombosis. These mechanisms are mediated by several pathways, involving molecules like nitric oxide and prostacyclin. PAH diagnosis requires clinical evaluation and right heart catheterization, confirming a value of mPAP ≥ 20 mmHg at rest and often elevated pulmonary vascular resistance (PVR). Even if an early and accurate diagnosis is crucial, PAH still lacks effective biomarkers to assist in its diagnosis and prognosis. Biomarkers could contribute to arousing clinical suspicion and serve for prognosis prediction, risk stratification, and dynamic monitoring in patients with PAH. The aim of the present review is to report the main novelties on new possible biomarkers for the diagnosis, prognosis, and treatment monitoring of PAH.
肺动脉高压（PAH）是 1 型肺动脉高压（PH）疾病的罕见亚型，其特征是肺动脉压升高导致右心室功能障碍和潜在的危及生命的后果。PAH 涉及复杂的机制：血管收缩、血管重塑、内皮功能障碍、炎症、氧化应激、纤维化、RV 重塑、细胞缺氧、代谢失衡和血栓形成。这些机制由几种途径介导，涉及一氧化氮和前列环素等分子。PAH 的诊断需要临床评估和右心导管检查，以确认静息状态下 mPAP≥20mmHg，且常伴有肺动脉阻力升高。即使早期和准确的诊断至关重要，但 PAH 仍然缺乏有效的生物标志物来协助其诊断和预后。生物标志物可以帮助引起临床怀疑，并有助于 PAH 患者的预后预测、风险分层和动态监测。本综述的目的是报告新的可能的生物标志物在 PAH 的诊断、预后和治疗监测方面的主要新进展。
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