1st Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
Cells. 2024 Sep 5;13(17):1494. doi: 10.3390/cells13171494.
Patients with cyanosis secondary to congenital heart disease (CHD) are characterized by erythrocytosis and increased blood viscosity, which contribute to endothelial dysfunction, increased arterial stiffness, and impaired vascular function, which may affect the final clinical presentation. Asymmetric dimethylarginine (ADMA) and e-selectin (e-sel) are valuable biomarkers for endothelial and vascular dysfunction. Their concentration levels in blood serum have the potential to be an accessible tool that reflects the severity of the disease. We aimed to assess e-sel and ADMA levels and their relationship with the clinical status and endothelial and vascular function. A cross-sectional study, including 36 adult CHD cyanotic patients [(17 males) (42.3 ± 16.3 years)] with an arterial blood oxygen saturation less than 92% and 20 healthy controls [(10 males) (38.2 ± 8.5 years)], was performed. All the patients underwent a clinical examination, blood testing, and cardiopulmonary tests. Their endothelial function was assessed using the intima media thickness and flow-mediated dilatation. Vascular function, using applanation tonometry methods, was determined using the aortic systolic pressure, aortic pulse pressure, augmentation pressure, augmentation index, pulse pressure amplification, and pulse wave velocity. The concentrations of e-sel and ADMA were significantly higher in the patients with CHD. The E-sel levels correlated positively with red blood cells, hemoglobin concentration, hematocrit, and augmentation pressure; they correlated negatively with blood oxygen saturation, the forced expiratory one-second volume, forced vital capacity, and oxygen uptake. The ADMA levels were found to correlate only with age. The E-sel level, unlike ADMA concentration, reflects the severity of erythrocytosis and hypoxia and, thus, the physical status of patients with cyanotic CHD.
患有先天性心脏病（CHD）导致发绀的患者表现为红细胞增多和血液粘度增加，这会导致内皮功能障碍、动脉僵硬增加和血管功能受损，可能影响最终的临床表型。不对称二甲基精氨酸（ADMA）和 E-选择素（E-sel）是内皮和血管功能障碍的有价值的生物标志物。其血清浓度水平有可能成为反映疾病严重程度的一种可行工具。我们旨在评估 E-sel 和 ADMA 水平及其与临床状况以及内皮和血管功能的关系。
一项横断面研究纳入了 36 例成人 CHD 发绀患者（男性 17 例，年龄 42.3 ± 16.3 岁），这些患者的动脉血氧饱和度＜92%，并纳入了 20 例健康对照者（男性 10 例，年龄 38.2 ± 8.5 岁）。所有患者均接受了临床检查、血液检查和心肺检查。使用内中膜厚度和血流介导的扩张来评估他们的内皮功能。使用平板压力测量法确定血管功能，包括主动脉收缩压、主动脉脉压、增强压、增强指数、脉压放大率和脉搏波速度。
CHD 患者的 E-sel 和 ADMA 浓度显著升高。E-sel 水平与红细胞、血红蛋白浓度、红细胞压积和增强压呈正相关，与血氧饱和度、用力呼气一秒量、用力肺活量和摄氧量呈负相关。ADMA 水平仅与年龄相关。
与 ADMA 浓度不同，E-sel 水平反映了红细胞增多症和缺氧的严重程度，因此反映了发绀性 CHD 患者的身体状况。
