Department of Cardiology, Malatya Turgut Ozal Universitesi Kardiyoloji ABD, Malatya, Turkey.
Department of Cardiology, Fethi Sekin Sehir Hastanesi, Elazıg, Turkey.
Heart Lung. 2025 Jan-Feb;69:202-207. doi: 10.1016/j.hrtlng.2024.10.010. Epub 2024 Nov 1.
Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary artery pressure with significant morbidity and mortality. Inflammatory processes are crucial in PAH pathogenesis, with inflammatory cells and mediators present early in disease progression. IL-34 involvement in inflammatory pathways suggests that IL-34 could be an important player in the progression of PAH, influencing both pulmonary pressures and vascular changes.
The purpose of this study was to investigate the correlation between IL-34 levels and pulmonary arterial hypertension (PAH), aiming to enhance the understanding of the molecular mechanisms underlying PAH and explore IL-34's potential as a biomarker.
Consecutive PAH patients diagnosed via right-heart catheterization at Malatya Turgut Ozal Eğitim ve Araştırma Hastanesi (Dec 2022 - Apr 2024) were enrolled. Patients were classified into low-risk and high-risk groups based on comprehensive risk assessments that included clinical parameters, hemodynamic measurements and biomarkers, in-line with ESC/ERS guidelines. Serum IL-34, hs-CRP, and NT-proBNP levels were measured and compared with those of healthy controls. Echocardiographic assessments and statistical analyses, including ROC analysis, were conducted to evaluate biomarker significance and predictive capabilities.
The mean age of low-risk and high-risk PAH patients was 42 ± 7.2 years and 45 ± 5.5 years, respectively. The mean age of the control group was 40 ± 6.4 years. Males comprised 54.29 % of the low-risk group, 56 % of the high-risk group, and 53.3 % of the control group. IL-34 and hs-CRP levels were significantly elevated in PAH patients compared to controls. IL-34 correlated positively with systolic pulmonary artery pressure, RA area, and NT-proBNP levels. Multivariate analysis revealed that IL-34 and hs-CRP were independent predictors of PAH. IL-34 levels>29.8 pg/mL predicted PAH with 78 % sensitivity and 69 % specificity, while levels >44.4 pg/mL predicted high-risk PAH with 84 % sensitivity and 77 % specificity.
Elevated IL-34 and hs-CRP levels are associated with PAH severity and right ventricular dysfunction, suggesting IL-34's potential as a diagnostic and prognostic biomarker. Further research is needed to validate these findings and explore IL-34-targeted therapies in pH management.
肺动脉高压（PAH）的特征是肺动脉压升高，具有显著的发病率和死亡率。炎症过程在 PAH 发病机制中至关重要，炎症细胞和介质在疾病进展早期就存在。IL-34 参与炎症途径表明，IL-34 可能是 PAH 进展的一个重要因素，影响肺压和血管变化。
本研究旨在探讨 IL-34 水平与肺动脉高压（PAH）之间的相关性，旨在增强对 PAH 分子机制的理解，并探索 IL-34 作为生物标志物的潜力。
连续招募了在马拉蒂亚图尔古特·奥扎尔教育与研究医院（2022 年 12 月至 2024 年 4 月）通过右心导管诊断为 PAH 的患者。根据 ESC/ERS 指南，基于包括临床参数、血流动力学测量和生物标志物在内的综合风险评估，将患者分为低危组和高危组。测量血清 IL-34、hs-CRP 和 NT-proBNP 水平，并与健康对照组进行比较。进行超声心动图评估和统计分析，包括 ROC 分析，以评估生物标志物的意义和预测能力。
低危和高危 PAH 患者的平均年龄分别为 42±7.2 岁和 45±5.5 岁，对照组的平均年龄为 40±6.4 岁。低危组男性占 54.29%，高危组男性占 56%，对照组男性占 53.3%。与对照组相比，PAH 患者的 IL-34 和 hs-CRP 水平显著升高。IL-34 与收缩期肺动脉压、右房面积和 NT-proBNP 水平呈正相关。多变量分析显示，IL-34 和 hs-CRP 是 PAH 的独立预测因子。IL-34 水平>29.8pg/mL 预测 PAH 的敏感性为 78%，特异性为 69%，而水平>44.4pg/mL 预测高危 PAH 的敏感性为 84%，特异性为 77%。
升高的 IL-34 和 hs-CRP 水平与 PAH 严重程度和右心室功能障碍相关，表明 IL-34 可能是诊断和预后的生物标志物。需要进一步研究来验证这些发现，并探讨针对 pH 管理的 IL-34 靶向治疗。
