Tunçez Abdullah, Yalçın Muhammed Ulvi, Tezcan Hüseyin, Altunkeser Bülent Behlül, Öztürk Bahadır, Aydoğan Canan, Toprak Aslıhan, Polat Onur Can, Aygül Nazif, Demir Kenan, Gürses Kadri Murat, Özen Yasin, Akyürek Fikret, Tunçez Hatice Betül
Department of Cardiology, Faculty of Medicine, Selçuk University, 42130 Selçuklu-Konya, Turkey.
Department of Biochemistry, Faculty of Medicine, Selçuk University, 42130 Selçuklu-Konya, Turkey.
J Clin Med. 2025 Jul 2;14(13):4671. doi: 10.3390/jcm14134671.
Pulmonary hypertension (PH) is a progressive disorder with high morbidity and mortality, partly driven by chronic inflammation. Soluble urokinase plasminogen activator receptor (suPAR) reflects immune activation. We evaluated whether suPAR is altered in Group 1 and Group 4 PH and its association with clinical, echocardiographic, and laboratory parameters. We enrolled 44 PH patients (36 in Group 1, 8 in Group 4) and 45 healthy controls. All underwent clinical and echocardiographic assessments; right heart catheterization was performed in the PH patients. Serum suPAR was measured by ELISA. N-terminal pro B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were also assessed. The suPAR plasma levels in the PH group were between 23.91 and 960.8 pg/mL (median: 73.14 p25: 62.77, p75: 167.13). suPAR was significantly higher in PH versus controls (73.14 [62.77-167.13] vs. 65.52 [53.06-80.91] pg/mL; = 0.012). In logistic regression, systolic blood pressure, erythrocyte sedimentation rate, NT-proBNP, and suPAR independently predicted PH. suPAR correlated negatively with six-minute walk distance (r = -0.310) and tricuspid annular plane systolic excursion (r = -0.295) but positively with systolic pulmonary artery pressure (r = 0.241). On multivariate analysis, six-minute walk distance was the only independent correlate of suPAR ( = 0.004). suPAR levels did not differ between Group 1 and Group 4 PH. suPAR is elevated in Group 1 and Group 4 PH and correlates with functional and echocardiographic indices of disease severity. Larger prospective studies are needed to determine suPAR's role in diagnosis, risk stratification, and therapeutic decision-making.
肺动脉高压（PH）是一种发病率和死亡率都很高的进行性疾病，部分由慢性炎症驱动。可溶性尿激酶型纤溶酶原激活物受体（suPAR）反映免疫激活情况。我们评估了suPAR在1组和4组PH患者中是否发生改变，以及它与临床、超声心动图和实验室参数之间的关联。我们纳入了44例PH患者（1组36例，4组8例）和45名健康对照者。所有人都接受了临床和超声心动图评估；对PH患者进行了右心导管检查。通过酶联免疫吸附测定法（ELISA）检测血清suPAR。还评估了N末端B型利钠肽原（NT-proBNP）和C反应蛋白（CRP）。PH组的suPAR血浆水平在23.91至960.8 pg/mL之间（中位数：73.14，p25：62.77，p75：167.13）。PH患者的suPAR显著高于对照组（73.14 [62.77 - 167.13] vs. 65.52 [53.06 - 80.91] pg/mL；P = 0.012）。在逻辑回归分析中，收缩压、红细胞沉降率、NT-proBNP和suPAR可独立预测PH。suPAR与六分钟步行距离（r = -0.310）和三尖瓣环平面收缩期位移（r = -0.295）呈负相关，但与肺动脉收缩压呈正相关（r = 0.241）。在多变量分析中，六分钟步行距离是suPAR的唯一独立相关因素（P = 0.004）。1组和4组PH患者的suPAR水平没有差异。suPAR在1组和4组PH患者中升高，并且与疾病严重程度的功能和超声心动图指标相关。需要开展更大规模的前瞻性研究来确定suPAR在诊断、风险分层和治疗决策中的作用。
