1. Circulating endothelial microparticle levels predict hemodynamic severity of pulmonary hypertension
- Author
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Eduardo J. Rame, Teresa De Marco, Wendy May Real, William Grossman, Dana McGlothlin, Petros Minasi, Nicolas Amabile, Christian Heiss, and Yerem Yeghiazarians
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Endothelium ,Hypertension, Pulmonary ,Hemodynamics ,Blood Pressure ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Cohort Studies ,Antigens, CD ,Predictive Value of Tests ,Intensive care ,Internal medicine ,medicine.artery ,medicine ,Humans ,Endothelial dysfunction ,Membrane Glycoproteins ,business.industry ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Surgery ,medicine.anatomical_structure ,Blood pressure ,Case-Control Studies ,Pulmonary artery ,Vascular resistance ,Cardiology ,Female ,Vascular Resistance ,business - Abstract
Rationale: Circulating microparticles (MPs) are submicron membrane fragments shed from damaged or activated vascular cells. Endothelial MPs are a biological marker of dysfunctional endothelium. Vascular remodeling and endothelial dysfunction are involved in pulmonary hypertension (PH). Objectives: We tested the hypothesis that circulating MPs are increased in patients with PH and that identifiable subgroups of MPs predict the hemodynamic severity of this condition progression. Methods :P atients (n5 24; age, 54 6 4 yr) undergoing right heart catheterization for precapillary PH without any endothelium-active vasodilator therapy participated in the study. Age- and sex-matched healthycontrolsubjects(n 520)wereincluded.Endothelial(PECAM 1 [CD31 1 ]/CD41 2 ,VE-cadherin 1 [CD144 1 ],andE-selectin 1 [CD62e 1 ]), platelet (CD41 1 ), leukocyte-derived (CD45 1 ), and annexin V 1 MPs weremeasuredbyflowcytometryinplatelet-freeplasmafromvenous blood. Measurements and Main Results: Levels of circulating endothelial PECAM 1 , VE-cadherin 1 , E-selectin 1 , and leukocyte-derived MPs, but not platelet and annexin V1 MPs, were increased in subjects with PH compared with control subjects (P , 0.01 each). PECAM1 and VEcadherin1 MP levels significantly correlated with mean pulmonary artery pressure (r 5 0.92 and r 5 0.87, respectively), pulmonary vascular resistance (r 5 0.78 and r 5 0.73), and mean right atrial pressure(r 5 0.43,andr 5 0.46) andcorrelated inverselywithcardiac index (r 52 0.59 and r 52 0.52). These relationships were not observed for other MP subgroups, and persisted in multivariate analysis after adjustment for confounding factors. Conclusions: In subjects with precapillary PH, levels of circulating endothelialandleukocyteMPswereincreasedcomparedwithcontrol subjects. In addition, levels of PECAM1 and VE-cadherin1 ,b ut not E-selectin 1 , endothelial MPs predicted hemodynamic severity of
- Published
- 2008