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Angiogenic and inflammatory biomarkers in the differentiation of pulmonary hypertension

Säleby, Joanna LU ; Bouzina, Habib LU ; Lundgren, Jakob LU and Rådegran, Göran LU (2017) In Scandinavian Cardiovascular Journal 51(5). p.261-270
Abstract

Objectives. Pulmonary hypertension (PH) is a serious condition where diagnosis often is delayed due to unspecific symptoms. New methods to diagnose and differentiate PH earlier would therefore be of great value. The aim of this study was therefore to evaluate the relationship between circulating angiogenic and inflammatory biomarkers and various hemodynamic variables in relation to different causes of PH. Design. Plasma samples from 63 patients at diagnosis were extracted from Lund Cardio Pulmonary Register, separated into pulmonary arterial hypertension (PAH, n = 22), chronic thromboembolic pulmonary hypertension (CTEPH, n = 15) and left heart disease (LHD) with (n = 21) and without (n = 5) PH. Blood samples from eight control subjects... (More)

Objectives. Pulmonary hypertension (PH) is a serious condition where diagnosis often is delayed due to unspecific symptoms. New methods to diagnose and differentiate PH earlier would therefore be of great value. The aim of this study was therefore to evaluate the relationship between circulating angiogenic and inflammatory biomarkers and various hemodynamic variables in relation to different causes of PH. Design. Plasma samples from 63 patients at diagnosis were extracted from Lund Cardio Pulmonary Register, separated into pulmonary arterial hypertension (PAH, n = 22), chronic thromboembolic pulmonary hypertension (CTEPH, n = 15) and left heart disease (LHD) with (n = 21) and without (n = 5) PH. Blood samples from eight control subjects devoid of PH were additionally evaluated. Plasma concentrations of angiogenic (PlGF, Tie2, VEGF-A, VEGF-D, bFGF, sFlt-1) and inflammatory (IL-6, IL-8, TNF-α) biomarkers were analysed and related to hemodynamic variables. Results. SFlt-1 (p < .004) and VEGF-A (p < .035) were higher in all PH groups compared to controls. TNF-α (p < .030) were elevated in PAH patients in relation to the other PH groups as well as controls. Likewise, plasma VEGF-D (p < .008) were elevated in LHD with PH compared to the other groups with PH and controls. In PAH, higher sFlt-1 concentrations correlated to a worse state of hemodynamics. Conclusions. Our findings indicate that sFlt-1 and VEGF-A may be future tools when discriminating PH from non-PH. Moreover, TNF-α may differentiate PAH and VEGF- D may differentiate LHD with PH, from the other groups with PH, as well as controls. SFlt-1 may furthermore play a role as a future marker of disease severity.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Angiogenesis, hemodynamics, inflammation, plasma biomarkers, pulmonary hypertension differentiation, sFlt-1
in
Scandinavian Cardiovascular Journal
volume
51
issue
5
pages
261 - 270
publisher
Taylor & Francis
external identifiers
  • pmid:28776404
  • wos:000416503800004
  • scopus:85026852718
ISSN
1401-7431
DOI
10.1080/14017431.2017.1359419
project
Biomarkers in Pulmonary Hypertension
language
English
LU publication?
yes
id
2cde0123-3f1e-46e9-b65c-92a075b11378
date added to LUP
2017-08-21 14:53:22
date last changed
2024-04-28 17:51:20
@article{2cde0123-3f1e-46e9-b65c-92a075b11378,
  abstract     = {{<p>Objectives. Pulmonary hypertension (PH) is a serious condition where diagnosis often is delayed due to unspecific symptoms. New methods to diagnose and differentiate PH earlier would therefore be of great value. The aim of this study was therefore to evaluate the relationship between circulating angiogenic and inflammatory biomarkers and various hemodynamic variables in relation to different causes of PH. Design. Plasma samples from 63 patients at diagnosis were extracted from Lund Cardio Pulmonary Register, separated into pulmonary arterial hypertension (PAH, n = 22), chronic thromboembolic pulmonary hypertension (CTEPH, n = 15) and left heart disease (LHD) with (n = 21) and without (n = 5) PH. Blood samples from eight control subjects devoid of PH were additionally evaluated. Plasma concentrations of angiogenic (PlGF, Tie2, VEGF-A, VEGF-D, bFGF, sFlt-1) and inflammatory (IL-6, IL-8, TNF-α) biomarkers were analysed and related to hemodynamic variables. Results. SFlt-1 (p &lt; .004) and VEGF-A (p &lt; .035) were higher in all PH groups compared to controls. TNF-α (p &lt; .030) were elevated in PAH patients in relation to the other PH groups as well as controls. Likewise, plasma VEGF-D (p &lt; .008) were elevated in LHD with PH compared to the other groups with PH and controls. In PAH, higher sFlt-1 concentrations correlated to a worse state of hemodynamics. Conclusions. Our findings indicate that sFlt-1 and VEGF-A may be future tools when discriminating PH from non-PH. Moreover, TNF-α may differentiate PAH and VEGF- D may differentiate LHD with PH, from the other groups with PH, as well as controls. SFlt-1 may furthermore play a role as a future marker of disease severity.</p>}},
  author       = {{Säleby, Joanna and Bouzina, Habib and Lundgren, Jakob and Rådegran, Göran}},
  issn         = {{1401-7431}},
  keywords     = {{Angiogenesis; hemodynamics; inflammation; plasma biomarkers; pulmonary hypertension differentiation; sFlt-1}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{5}},
  pages        = {{261--270}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Cardiovascular Journal}},
  title        = {{Angiogenic and inflammatory biomarkers in the differentiation of pulmonary hypertension}},
  url          = {{http://dx.doi.org/10.1080/14017431.2017.1359419}},
  doi          = {{10.1080/14017431.2017.1359419}},
  volume       = {{51}},
  year         = {{2017}},
}