Impaired Blood Rheology in Pulmonary Arterial Hypertension

Yaylali, Yalın Tolga; Kilic‐Toprak, Emine; Özdemir, Yasin; Şenol, Hande; Bor-Küçükatay, Melek

doi:10.1016/j.hlc.2018.07.014

Cited by 13 publications

(14 citation statements)

References 25 publications

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“…All five publications on RDW were eligible for meta-analysis. RDW was determined in treatment-naïve iPAH [ 24 ] and PAH [ 25 ] patients, and in PAH patients receiving vasodilatory treatment [ 11 , 26 ]. As a reference, asymptomatic controls [ 11 , 24 – 26 ] and patients suspected of PH [ 26 ] or common disease controls [ 24 ] were included ( figure 2a ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review with meta-analysis of biomarkers for detection of pulmonary arterial hypertension

et al. 2022

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RationaleThe blood is a rich source of potential biomarkers for the diagnosis of idiopathic and hereditary pulmonary arterial hypertension (iPAH and hPAH, referred to as “PAH”). While a lot of biomarkers have been identified for PAH, the clinical utility of these biomarkers often remains unclear. Here, we used unbiased meta-analysis of published biomarkers to identify biomarkers with the highest performance in the detection of PAH.MethodsA literature search (in PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection and Wiley/Cochrane Library) was performed up to January 28, 2021. Primary end points were blood biomarker levels in PAH versus asymptomatic controls or patients suspected of pulmonary hypertension (PH) with proven normal haemodynamic profiles.Results149 articles were identified by the literature search. Meta-analysis of 26 biomarkers yielded 17 biomarkers that were differentially expressed in PAH and non-PH control subjects. Red cell distribution width, LDL-c, d-dimer, NT-proBNP, IL-6 and uric acid were biomarkers with the largest observed differences, largest sample sizes and a low risk of publication bias. Receiver operating characteristic curves and sensitivity/specificity analyses demonstrated that NT-proBNP had a high sensitivity, but low specificity for PAH. For the other biomarkers, insufficient data on diagnostic accuracy with receiver operating characteristic curves were available for meta-analysis.ConclusionThis meta-analysis validates NT-proBNP as a biomarker with high sensitivity for PAH, albeit with low specificity. The majority of biomarkers evaluated in this meta-analysis lacked either external validation or data on diagnostic accuracy. Further validation studies are required, and studies that test combinations of biomarkers to improve specificity.

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Section: Resultsmentioning

confidence: 99%

A systematic review with meta-analysis of biomarkers for detection of pulmonary arterial hypertension

et al. 2022

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“…Lung histology samples from 13 children with DS who died between the ages of 0 to 8 years demonstrated alveolar simplification, features of pulmonary arterial hypertensive remodelling, prominent bronchial vessels and persistence of a double capillary network in the distal lung 10. Galambos et al observed that lung tissue from fetuses with DS overexpresses antiangiogenic factors, including collagen type XVIII alpha1, Collagen type IV alpha3 and tissue inhibitor of metalloproteinases metallopeptidase inhibitor 3, and suggested that impaired pulmonary vascular growth might subsequently cause impaired alveolarisation and progression to PAH 11 12. Collectively this can block capillary vasculature growth, a mechanistic perturbation that is associated with PH in adults 12.…”

Section: Ph In Dsmentioning

confidence: 99%

“…Galambos et al observed that lung tissue from fetuses with DS overexpresses antiangiogenic factors, including collagen type XVIII alpha1, Collagen type IV alpha3 and tissue inhibitor of metalloproteinases metallopeptidase inhibitor 3, and suggested that impaired pulmonary vascular growth might subsequently cause impaired alveolarisation and progression to PAH 11 12. Collectively this can block capillary vasculature growth, a mechanistic perturbation that is associated with PH in adults 12. Such inherent biological traits explain the significantly higher incidence of early PH that is clinically observed in this population of neonates.…”

Section: Ph In Dsmentioning

confidence: 99%

Pulmonary hypertension and myocardial function in infants and children with Down syndrome

et al. 2020

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Down Syndrome (DS) is the most common chromosomal abnormality of live born babies. Individuals with DS are at increased risk of cardiopulmonary morbidities in the early neonatal period, infancy and childhood that manifest with elevated pulmonary arterial pressures and altered myocardial performance. Pulmonary hypertension (PH) during the early neonatal period remains under-recognised in this population. PH may occur with or without a congenital heart defect in children with DS and is more common than in the general population. Early detection and continued screening of PH throughout infancy and childhood for these at-risk children is crucial for prompt intervention and potential prevention of long-term sequelae on cardiac function. This review summarises the main physiological concepts behind the mechanisms of PH in children with DS and provides a summary of the current available literature on PH and its impact on myocardial performance.

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“…It has been repeatedly shown that the properties of erythrocytes are impaired in various pathologies [ 9 ]. Reduced erythrocyte deformability and increased aggregation were observed in patients with PAH; in addition, erythrocyte aggregation increased with the disease progression [ 10 ]. Erythrocyte characteristics are largely dependent on the proper function of the sodium–potassium pump (Na,K-ATPase) in erythrocyte membranes.…”

Section: Introductionmentioning

confidence: 99%

Monocrotaline-Induced Pulmonary Arterial Hypertension and Bosentan Treatment in Rats: Focus on Plasma and Erythrocyte Parameters

et al. 2022

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The objective of our study was to contribute to the characterization of monocrotaline-induced pulmonary arterial hypertension (PAH) in a rat model, with emphasis on the renin–angiotensin–aldosterone system, parameters of oxidative stress, the activity of matrix metalloproteinases, and erythrocyte parameters. Moreover, we aimed to analyze the effects of bosentan. Experiments were performed on 12-week-old male Wistar rats randomly assigned to 3 groups: control, monocrotaline-treated (60 mg/kg), and monocrotaline combined with bosentan (300 mg/kg/day). Our study confirmed the well-known effects of monocrotaline administration on lungs and the right ventricle, as well as pulmonary arterial pressure. In addition, we observed activation of the alternative pathway of the renin–angiotensin system, namely an increase in angiotensin (Ang) 1–7 and Ang 1-5 together with an increase in Ang I, but without any change in Ang II level, and downregulation of aldosterone 4 weeks after monocrotaline administration. For the first time, modifications of erythrocyte Na,K-ATPase enzyme kinetics were demonstrated as well. Our observations do not support data obtained in PAH patients showing an increase in Ang II levels, increase in oxidative stress, and deterioration in RBC deformability. Although bosentan primarily targets the vascular smooth muscle, our study confirmed its antioxidant effect. The obtained data suggest that besides the known action of bosentan, it decreases heart rate and increases erythrocyte deformability, and hence could have a beneficial hemodynamic effect in the PAH condition.

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Impaired Blood Rheology in Pulmonary Arterial Hypertension

Cited by 13 publications

References 25 publications

A systematic review with meta-analysis of biomarkers for detection of pulmonary arterial hypertension

A systematic review with meta-analysis of biomarkers for detection of pulmonary arterial hypertension

Pulmonary hypertension and myocardial function in infants and children with Down syndrome

Monocrotaline-Induced Pulmonary Arterial Hypertension and Bosentan Treatment in Rats: Focus on Plasma and Erythrocyte Parameters

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