Increased Serum Levels of Fetal Tenascin-C Variants in Patients with Pulmonary Hypertension: Novel Biomarkers Reflecting Vascular Remodeling and Right Ventricular Dysfunction?
Abstract
:1. Introduction
2. Results
2.1. Baseline Characteristics
2.2. Serum Levels of B+ and C+ Tn-C
2.3. Correlation of Tn-C Serum Levels with Echocardiographic Parameters
2.4. Correlation of Tn-C Serum Levels with BNP
2.5. Correlation of Tn-C Serum Concentrations with the 6-Minute Walk Distance
2.6. Impact of Clinical Parameters on Tn-C Serum Levels
3. Discussion
4. Material and Methods
4.1. Patients
4.2. Quantification of Serum Tn-C Levels and Standard Laboratory Values
4.3. Investigation of Echocardiographic Parameters and 6-Minute Walk Test
4.4. Statistical Analysis
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
ACE | Angiotensin-converting enzyme |
ASA | Acetyl-salicylic acid |
BMI | Body mass index |
BNP | Brain natriuretic peptide |
CAD | Coronary artery disease |
CKD | Chronic kidney disease |
CRP | C-reactive protein |
ECM | Extracellular matrix |
IVSDd | Intraventricular septum diameter in diastole |
LDL | Low-density lipoprotein |
LV-EF | Left ventricular ejection fraction |
PH | Pulmonary hypertension |
PAH | Pulmonary arterial hypertension |
PAP | Pulmonary arterial pressure |
RA | Right atrium |
RV | Right ventricle |
TAPSE | Tricuspid annular plane systolic excursion |
TDI | Tissue doppler imaging |
Tn-C | Tenascin C |
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Clinical Parameter | Control Persons (n = 40) | PH Patients (n = 80) | p-Value |
---|---|---|---|
Age (years) | 66 ± 7 | 70 ± 13 | n.s. |
BMI (kg/m2) | 27.9 ± 4.7 | 28.6 ± 6.0 | n.s. |
Gender, male (%) | 33 | 39 | n.s. |
Systolic BP (mmHg) | 146 ± 33 | 146 ± 33 | n.s. |
Diastolic BP (mmHg) | 81 ± 17 | 78 ± 13 | n.s. |
Functional class | 1.5 ± 0.6 | 2.6 ± 0.8 | <0.001 |
Laboratory: | |||
BNP (pg/mL) | 56 ± 70 | 445 ± 584 | <0.001 |
CRP (mg/L) | 2.7 ± 2.6 | 11.7 ± 17.5 | 0.002 |
Creatinine (μmol/l) | 76 ± 16 | 111 ± 50 | <0.001 |
LDL (mmol/l) | 3.6 ± 1.0 | 2.7 ± 1.0 | <0.001 |
Haemoglobin (mmol/l) | 8.7 ± 0.8 | 7.9 ± 1.3 | <0.001 |
Leukocytes (Gpt/l) | 7.1 ± 1.4 | 7.5 ± 2.2 | n.s. |
Co-Morbidities: | |||
Hypertension (%) | 95 | 83 | 0.03 |
Hyperlipidemia (%) | 88 | 56 | <0.001 |
Obesity (%) (BMI>30 kg/m2) | 42 | 38 | n.s. |
CAD (%) | 0 | 26 | <0.001 |
CKD (%) (GFR < 50 mL/min) | 8 | 50 | <0.001 |
Diabetes (%) | 20 | 50 | 0.002 |
Smoking (%) | 29 | 52 | 0.027 |
Medication: | |||
ASA (%) | 25 | 18 | n.s. |
Beta blocker (%) | 63 | 60 | n.s. |
ACE Inhibitor/Sartans (%) | 85 | 78 | n.s. |
Statins (%) | 38 | 59 | 0.026 |
Prednisolon (%) | 0 | 11 | 0.027 |
ICS (%) | 0 | 21 | 0.002 |
Characteristics | Control (n = 40) | PH Class I (n = 13) | PH Class II (n = 30) | PH Class III (n = 11) | PH Class IV (n = 12) | PH Class II & III (n = 14) | p-Value between Different PH-Classes |
---|---|---|---|---|---|---|---|
Age (years) | 66.0 ± 6.8 | 64.5 ± 11.5 | 75.1 ± 8.1 | 58.5 ± 22.3 | 69.8 ± 11.5 | 74.9 ± 7.9 | <0.001 |
BMI (kg/m2) | 28.0 ± 4.7 | 29.0 ± 8.4 | 27.9 ± 3.9 | 25.9 ± 7.5 | 30.6 ± 5.2 | 29.9 ± 6.5 | n.s. |
Functional class | 1.5 ± 0.6 | 2.6 ± 0.8 | 2.6 ± 0.7 | 2.4 ± 1.1 | 2.3 ± 0.7 | 2.8 ± 0.7 | n.s. |
Laboratory: | |||||||
BNP (pg/mL) | 56 ± 70 | 113 ± 82 | 635 ± 678 | 469 ± 469 | 111 ± 87 | 627 ± 731 | 0.021 |
CRP (mg/L) | 2.7 ± 2.6 | 7.8 ± 10.7 | 13.8 ± 21.0 | 10.5 ± 12.9 | 5.2 ± 5.8 | 16.1 ± 22.0 | n.s. |
Creatinine (μmol/L) | 76 ± 16 | 88 ± 44 | 127 ± 59 | 93 ± 24 | 99 ± 40 | 121 ± 47 | n.s. |
LDL (mmol/L) | 3.6 ± 1.0 | 2.5 ± 1.0 | 2.5 ± 1.0 | 3.0 ± 1.0 | 3.0 ± 0.9 | 2.7 ± 1.2 | n.s. |
Haemoglobin (mmol/L) | 8.7 ± 0.8 | 7.7 ± 1.5 | 7.5 ± 1.2 | 8.5 ± 1.0 | 8.9 ± 1.4 | 7.6 ± 1.6 | 0.012 |
Leukocytes (Gpt/L) | 7.1 ± 1.4 | 6.7 ± 2.4 | 7.6 ± 1.7 | 8.3 ± 1.5 | 7.4 ± 1.8 | 7.7 ± 3.4 | n.s. |
Parameter | Control (n = 40) | PH Class I (n = 13) | PH Class II (n = 30) | PH Class III (n = 11) | PH Class IV (n = 12) | PH Class II & III (n = 14) |
---|---|---|---|---|---|---|
LV-EF (%) | 68 ± 7 | 63 ± 7 | 56 ± 13 | 63 ± 9 | 60 ± 6 | 52 ± 12 |
IVSDd (mm) | 12 ± 2 | 12 ± 3 | 13 ± 3 | 13 ± 2 | 11 ± 2 | 12 ± 2 |
RVd basal (mm) | 35 ± 2 | 41 ± 9 | 46 ± 7 | 47 ± 10 | 44 ± 7 | 49 ± 9 |
TAPSE (mm) | 25 ± 2 | 22 ± 5 | 15 ± 3 | 19 ± 7 | 18 ± 3 | 16 ± 4 |
TDI-S’ (RV) (cm/s) | 14 ± 2 | 12 ± 1 | 8 ± 1 | 9 ± 0 | 11 ± 1 | 9 ± 2 |
RA area (cm2) | 15.4 ± 2.3 | 20.8 ± 8.3 | 27.9 ± 9.6 | 19.7 ± 8.8 | 22.2 ± 5.2 | 31.0 ± 13.7 |
PAP sys (mmHg) | 21 ± 4 | 59 ± 22 | 52 ± 16 | 57 ± 22 | 50 ± 20 | 56 ± 16 |
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Share and Cite
Rohm, I.; Grün, K.; Müller, L.M.; Kretzschmar, D.; Fritzenwanger, M.; Yilmaz, A.; Lauten, A.; Jung, C.; Schulze, P.C.; Berndt, A.; et al. Increased Serum Levels of Fetal Tenascin-C Variants in Patients with Pulmonary Hypertension: Novel Biomarkers Reflecting Vascular Remodeling and Right Ventricular Dysfunction? Int. J. Mol. Sci. 2017, 18, 2371. https://doi.org/10.3390/ijms18112371
Rohm I, Grün K, Müller LM, Kretzschmar D, Fritzenwanger M, Yilmaz A, Lauten A, Jung C, Schulze PC, Berndt A, et al. Increased Serum Levels of Fetal Tenascin-C Variants in Patients with Pulmonary Hypertension: Novel Biomarkers Reflecting Vascular Remodeling and Right Ventricular Dysfunction? International Journal of Molecular Sciences. 2017; 18(11):2371. https://doi.org/10.3390/ijms18112371
Chicago/Turabian StyleRohm, Ilonka, Katja Grün, Linda Marleen Müller, Daniel Kretzschmar, Michael Fritzenwanger, Atilla Yilmaz, Alexander Lauten, Christian Jung, P. Christian Schulze, Alexander Berndt, and et al. 2017. "Increased Serum Levels of Fetal Tenascin-C Variants in Patients with Pulmonary Hypertension: Novel Biomarkers Reflecting Vascular Remodeling and Right Ventricular Dysfunction?" International Journal of Molecular Sciences 18, no. 11: 2371. https://doi.org/10.3390/ijms18112371