Circulating Endothelin 1 but Not Transforming Growth Factor-β Levels Are Reduced after Pulmonary Endarterectomy in Subjects Affected by Chronic Thromboembolic Pulmonary Hypertension: A Prospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
3. Statistical Analysis
4. Results
4.1. Overall Operative Data
4.2. Correlations between Preoperative ET-1 and TGF-β Levels and Hemodynamic and Clinical Parameters
4.3. Evaluation of Post-PEA Levels of ET-1 and TGF-β
4.4. Impact of ET-1 and TGF-β Levels on Long-Term Outcomes Following PEA
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall Patients Enrolled n.340 | |||
---|---|---|---|
Gender | mPAP(mmHg) | ||
Male | 145 (42.6%) | Range | 12–81 |
Female | 195 (57.3%) | Mean ± sd | 44 ± 12 |
Age (Years) | CO (L/min) | ||
Range | 18–83 | Range | 1.60–8.50 |
Mean ± sd | 61 ± 14 | Mean ± sd | 3.90 ± 1.81 |
Smoking History | PVR (dyn·s/cm5) | ||
Yes | 26 (7.6%) | PVR [Wood units] | 78–2044 [0.975–25.55] |
No | 204 (60%) | Range | 851 ± 379 |
Previous | 107 (31.4%) | Mean ± sd | [10.63 ± 4.73] |
WHO Class | |||
Weight (kg) | 73 ± 17 | II | 56 (16.5%) |
Height (m) | 1.66 ± 10 | III | 175 (51.5%) |
BSA (m2) | 1.82 ± 0.24 | IV | 109 (32%) |
History of DVT | 181 (53.2%) | Hypertension | 126 (37%) |
O2 Therapy | 158 (46.4%) | PAD | 6 (1.7%) |
COPD | 54 (15.8%) | CRF | 23 (6.7%) |
Diabetes | 17 (5%) | AF | 7 (2%) |
Intraoperative Parameters | Postoperative Parameters | ||
---|---|---|---|
ECC Time (min) | In-Hospital Mortality | 25 (7.3%) | |
Range | 115–721 | ||
Mean ± sd | 343 ± 77 | ||
Cross-Clamp Time (pts) | 23 (7%) | ICU Stay (day) | |
Range (min) | 17–86 | Range | 0–83 |
Mean ± sd (min) | 33 ± 17 | Mean ± sd | 8 ± 13 |
NF Temperature (°C) | In-Hospital Stay (day) | ||
Range | 21–30 | Range | 0–100 |
Mean ± sd | 24 ± 1 | Mean ± sd | 16 ± 12 |
CA (number of events) | Postoperative Complications | ||
Range Mean ± sd | 2–26 12 ± 4 | Arrhythmia ECMO Tracheostomy Neurological | 90 (26.4%) 14 (4.1%) 25 (7.3%) 28 (8.2%) |
CA Total Time (min) | Caval Filter | 298 (87.6%) | |
Range | 11–192 | ||
Mean ± sd | 89 ± 32 | ||
Combined Procedure | 64 (19%) |
Coefficient | p-Value | 95% CI | |
---|---|---|---|
ET-1 | 0.37 | <0.001 | 0.21–0.53 |
TGF-β | −0.05 | 0.54 | −0.21–0.11 |
Sex | −0.04 | 0.936 | −0.98–0.91 |
Value | mPAP ≤ 40 (n.125) | mPAP > 40 (n.215) | p |
ET-1 pre | 1.35 (1.00–1.72) | 1.87 (1.54–2.24) | 0.0174 |
ET-1 3 months | 1.22 (0.93–1.59) | 1.29 (1.07–1.69) | 0.5245 |
ET-1 1 year | 1.40 (1.08–1.83) | 1.28 (1.06–1.52) | 0.5084 |
Value | mPAP ≤ 40 (n.80) | mPAP > 40 (n.126) | p |
TGF-β pre | 17,794 (14,408–19,536) | 14,679 (11,061–17,398) | 0.2422 |
TGF-β 3 months | 16,182 (13,409–18,499) | 15,065 (12,958–18,269) | 0.8212 |
TGF-β 1 year | 15,736 (13,951–17,721) | 15,529 (13,500–17,394) | 0.7824 |
ET-1 | Class II (n = 56) | Class III (n = 175) | Class IV (n = 109) | |||
r | p | r | p | r | p | |
mPAP | 0.286 | 0.016 | 0.052 | 0.47 | 0.139 | 0.12 |
CO | −0.072 | 0.55 | 0.005 | 0.94 | 0.070 | 0.44 |
PVR | 0.236 | 0.048 | 0.013 | 0.85 | −0.010 | 0.91 |
TFG-β | Class II (n = 44) | Class III (n = 103) | Class IV (n = 59) | |||
r | p | r | p | r | p | |
mPAP | 0.179 | 0.2298 | 0.160 | 0.0880 | 0.130 | 0.2775 |
CO | −0.0085 | 0.5668 | 0.0066 | 0.4824 | 0.034 | 0.7765 |
PVR | 0.197 | 0.1857 | 0.074 | 0.4288 | −0.121 | 0.3117 |
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Totaro, P.; Tirelli, C.; De Amici, M.; Grosjean, F.; Testa, G.; Sacchi, L.; De Silvestri, A.; Alloni, A.; Kushta, E.; Albertini, R.; et al. Circulating Endothelin 1 but Not Transforming Growth Factor-β Levels Are Reduced after Pulmonary Endarterectomy in Subjects Affected by Chronic Thromboembolic Pulmonary Hypertension: A Prospective Cohort Study. J. Clin. Med. 2024, 13, 4977. https://doi.org/10.3390/jcm13174977
Totaro P, Tirelli C, De Amici M, Grosjean F, Testa G, Sacchi L, De Silvestri A, Alloni A, Kushta E, Albertini R, et al. Circulating Endothelin 1 but Not Transforming Growth Factor-β Levels Are Reduced after Pulmonary Endarterectomy in Subjects Affected by Chronic Thromboembolic Pulmonary Hypertension: A Prospective Cohort Study. Journal of Clinical Medicine. 2024; 13(17):4977. https://doi.org/10.3390/jcm13174977
Chicago/Turabian StyleTotaro, Pasquale, Claudio Tirelli, Mara De Amici, Fabrizio Grosjean, Giorgia Testa, Lucia Sacchi, Annalisa De Silvestri, Alessia Alloni, Eraldo Kushta, Riccardo Albertini, and et al. 2024. "Circulating Endothelin 1 but Not Transforming Growth Factor-β Levels Are Reduced after Pulmonary Endarterectomy in Subjects Affected by Chronic Thromboembolic Pulmonary Hypertension: A Prospective Cohort Study" Journal of Clinical Medicine 13, no. 17: 4977. https://doi.org/10.3390/jcm13174977