Abstract:
Background: Pulmonary arterial hypertension secondary to untreated
left-to-right shunt defects leads to increased pulmonary blood
flow, endothelial dysfunction, increased pulmonary vascular resistance,
vascular remodelling, neointimal and plexiform lesions. Some
recent studies have shown that inflammation has an important role in
the pathophysiology of pulmonary arterial hypertension.
Aims: The aim of this study is to evaluate serum pentraxin 3 and high
sensitive (hs)-C reactive protein (hs-CRP) levels in children with severe
pulmonary arterial hypertension (PAH) secondary to untreated
congenital heart defects and evaluate the role of inflammation in pulmonary
hypertension.
Study Design: Cross sectional study.
Methods: After ethics committee approval and receiving consent
from parents, there were 31 children were selected for the study
with severe PAH, mostly with a left-to-right shunt, who had been
assessed by cardiac catheterisation and were taking specific pulmonary
vasodilators. The control group consisted of 39 age and gender
matched healthy children. After recording data about all the patients
including age, gender, weight, haemodynamic studies and vasodilator
testing, a physical examination was done for all subjects. Blood
was taken from patients and the control group using peripheral veins
to analyse serum Pentraxin 3, N-terminal pro-Brain Natriuretic Peptide
(NT-ProBNP) and hs-CRP levels. Serum Pentraxin-3 levels were
measured by enzyme linked immunosorbent assay (ELISA) and
expressed as ng/mL. Serum hs-CRP levels were measured with an
immunonephelometric method and expressed as mg/dL. The serum
concentration of NT-proBNP was determined by a chemiluminescent
immunumetric assay and expressed as pg/mL.
Results: Serum Pentraxin- 3 levels were determined to be 1.28±2.12
(0.12-11.43) in the PAH group (group 1) and 0.40±0.72 (0.07-3.45)
in group 2. There was a statistically significant difference between
the two groups (p<0.01). Serum hs-CRP levels were measured as
2.92±2.12 (0.32-14.7) mg/dL in group 1 and 0.35±0.16 (0.07-3.45)
mg/dL in group 2. The hs-CRP level was increased in the PAH group
to a significant degree (p<0.01).
Conclusion: Our study showed that pentraxin 3 and hs-CRP levels
were increased significantly in the PAH group. We consider that inflammation
plays an important role in severe pulmonary hypertension
and progressive pulmonary arterial hypertension in children
with PAH.
