Elevated Levels of Circulating Bone Morphogenetic Protein 7 Predict Mortality in Pulmonary Arterial Hypertension
Elevated Levels of Circulating Bone Morphogenetic Protein 7 Predict Mortality in Pulmonary Arterial Hypertension
复制标题
循环骨形态发生蛋白 7 水平升高可预测肺动脉高压患者的死亡率
DOI：
10.1016/j.chest.2016.03.007
复制
发表时间：
2016-08-01
期刊：
影响因子：
9.6
通讯作者：
Jing, Zhi-Cheng
中科院分区：
文献类型：
--
作者：
Liu, Dong;Wu, Bing-Xiang;Jing, Zhi-Cheng
背景：本研究旨在显示循环骨形态发生蛋白（BMPs）水平是否与肺动脉高压（PAH）患者死亡风险增加相关。方法：156例PAH患者纳入研究，其中43例为遗传性PAH (HPAH)， 113例为特发性PAH （IPAH）。采用ELISA法测定了43例HPAH患者（n = 43）、113例IPAH患者（n = 113）和51例对照患者的血浆样本的循环BMPs。根据不同的BMP水平比较基线和长期生存期的临床特征。结果：HPAH患者BMP7浓度显著高于IPAH患者和对照组(分别为20.1[四分位间距（IQR）， 9.4, 55.2] vs 6.5 [IQR, 3.5, 11.7]和2.5 [IQR, 0.9, 6.6] pg/mL；P < 0.001)。调整性别、6分钟步行距离、平均右心房压、平均肺动脉压、肺血管阻力和心输出量后，血浆BMP7升高与较高的死亡风险相关（HR, 1.904; 95% CI, 1.021-3.551; P = 0.043）。BMP7水平为> 7.85 pg/mL的IPAH患者死亡风险高于BMP7浓度较低的患者（P = 0.042， log-rank检验）。结论：循环BMP7水平与PAH患者的死亡率相关，并且可能是hah和IPAH患者疾病的预测因子。
BACKGROUND: This study aimed to show whether circulating bone morphogenetic proteins (BMPs) levels are associated with increased risk of mortality in patients with pulmonary arterial hypertension (PAH).METHODS: A total of 156 patients with PAH including 43 with heritable PAH (HPAH) and 113 with idiopathic PAH (IPAH) diagnosed by gene screening were enrolled in the study. Circulating BMPs were measured by ELISA in plasma samples from patients with HPAH (n = 43) and IPAH (n = 113) and from control subjects (n = 51). Clinical characteristics at baseline and long-term survival were compared according to the different BMP levels.RESULTS: Patients with HPAH had significantly higher BMP7 concentrations than patients with IPAH and control subjects (20.1 [interquartile range (IQR), 9.4, 55.2] vs 6.5 [IQR, 3.5, 11.7] and 2.5 [IQR, 0.9, 6.6] pg/mL, respectively; P < .001). Elevated plasma BMP7 were associated with a higher risk of mortality after adjustment for sex, 6-minute walk distance, mean right atrial pressure, mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac output (HR, 1.904; 95% CI, 1.021-3.551; P = .043). Patients with IPAH with a BMP7 level > 7.85 pg/mL had a higher risk of mortality than those with a low BMP7 concentration (P = .042, log-rank test).CONCLUSIONS: Levels of circulating BMP7 correlate with mortality in PAH, and may be a predictor of disease in patients with HPAH and IPAH.