Elevated plasma Pim-1 and its clinical significance in patients with pulmonary arterial hypertension
Elevated plasma Pim-1 and its clinical significance in patients with pulmonary arterial hypertension
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肺动脉高压患者血浆Pim-1升高及其临床意义
DOI：
10.1111/1440-1681.13102
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发表时间：
2019
影响因子：
2.9
通讯作者：
Li Jiang
中科院分区：
文献类型：
--
作者：
Zhu Tengteng;Luo Jun;Wang Yi;Xiong Xianliang;Sheng Bin;Yang Xiaojie;Ndongala Nsusu A Mpembe Tresor;Li Jiang
本研究旨在测定肺动脉高压（PAH）患者血浆Pim‐1水平，并评估Pim‐1作为PAH生物标志物的临床价值。这是一项单中心回顾性研究，纳入了111例先天性心脏病（CHD）和特发性肺动脉高压（IPAH）患者。这些冠心病患者被分为两组：PAH合并冠心病（PAH‐CHD）和无PAH的冠心病（nPAH‐CHD）。采用酶联免疫吸附法测定血浆Pim - 1水平。(a)与健康对照组相比，PAH‐CHD和IPAH患者血浆Pim‐1水平显著升高（27.81±11.34 ng/mL vs 13.02±5.30 ng/mL; 32.81±12.28 ng/mL vs 13.02±5.30 ng/mL，P<0.05）， nPAH‐CHD患者血浆Pim‐1水平显著升高（27.81±11.34 ng/mL vs 17.33±7.99 ng/mL; 32.81±12.28 ng/mL vs 17.33±7.99 ng/mL，P<0.05）。与轻至中度PAH‐CHD患者相比，重度PAH‐CHD患者Pim‐1水平显著升高（19.12±6.70 ng/mL vs 8.54±3.71 ng/mL，P< 0.05）。(b) Pim‐1水平与平均肺动脉压（mPAP）和肺血管阻力（PVR）呈正相关（r= 0.582, 0.516， P分别< 0.001），而与三尖瓣环平面收缩偏移（TAPSE）、三尖瓣环平面收缩速度（S’）和右心室分数面积变化（RVFAC）呈负相关（r= - 0.375, - 0.354, - 0.507， P分别< 0.05）。(c)血浆Pim‐1检测PAH‐CHD和重度PAH‐CHD的临界值分别为16.8 ng/mL （P< 0.001）和20.53 ng/mL (P< 0.001)，敏感性为87.3%，特异性为52%。PAH - CHD和IPAH患者血浆Pim - 1水平明显升高。血浆Pim‐1可能是PAH患者的有效生物标志物。
This study was aimed to determine plasma Pim‐1 levels in patients with pulmonary arterial hypertension (PAH) and to estimate the clinical value of Pim‐1 as a biomarker of PAH. This was a single‐centre retrospective study in 111 patients with congenital heart disease (CHD) and idiopathic PAH (IPAH). Those CHD patients were divided into two groups: PAH associated with CHD (PAH‐CHD) and CHD without PAH (nPAH‐CHD). Plasma Pim‐1 levels were measured by enzyme‐linked immunosorbent assay. (a) Plasma Pim‐1 levels were significantly increased in patients with PAH‐CHD and IPAH compared with the healthy control group (27.81 ± 11.34 ng/mL vs 13.02 ± 5.30 ng/mL; 32.81 ± 12.28 ng/mL vs 13.02 ± 5.30 ng/mL,P<0.05) and nPAH‐CHD (27.81 ± 11.34 ng/mL vs 17.33 ± 7.99 ng/mL; 32.81 ± 12.28 ng/mL vs 17.33 ± 7.99 ng/mL,P< 0.05). Pim‐1 levels were substantially increased in patients with severe PAH‐CHD compared with mild‐to‐moderate PAH‐CHD (19.12 ± 6.70 ng/mL vs 8.54 ± 3.71 ng/mL,P< 0.05). (b) Pim‐1 levels were correlated positively with the mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) (r= 0.582, 0.516;P< 0.001, respectively), while negatively with tricuspid annular plane systolic excursion (TAPSE), tricuspid annular plane systolic velocity (S’) and right ventricular fractional area changes (RVFAC) (r= −0.375, −0.354, −0.507;P< 0.05, respectively). (c) PAH‐CHD and severe PAH‐CHD was identified by plasma Pim‐1 with a cutoff value of 16.8 ng/mL (P< 0.001) with a sensitivity of 87.3% and a specificity of 65%, and a cutoff value of 20.53 ng/mL (P< 0.001) with a sensitivity of 87.3% and a specificity of 52%, respectively. Plasma Pim‐1 levels were significantly higher in patients with PAH‐CHD and IPAH. Plasma Pim‐1 may represent an effectively biomarker in patients with PAH.