04 February 2019

Systemic circulation arteries structure and function in patients with idiopathic pulmonary arterial hypertension.

The aim of the research was to study the elastic properties of systemic circulation arteries in patients with idiopathic pulmonary arterial hypertension (IPAH).

The study included 77 patients: 45 of them were diagnosed with IPAH (1st group), 32 patients with arterial hypertension (AH) (2nd group).

Level of cardio-ankle vascular index (CAVI) dimension on the both sides was the same in patients with IPAH and AH patients (right 7,41±0,20 vs 7,33±0,19, NS and left 7,52±0,20 vs 7,14±0,15, NS), that which indicates an infraction changes abnormalities of the elastic properties of systemic circulation arteries in patients with IPAH.

In our research, patients with IPAH with impaired functionality (6MWD < 330m) had a significantly higher NT-proBNP, right atrium size index and pressure, estimated by right heart catheterization, a significantly lower TAPSE and SvO2. CAVI index in this group was also significantly higher than in patients with preserved functionality (6 MWD > 330 m) (right 8,18±0,27 vs 7,02±0,23, p<0,05 and left 8,43±0,30 vs 7,07±0,21, p<0,05).

During 3 years of follow-up 10 patients (22,2%) with IPAH had died. They formed the first subgroup. The second subgroup was formed by 35 patients (78,8%) with IPAH who survived. In first subgroup NT-proBNP level 23 times exceeded the normal range and it was 4 times higher in comparison with the second subgroup. In first subgroup on 6 MWD patients covered distanse on 87 metres less than in survival group. These data indicate a significant functionality impairment in patients with favorable prognosis. The analysis of CAVI examinations showed that its level in first group was significantly higher compared with the results of the second subgroup (right 8,60±0,42 vs 7,01±0,20, p<0,05 and left 8,53±0,46 vs 7,03±0,17, p<0,05).

Thus, CAVI can be used as an indicator of systemic circulation arteries stiffness and may be considered an additional risk factor of complications in patients with IPAH.

 

Key Contributors

Sirenko Yu. M. , Zhyvylo I. O : 'National Scientific Center ' Institute of Cardiology named after academician M.D. Strazhesko of the National Academy of Medical Sciences of Ukraine, Kiev. .


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