| Background and ObjectiveCongenital heart disease(CHD) can be complicated by pulmonary arterial hypertension (PAH), the reversibility of which is often difficult to predict before cardiac defect repair surgery. Research shows that there are endothelial cells impaired in irreversible PAH.We choose the patients with pulmonary artic hypertension secondary to congenital heart disease in this study,The objective of the present study is to identify noninvasive biomarkers of endothelial turnover which could be used to identify congenital heart disease patients at risk of irreversible PAH.We try to find the relationship between circulating endothelial cells(CECs) and PAH,So we will take CECs as a new noninvasive biomarker of irreversible PAH.MethodsTwenty-eight consecutive CHD patients with PAH were enrolled,all of them took peripheral blood test before cardiac defect repair surgery to calculate circulating endothelial cell number with Flow Cytometric, all patients had measurements of pulmonary artery pressure. Patients were respectively separated into 2 groups based on pulmonary artery pressure 6 months after surgery. We Compared reversible and irreversible group, controls group circulation endothelial cell count in order to check whether the three group have significant differences.ResultsEndothelial remodeling was observed in irreversible PAH but not in reversible PAH. CECs numbers were similar in the 3 types of blood samples:peripheral venous (20.8±2.1 n/ml),pulmonary arterial (21.4±1.8 n/ml) and venous blood samples (22.1±2.5 n/ml).CECs numbers were significantly higher in patients with irreversible PAH (39±3.8 n/mL) than reversible PAH (5.5±1.1 n/mL) and control subjects (4.5±1.3 n/mL).ConclusionCECs increase was associated with irreversible PAH secondary to CHD, compared with control subjects and patients with reversible PAH. CECs count in peripheral blood as a noninvasive inspection method could be helpful predict the reversibility of PAH associated with CHD. |
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