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SYSTEMIC INFLAMMATORY BURDEN IN DIASTOLIC HEART FAILURE-INDUCED PULMONARY HYPERTENSION COMPARED TO PULMONARY ARTERIAL HYPERTENSION
E1294 JACC March 12, 2013 Volume 61, Issue 10
Pericardial/Myocardial Disease/Pulmonary Hypertension Systemic Inflammatory Burden in Diastolic Heart Failure-Induced Pulmonary Hypertension Compared to Pulmonary Arterial Hypertension Poster Contributions Poster Sessions, Expo North Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension: Pre-Clinical, Clinical, Biomarkers Abstract Category: 27. Pulmonary Hypertension Presentation Number: 1294-142 Authors: Jason N. Salamon, Jeremy Mazurek, Muhammad Iqbal, Siddharth Wartak, Ronald Zolty, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA Background: C-reactive protein (CRP) is a robust and reproducible marker of systemic inflammation. Diastolic heart failure is associated with multiple chronic medical conditions including pulmonary hypertension (DHF-PH). DHF-PH has significant echocardiographic overlap with PAH complicating non-invasive diagnosis. We compared levels of hs-CRP in patients with both PAH and DHF-PH to assess their systemic inflammatory burden. Methods: Prior to initiation of treatment, levels of hs-CRP were measured during right heart catheterization (RHC) in consecutive patients with PAH (mPAP>25mmHg, PCWP<15mmHg, gradient dPAP-PCWP >5mmHg and transpulmonary gradient [TPG] >12mmHg) and DHF-PH (clinical symptoms of CHF, TTE parameters consistent with diastolic dysfunction, LVEF ≥50% and PASP>35mmHg on TTE, RHC mPAP>25mmHg, gradient dPAP-PCWP <5mmHg and TPG ≤12mmHg). Patients with significant valvular disease were excluded. Results: Patients with DHF-PH (I, n=27) had significantly elevated hs-CRP compared to both PAH (II, n=24) and no-PH (III, n=22). However, there was no significant difference between PAH and no-PH (figure).
Conclusions: This study is the first to measure and compare hs-CRP levels in DHF-PH and PAH and highlights the increased systemic inflammatory burden in the pathogenesis of DHF-PH compared to PAH. As both PAH and DHF-PH share many echocardiographic features making their non-invasive diagnosis difficult, hs-CRP may play a role in differentiating and diagnosing these two diseases.
Pericardial/Myocardial Disease/Pulmonary Hypertension Systemic Inflammatory Burden in Diastolic Heart Failure-Induced Pulmonary Hypertension Compared to Pulmonary Arterial Hypertension Poster Contributions Poster Sessions, Expo North Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension: Pre-Clinical, Clinical, Biomarkers Abstract Category: 27. Pulmonary Hypertension Presentation Number: 1294-142 Authors: Jason N. Salamon, Jeremy Mazurek, Muhammad Iqbal, Siddharth Wartak, Ronald Zolty, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA Background: C-reactive protein (CRP) is a robust and reproducible marker of systemic inflammation. Diastolic heart failure is associated with multiple chronic medical conditions including pulmonary hypertension (DHF-PH). DHF-PH has significant echocardiographic overlap with PAH complicating non-invasive diagnosis. We compared levels of hs-CRP in patients with both PAH and DHF-PH to assess their systemic inflammatory burden. Methods: Prior to initiation of treatment, levels of hs-CRP were measured during right heart catheterization (RHC) in consecutive patients with PAH (mPAP>25mmHg, PCWP<15mmHg, gradient dPAP-PCWP >5mmHg and transpulmonary gradient [TPG] >12mmHg) and DHF-PH (clinical symptoms of CHF, TTE parameters consistent with diastolic dysfunction, LVEF ≥50% and PASP>35mmHg on TTE, RHC mPAP>25mmHg, gradient dPAP-PCWP <5mmHg and TPG ≤12mmHg). Patients with significant valvular disease were excluded. Results: Patients with DHF-PH (I, n=27) had significantly elevated hs-CRP compared to both PAH (II, n=24) and no-PH (III, n=22). However, there was no significant difference between PAH and no-PH (figure).
Conclusions: This study is the first to measure and compare hs-CRP levels in DHF-PH and PAH and highlights the increased systemic inflammatory burden in the pathogenesis of DHF-PH compared to PAH. As both PAH and DHF-PH share many echocardiographic features making their non-invasive diagnosis difficult, hs-CRP may play a role in differentiating and diagnosing these two diseases.