Abstract
Introduction: Pulmonary hypertension (PH) is a severe, progressive condition of the small pulmonary vessels that leads to increased pulmonary vascular resistance, right ventricular failure and death. Previous studies suggest the role of VEGF (vascular endothelial growth factor) in the pathomechanism of PH by several pathways. Still, the relationship between airway VEGF and right ventricular function has not been investigated yet.
Aims: We aimed to evaluate the exhaled breath condensate (EBC), as an airway sampling technique for VEGF detection in subjects with PH and to compare EBC and plasma VEGF with the best noninvasive clinical sign of advanced disease, by measuring right ventricular longitudinal function, tricuspid anular plane systolic excursion (TAPSE).
Methods: 10 PH patients (6 IPAH, 2 CTEPH, 1 scleroderma, 1 congenital heart disease, 58±17 years, mean pulmonary pressure 58±21 mmHg), and 9 healthy controls (50±13 year) participated in the study. Plasma and EBC (Rtube, Charlotteswille, US) were collected for VEGF measurements (Quantikine ELISA kit, R&D) and echocardiography was performed to assess TAPSE.
Results: In EBC the VEGF concentration was under the limit of detection in both groups. The level of plasma VEGF was significantly higher in the patient group than in controls (130±98 pg/ml, 30±40 pg/ml, p=0,004). We found significant correlation between TAPSE and plasma VEGF level in PH patients (p=0,02, r=0,69).
Conclusion: We suggest, that decrease of VEGF with advanced PAH disease can be a result of deterioration of right ventricular contractility accompanied with decreased pulmonary flow and wall stress. However, EBC is not applicable to assess airway VEGF levels in PH patients.
- © 2011 ERS
