1. Cyclophilin A as a biomarker for the therapeutic effect of balloon angioplasty in chronic thromboembolic pulmonary hypertension
- Author
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Masanobu Miura, Tatsuo Aoki, Nobuhiro Yaoita, Taijyu Satoh, Koichiro Sugimura, Katsuya Kozu, Saori Yamamoto, Hideaki Suzuki, Kotaro Nochioka, Yosuke Terui, Kimio Satoh, Ryo Konno, Toru Shimizu, Haruka Sato, Hiroaki Shimokawa, Satoshi Miyata, Nobuhiro Kikuchi, and Shunsuke Tatebe
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,Hypertension, Pulmonary ,medicine.medical_treatment ,Hemodynamics ,Cypa ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Angioplasty ,medicine ,Natriuretic peptide ,Humans ,030212 general & internal medicine ,Aged ,biology ,business.industry ,Venous Thromboembolism ,Middle Aged ,Hypoxia (medical) ,Brain natriuretic peptide ,medicine.disease ,biology.organism_classification ,Treatment Outcome ,Heart failure ,Chronic Disease ,Cardiology ,Biomarker (medicine) ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Cyclophilin A ,Angioplasty, Balloon ,Biomarkers - Abstract
Although cardiac troponin and natriuretic peptide have been shown to decrease after balloon pulmonary angioplasty (BPA) with improved right ventricular afterload in chronic thromboembolic pulmonary hypertension (CTEPH), biomarkers to evaluate the effects of BPA independently of heart failure status remain to be developed.In 39 consecutive CTEPH patients including 31 who underwent BPA, we measured plasma levels of cyclophilin A (CyPA), which we demonstrated is secreted from pulmonary vascular smooth muscle cells in response to mechanical stretch and hypoxia.CyPA levels were elevated in CTEPH patients (12.7, IQR: 7.6-16.0) compared with 8 thromboembolic controls with a history of venous thromboembolism (4.9, IQR: 2.4-11.2) or 18 healthy controls (4.1, IQR: 2.4-6.8) (both p0.05) and were linearly correlated with mean pulmonary arterial pressure (r=0.50, p = 0.0003) and pulmonary vascular resistance (r=0.32, p= 0.026). BPA reduced CyPA levels and tended to lower brain-type natriuretic peptide (BNP) levels (p0.01 and p = 0.07). When comparing the changes in CyPA before and after BPA in the two subgroups with higher (≥35pg/mL) and normal (35pg/mL) BNP at baseline, CyPA decreased both in patients with higher BNP and those with normal BNP (both p0.05). In contrast, BNP decreased only in patients with higher BNP (p0.05). Also, CyPA decreased both in patients with lower (25 kg/mCyPA could be a useful biomarker to evaluate the effects of BPA even in patients with normal BNP or high BMI.
- Published
- 2020
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