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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.
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.
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).
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.
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
- 2013 American College of Cardiology Foundation