Author + information
- Muhittin Demirel,
- Ozgur Akbal,
- Aykun Hakgor,
- Fatih Yilmaz,
- Canan Elif Yildiz,
- Hacer Ceren Tokgoz Demircan,
- ibrahim Halil Tanboga,
- Sevim Turkday,
- Durmus Demir,
- Seda Tanyeri,
- Seda Tanyeri,
- Nihal Ozdemir and
- Cihangir Kaymaz
Background: Although endothelium-dependent (ED) and independent (El) flow-mediated vasodilatation (FMD) have been used as measures of systemic arterial vasodilatory reserve (SAVR) in various diseases, their clinical relevance in pulmonary hypertension (PH) remains to be determined. In this study, we aimed to assess both ED-FMD and EI-FMD in different groups of PH and investigate their relationship with clinical, echo and catheterization parameters and targeted treatment (TT) status.
Methods: Study population comprised 41 pts with confirmed PH (Female:28, age 46,3±19,6 yrs) and 17 healthy controls without detectable cardiac abnormalities or risk factors, history of alcohol consumption or smoking. Pts with idiopathic pulmonary arterial hypertension (IPAH, n=17), Eisenmenger sydrome (ES, n=17) and chronic thromboembolic PH (CTEPH, n=7) were included. Brachial artery (BA) was used for assessment of FMD with Duplex ultrasound and serial changes in diameter were recorded at baseline and 1 and 3 minutes after termination of 2-minute external occlusion for ED-FMD and after sublingual intake of glyceryl trinitrate for EI-FMD, respectively. The FMD (%) was calculated as the change from baseline divided by baseline diameter (mm) multiplied by 100. The relationship between % FMD and echo measures, invasively measured pulmonary arterial pressures (PAP), pulmonary and systemic vascular resistance (PVR, SVR), functional class (FC), six-minute walk distance (6MWD) and TT were also evaluated.
Results: Compared with controls, overall PH group showed significantly lower ED-FMD (0,65+0,21 vs 0,30+0,23 and 0,65+0,18 vs 0,24+0,21) and EI-FMD (0,67+0,15 vs 0,37+0,25 and 0,75+0,20 vs 0,32+0,24) responses at 1 and 3 min (p<0,001 for all). All ED-FMD and EI-FMD measures were comparable among IPAH, ES and CTEPH subgroups. Neither ED-FMD, nor EI-FMD were correlated with echo measures, PAP, PVR, SVR, PVR/SVR ratio, FC, 6MWD or TT status (p>0,05).
Conclusions: Our results suggest significant impairment in SAVR in pts with PH as assessed by ED-FMD and EI-FMD, regardless of the clinical group. Acute FMD may not reflect the severity of PH and can not be used as a potential surrogate for outcome in this setting.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Understanding Pulmonary Vascular Disease: From Bench to Bedside
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1181-007
- 2017 American College of Cardiology Foundation