Evaluation of inflammatory and coagulation markers in patients with idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension with comorbid hypercholesterolemia

The aim of the study was to assess inflammatory and coagulation disorders in patients with idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in dependence on dyslipidemia. Methods. The study involved 22 patients with IPAH and 6 patients with inoperable CTEPH complicated by hypercholesterolemia (total cholesterol (TC) level > 5.8 mmol/L). Healthy volunteers with normal TC level (n = 20) were included in a control group. We measured serum cytokine concentrations, such as interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, IL-12, and interferon (INF)-γ, using a multiplex fluorescent analyzer GEN-PROBE (Luminex 200) with Bio-Plex Precision Pro set. Von Willebrand factor was measured using an immunoturbidimetric assay with STA-Liatest VWF: Ag set. D-dimer, fibrinogen, C-reactive protein, and the total blood cell count were also measured. Results. CTERH patients had lower IL-2 level and more prominent signs of chronic heart failure (CHF) compared to patients with IPAH. Serum levels of IL-10, IL-4, and IL-12 were significantly related to syncope frequency, INF-γ level and cardiac index (CI). High density lipoprotein (HDL) level was inversely related to mean pulmonary arterial pressure (mPAP) in IPAH/CTEPH patients with TC > 6.5 mmol/L. Decreased thrombocyte count and decreased thrombocrit were associated with increased mPAP and mean right atrium (RA) pressure in patients with dilated right pulmonary artery. Increased D-dimer level was associated with enlarged RA area, enlarged right ventricle size, tricuspid regurgitation and decreased CI. Conclusion. Serum concentrations of the inflammatory and coagulation markers, excepting LI-2, did no differ significantly in patients with IPAH and CTEPH. Dyslipidemia was associated with activation of inflammation. Further studies are needed to estimate a predictive value of decreased HDL in patients with IPAH and CTEPH.