scholarly journals The relationship between endothelial progenitor cells and pulmonary arterial hypertension in children with congenital heart disease

2019 ◽  
Author(s):  
Hong-Xiao Sun ◽  
Guo-Ju Li ◽  
Zhan-Hui Du ◽  
Zhen Bing ◽  
Zhi-Xian Ji ◽  
...  

Abstract Background: Pulmonary arterial hypertension (PAH) caused by congenital heart disease (CHD) is very common in clinics. Some studies have shown that PAH is related to the number of endothelial progenitor cells (EPCs), but there is no report on the relationship between PAH and the number of EPCs in children with CHD. Methods: In this study, a total of 173 cases with CHD (from 0 to 6 years old) were collected. According to the mean pulmonary arterial pressure (mPAP) measured by right heart catheterization, these cases were divided into PAH groups (including high PAH group, mPAP>25mmHg, n=32, and the middle PAH group, 20mmHg≤mPAP≤25mmHg, n=30) and non-PAH group (mPAP<20mmHg, n=111). Peripheral blood was taken for flow cytometry, and the number of EPCs (CD133+/KDR+ cells) was counted. The number of EPCs /μL of peripheral blood was calculated using the following formula: EPCs /μL =WBC /L × lymphocytes % × EPCs % × 10-6. Results: The median EPCs of the non-PAH group, middle PAH group and high PAH group is 1.86/μL, 1.30 /μL and 0.98/μL, respectively. The mPAP decreases steadily as the level of EPCs increases (P<0.05). After adjustment of gender, age and BMI, the number of EPCs was significantly associated with a decreased risk of high PAH (OR=0.37, 95% CI: 0.16-0.87, P<0.05). However, EPCs was not significantly associated with middle PAH (P>0.05). Conclusion: The findings revealed that the EPCs and high PAH in patients with CHD correlate significantly and EPCs may become an effective treatment for PAH in patients with CHD. EPCs may be a protective factor of high PAH for children with CHD.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hong-Xiao Sun ◽  
Guo-Ju Li ◽  
Zhan-Hui Du ◽  
Zhen Bing ◽  
Zhi-Xian Ji ◽  
...  

Abstract Background Pulmonary arterial hypertension (PAH) caused by congenital heart disease (CHD) is very common in clinics. Some studies have shown that PAH is related to the number of endothelial progenitor cells (EPCs), but there is no report on the relationship between PAH and the number of EPCs in children with CHD. Methods In this study, a total of 173 cases with CHD (from 0 to 6 years old) were collected. According to the mean pulmonary arterial pressure (mPAP) measured by right heart catheterization, these cases were divided into PAH groups (including high PAH group, mPAP> 25 mmHg, n = 32, and the middle PAH group, 20 mmHg ≤ mPAP≤25 mmHg, n = 30) and non-PAH group (mPAP< 20 mmHg, n = 111). Peripheral blood was taken for flow cytometry, and the number of EPCs (CD133+/KDR+ cells) was counted. The number of EPCs /μL of peripheral blood was calculated using the following formula: EPCs /μL = WBC /L × lymphocytes % × EPCs % × 10− 6. Results The median EPCs of the non-PAH group, middle PAH group and high PAH group is 1.86/μL, 1.30 /μL and 0.98/μL, respectively. The mPAP decreases steadily as the level of EPCs increases (P < 0.05). After adjustment of gender, age and BMI, the number of EPCs was significantly associated with a decreased risk of high PAH (OR = 0.37, 95% CI: 0.16–0.87, P < 0.05). However, EPCs was not significantly associated with middle PAH (P > 0.05). Conclusion The findings revealed that the EPCs and high PAH in patients with CHD correlate significantly and EPCs may become an effective treatment for PAH in patients with CHD. EPCs may be a protective factor of high PAH for children with CHD.


2019 ◽  
Author(s):  
Hong-Xiao Sun ◽  
Guo-Ju Li ◽  
Zhan-Hui Du ◽  
Zhen Bing ◽  
Zhi-Xian Ji ◽  
...  

Abstract Background: Pulmonary arterial hypertension (PAH) caused by congenital heart disease (CHD) is very common in clinical. Some studies have shown that PAH is related to the number of endothelial progenitor cells (EPCs), but there is no report on the relationship between PAH and the number of EPCs in children with CHD. Methods: In this study, a total of 173 cases with CHD (from 0 to 6 years old) were collected. According to the mean pulmonary arterial pressure (mPAP) measured by right heart catheterization, these cases were divided into PAH groups (including high PAH group, mPAP>25mmHg, n=32, and the middle PAH group, 20mmHg≤mPAP≤25mmHg, n=30) and non-PAH group (mPAP<20mmHg, n=111). Peripheral blood was taken for flow cytometry, and the number of EPCs(CD133+/KDR+ cells) was counted. The number of EPCs /μL of peripheral blood was calculated using the following formula: EPCs /μL =WBC /L × lymphocytes % × EPCs % × 10-6. Results: The median EPCs of the non-PAH group, middle PAH group and high PAH group is 1.86/μL, 1.30 /μL and 0.98/μL, respectively. The mPAP decreases steadily as the level of EPCs increases (P<0.05). After adjustment of gender, age and BMI, the number of EPCs was significantly associated with a decreased risk of high PAH (OR=0.37, 95% CI: 0.16-0.87, P<0.05). However, EPCs was not significantly associated with middle PAH (P>0.05). Conclusion: The findings revealed that the EPCs and high PAH in patients with CHD correlate significantly and EPCs may become an effective treatment for PAH in patients with CHD. EPCs may be a protective factor of high PAH for children with CHD


2019 ◽  
Author(s):  
Hong-Xiao Sun ◽  
Guo-Ju Li ◽  
Zhan-Hui Du ◽  
Zhen Bing ◽  
Zhi-Xian Ji ◽  
...  

Abstract Background: To assess the relationship between endothelial progenitor cells (EPCs) in peripheral blood and pulmonary hypertension (PH) in children with congenital heart disease (CHD) and explore the possibility of applying EPCs to treatment of PH in children with CHD. Methods: In this study, a total of 173 cases with CHD (from 0 to 6 years old) were collected. According to the right heart catheterization of mean pulmonary arterial pressure (mPAP) results, these cases were divided into PH groups (including high PH group, n=32, and the middle PH group, n=30) and non-PH group (n=111). We took their peripheral blood for flow cytometry, and counted the number of EPCs(CD133+/KDR+ cells). The number of EPCs /μL of peripheral blood was calculated using the following formula: EPCs /μL =WBC /L × lymphocytes % × EPCs % × 10-6. Results: The median EPCs of the non-PH group, middle PH group and high PH group are 1.86/μL, 1.30 /μL and 0.98/μL, respectively. The mPAP decreases steadily as the level of EPCs increases (P<0.05). After adjustment of gender, age and BMI, the EPCs was significantly associated with a decreased risk of high PH (OR=0.37, 95%CI: 0.16-0.87, P<0.05). However, EPCs was not significantly associated with middle PH (P>0.05). Conclusion: The findings revealed that the EPCs and high PH in CHD patients correlate significantly and EPCs may become an effective treatment for PH in CHD patients.EPCs may be a protective factor of high PH for children with CHD.


2007 ◽  
Vol 6 (3) ◽  
pp. 121-125 ◽  
Author(s):  
Ingram Schulze-Neick ◽  
John E. Deanfield

Adults with congenital heart disease (CHD) have become a rapidly expanding group of complex patients requiring multidisciplinary care in specialty centers by those trained in CHD. They represent one of the most challenging subgroups of patients with pulmonary arterial hypertension (PAH) due to the presence of structural heart disease with or without coexisting cyanosis and its complications. The primary focus of attention for these patients is the lungs, whose vascular system is affected by shunt flow, or is also congenitally malformed, or has been altered by surgical procedures. When PAH develops, it affects physical exercise tolerance, travel to high altitudes, pregnancy, operability, and anesthesia (myocardial failure due to pulmonary hypertensive crisis), and thus general morbidity and mortality in this special patient group.


2020 ◽  
Vol 4 (S1) ◽  
Author(s):  
Nathalie Liew ◽  
Zoya Rashid ◽  
Robert Tulloh

Abstract Background Pulmonary hypertension (PH) is commonly seen in adults who have congenital heart disease (CHD). Therapy is available for pulmonary arterial hypertension (PAH) and has greatly benefitted many patients with PAH related to CHD (PAH-CHD) over the last 15 years, with evidence of improved quality of life and prognosis in those with Eisenmenger syndrome and repaired PAH-CHD. In this review, we describe the standard management and advanced therapies for PAH, which are available in specialist PH centres around the UK and Ireland, and how these are used in PAH-CHD. Decisions around the choice of therapy are governed by commissioning and available evidence. Conclusion We explain the different pathways for action and the variety of medications now at our disposal to help this important group of patients.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoqiang Yin ◽  
Mei Xin ◽  
Sheng Ding ◽  
Feng Gao ◽  
Fan Wu ◽  
...  

Abstract Background We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. Methods A retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected. Results We found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05). Conclusion For patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.


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