Plasma endothelin-1 and thrombomodulin : correlation with extent of pulmonary hypertension in patients with chronic hypoxic pulmonary disease

الملخص EN

Endothelia is a family of potent vasoconstrictor peptides of vascular endothelial origin, although it has been proposed that the vasoconstrictor effects of endothelin are produced at the local vascular level, increased plasma concentration of endotheline has been identified in cardiovascular disorders The level of the immunoreactive endotheline -l, [a potent endothelial-vasoconstrictor present in pulmonary hypertension (PH), was assayed by measuring its Concentration in plasma and correlates its level with the level of partial pressure of oxygen (PaO) ,and echo parameters of pulmonary hypertension Vie study included forty-seven pulmonary hypertensive patterns secondary to chronic hypoxia due to chronic obstructive pulmonary diseases (COPD) and interstitial pulmonary fibrosis flPF).

They were admitted to chest department.

Assiut University Hospital.

?;."jU-d in the mcrmng afler cm overnight fast h-Jbre n;edt> at :on j>nl after termination of treatment.

The endo'-helin-! level Ml 1.45'0 32 pgml, which was increased compared with normal controls (0.5^0.02), the difference was statistically significant (P<0.0S).

Endothelium! significantly correlated with pulmonary pressure and its degree of severity (r ~ 0.4?I, p < 0.01/ especially among chronic obstructive pulmonary disease patients.

There was significant reduction in the level ofendothelin I after long term oxygen therapy, whereas, the I'evet of endotheiiin-1 did not correlate with the level of PaO.

either before or after oxygen therapy.

Plasma thrombomodulin level was measured to study its pathophysiological significance in pulmonary hypertension secondary to hypoxia Patients with pulmonary hypertension had higher concentrations of thrombomodulin (J5.25 +1.5) than age matched normal controls (4.H±0.S ng/raL P< 0.00/).

There was a significant reduction in thrombomodulin after oxygen therapy Plasma concentrations of thrombomodulin were significantly correlated with time to peak velocity (TPV) as a strong echo parameter of pulmonary hypertension and Its severity, in mild PH thrombomodulin level recorded was 10.40+0.56 ng'mL versus I'5.82+3.08 ng/ml.

among patients with severe pulmonary hypertension.

Moreover, thrombomodulin correlates with Pa02 after oxygen therapy especially with patients of IFF (r - 0.749 p < 0.001).