Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Foris, V.
SCREENING FOR PAH AND ANALYSIS OF PROGNOSTIC MARKERS IN PULMONARY HYPERTENSION
PhD-Studium (Doctor of Philosophy); Humanmedizin; [ Dissertation ] Graz Medical University; 2016. pp.
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- Autor*innen der Med Uni Graz:
- Foris Vasile
- Betreuer*innen:
- Olschewski Horst
- Altmetrics:
- Abstract:
- Available screening tools for pulmonary arterial hypertension (PAH) are not sufficiently sensitive and specific, hence there is an unmet need to further develop tools that may increase the number of detected PAH patients. Biomarkers may deliver important information that could be implemented in screening processes. Here we present four approaches that assess different characteristics of the disease and may serve as tools for further screening or risk stratification. First, inert gas rebreathing method was used for assessing cardiac output in patients with pulmonary hypertension (PH) undergoing right heart catheterization. The assessment of cardiac output is relatively accurate, however, the precision is poor. Therefore the method is not suitable for non-invasive assessment of changes in cardiac output during pharmacologic testing. Second, blood-derived markers were measured in different forms of PH and their relevance for diagnosis of PH was assessed. Apelin-17 and GDF-15 were identified as promising circulating serum derived biomarkers for idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Third, the level and activity of endothelial microparticles in PAH patients undergoing diagnostic or follow-up right heart catheterization was assessed. Endothelial microparticles are elevated in the circulation of PAH. Whether they play a role in the pathogenesis of PH or their elevation is a result of the disease remains to be determined. Fourth, circulating mononuclear cells and their subpopulations were investigated in PAH. The relative number of bone marrow-derived circulating CD133 positive progenitor cells was found to be elevated in PAH patients. In the lung tissue, CD133 positive cells consist of phenotypically different populations including pneumocytes type II.