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[A clinical study on the relationship between endogenous carbon monoxide and hypoxic pulmonary hypertension]
Ya Liu1, Peizong Sun, Songyun Ouyang
1Department of Respiratory Medicine, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
Objective:
To study the plasma level of endogenous carbon monoxide (CO) in patients with chronic cor pulmonale (CCP) and its relationship with endothelin-1 (ET-1) and hypoxic pulmonary hypertension (HPH).
Methods:
There were examinations on the plasma levels of endogenous CO and ET-1 in 33 patients with CCP, and their correlation with PaO(2) and the ratio of right ventricular pre-ejection period to the pulmonary flow acceleration time (RVPEP/AT), an indicator of pulmonary hypertension. Thirty healthy subjects served as normal controls.
Results:
The levels of endogenous CO, ET-1 and the ET-1/CO ratio in acute exacerbation and remission in the CCP group [CO: (1.34 +/- 0.18) mg/L, (1.07 +/- 0.14) mg/L; ET-1: (82 +/- 15) ng/L, (57 +/- 10) ng/L; ET-1/CO: 61 +/- 6, 53 +/- 5] were higher than those in the normal control group [CO: (0.55 +/- 0.12) mg/L, P < 0.001; ET-1: (27 +/- 9) ng/L, P < 0.001; ET-1/CO: 48 +/- 7, P < 0.05]. The levels of plasma endogenous CO, ET-1, and the ET-1/CO ratio in acute exacerbation were higher than those in the remission stage (P < 0.001, P < 0.001, P < 0.05). The level of endogenous CO was negatively correlated with PaO(2) (r = -0.733, P < 0.01; r = -0.672, P < 0.01) and positively correlated with RVPEP/AT (r = 0.620, P < 0.01; r = 0.557, P < 0.01). The ET-1/CO ratio was positively correlated with RVPEP/AT (r = 0.501, P < 0.01; r = 0.485, P < 0.05) in patients with acute exacerbation or in remission.
Conclusion:
The increased level of plasma endogenous CO in patients with CCP suggests the involvement of CO in the pathophysiologic process of HPH. An imbalance between ET-1 and CO may be involved in the development of HPH.