Abstract
Background and Objectives
Despite the similar degree of pressure or volume overloading, the development of secondary pulmonary hypertension (PH) shows diverse variability among individual patients.
Subjects and Methods
Using microarray technology, we compared the gene expression pattern of the lung tissues in 13 patients with secondary PH due to congenital shunt (pulmonary arterial hypertension, PAH, n=6) or valvular heart disease (pulmonary venous hypertension, PVH, n=7) with 5 normal subjects.
Results
As compared to the normal controls, secondary PH showed a decreased expression of genes encoding transcriptional factors (BHLHB2, EGR3, JUNB, KLF4, KLF6 and MAFF), cytoskeleton protein (VIL2 and XLKD1) and cell differentiation and viability (MCL1, SNF1LK and TNFAIP3). PVH showed an increased expression of genes encoding proliferation of pulmonary capillary endothelial cells (ESM1), cell proliferation (IGFBP2 and BMP6), collagen synthesis (COL4A2 and SERPINH1), and cytoskeleton (TMSL8) as compared with the normal controls. In patients with secondary PH, PVH showed an up-regulated expression of proliferation of pulmonary capillary endothelial cells (ESM1), cell proliferation (EGR2, PLK2 and TNC) and collagen synthesis (COL4A1), and an down-regulated expression of inflammation (IL1RL1, IL7R, CCL5, CCL19, CXCR 6 and XCL1/XCL2) and immune response (IGHM and TRA@; TRAC), as compared with PAH.
Figures and Tables
Table 1
*Wagenvoort and Wagenvoort classification. TR Vmax: tricuspid regurgitation jet peak velocity, PGTR: peak pressure gradient of tricuspid regurgitation, PAP: pulmonary artery pressure, PVR: pulmonary vascular resistance, PCWP: pulmonary capillary wedge pressure, Modified HE grade: modified Heath-Edwards grade, VSD: ventricular septal defect, ASD: atrial septal defect, MR: mitral regurgitation, MS: mitral stenosis, AR: aortic regurgitation, AS: aortic stenosis, NA: not available, S: systolic, D: diastolic, M: mean, ASR: aortic steno-regurgitation
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