Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T01:29:23.008Z Has data issue: false hasContentIssue false

Diagnostic and predictive values of plasma connective tissue growth factor in children with pulmonary hypertension associated with CHD

Published online by Cambridge University Press:  31 March 2020

Eslam Hella
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University Hospital, Egypt
Doaa El Amrousy*
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University Hospital, Egypt
Hesham El-Serogy
Affiliation:
Clinical Pathology Department, Faculty of Medicine, Tanta University Hospital, Egypt
Amr Zoair
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University Hospital, Egypt
*
Author for correspondence: Prof. Doaa El Amrousy, Pediatric Department, Tanta University Hospital, Tanta, El Motasem Street No 6, Egypt. Tel: +20 1278155283; Fax: +20 403280477. E-mail: [email protected]

Abstract

Objective:

To evaluate the diagnostic and predictive values of plasma connective tissue growth factor in children with pulmonary hypertension (PH)-related CHD.

Patients and methods:

Forty patients with PH-related CHD were enrolled as group I, and 40 patients with CHD and no PH served as group II. Forty healthy children of matched age and sex served as a control group. Echocardiographic examinations and plasma connective tissue growth factor levels were performed for all included children. Cardiac catheterisation was performed for children with CHD only.

Results:

Plasma connective tissue growth factor levels were significantly higher in children with PH-related CHD compared to CHD-only patients and to control group and this elevation went with the severity of PH. There was a significant positive correlation between connective tissue growth factor levels and mean pulmonary pressure, pulmonary vascular resistance, and right ventricular diameter. A significant negative correlation was noticed between connective tissue growth factor levels, oxygen saturation, and right ventricular diastolic function. The sensitivity of plasma connective tissue growth factor as a diagnostic biomarker for PH was 95%, and the specificity was 90% at a cut-off value ≥650 pg/mL. The predictive value of plasma connective tissue growth factor for adverse outcome had a sensitivity of 88% and a specificity of 83% at a cut-off value ≥1900 pg/mL.

Conclusion:

Connective tissue growth factor is a promising biomarker with good diagnostic and predictive values in children with PH-related CHD.

Type
Original Article
Copyright
© The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Saleh, A, Shabana, A, El Amrousy, D, Zoair, A. Predictive value of p-wave and QT interval dispersion in children with congenital heart disease and pulmonary arterial hypertension. J Saudi Heart Assoc 2018; 31: 5763.CrossRefGoogle ScholarPubMed
Rabinovitch, M. Molecular pathogenesis of pulmonary arterial hypertension. J Clin Invest 2008; 118: 23722379.CrossRefGoogle ScholarPubMed
Voelkel, NF, Gomez-Arroyo, J, Abbate, A, Bogaard, HJ, Nicolls, MR. Pathobiology of pulmonary arterial hypertension and right ventricular failure. Eur Respir J 2012; 40: 15551565.CrossRefGoogle ScholarPubMed
Giannakoulas, G, Mouratoglou, SA, Gatzoulis, MA, Karvounis, H. Blood biomarkers and their potential role in pulmonary arterial hypertension associated with congenital heart disease. A systematic review. Int J Cardiol 2014; 174: 618623.CrossRefGoogle ScholarPubMed
Foris, V, Kovacs, G, Tscherner, M, Olschewski, A, Olschewski, H. Biomarkers in pulmonary hypertension: what do we know. Chest 2013; 144: 274283.CrossRefGoogle ScholarPubMed
Abd-Rabo, F, El-Amrousy, D, El-Serogy, H, Zoair, A. Plasma N-terminal pro brain natriuretic peptide as a prognostic biomarker in children with pulmonary hypertension. J Adv Med Med Res 2017; 23: 17.CrossRefGoogle Scholar
Chen, CC, Lau, LF. Functions and mechanisms of action of CCN matricellular proteins. Int J Biochem Cell Biol 2009; 41: 771783.CrossRefGoogle ScholarPubMed
Li, G, Hu, Y, Jia, P, et al. Integrin ß3 pathway mediated connective tissue growth factor induced proliferation, migration and extracellular matrix deposition of pulmonary arterial smooth muscle cells. Zhonghua Er Ke Za Zhi 2011; 49: 895900.Google Scholar
Tahira, Y, Fukuda, N, Endo, M, et al. Transforming growth factor-beta expression in cardiovascular organs in stroke-prone spontaneously hypertensive rats with the development of hypertension. Hypertens Res 2002; 25: 911918.CrossRefGoogle ScholarPubMed
Watari, H, Xiong, Y, Hassan, MK, Sahuragi, N. Cy r61, a member of CCN (connective tissue growth factor/cysteine-rich 61/nephroblastoma overexpressed) family, predicts survival of patients with endometrial cancer of endometrioid subtype. Gynecol Oncol 2009; 112: 229234.CrossRefGoogle Scholar
Behnes, M, Brueckmann, M, Lang, S, et al. Connective tissue growth factor (CTGF/CCN2): diagnostic and prognostic value in acute heart failure. Clin Res Cardiol 2014; 103: 107116.CrossRefGoogle ScholarPubMed
DiLorenzo, MP, Bhatt, SM, Mercer-Rosa, L. How best to assess right ventricular function by echocardiography. Cardiol Young 2015; 25: 14731481.CrossRefGoogle ScholarPubMed
Galiè, N, Hoeper, MM, Humbert, M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009; 30: 2493–537.Google Scholar
Li, G, Tang, L, Jia, P, Zhao, J, Liu, D, Liu, B. Elevated plasma connective tissue growth factor levels in children with pulmonary arterial hypertension associated with congenital heart disease. Pediatr Cardiol 2016; 37: 714721.CrossRefGoogle ScholarPubMed
Blom, IE, Goldschmeding, R, Leask, A. Gene regulation of connective tissue growth factor: new targets for antifibrotic therapy. Matrix Biol 2002; 21: 473482.CrossRefGoogle ScholarPubMed
Zhu, R, He, L, Xu, J, Zhang, Y, Hu, Y. Changes of TGF-b1 and CTGF in rats with increased blood flow-induced pulmonary artery hypertension. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2014; 37: 10131020.Google Scholar
Liu, B, Wang, XM, Zhou, TF, et al. Expression of connective tissue growth factor and its down-regulation by simvastatin administration in pulmonary hypertensive rats. Zhonghua Er Ke Za Zhi 2008; 46: 359365.Google ScholarPubMed
Noordegraaf, AV, Galie, N. The role of the right ventricle in pulmonary arterial hypertension. Eur Respir Rev 2011; 20: 243253.CrossRefGoogle Scholar
Huang, X, Zou, L, Yu, X, et al. Salidroside attenuates chronic hypoxia-induced pulmonary hypertension via adenosine A2a receptor related mitochondria-dependent apoptosis pathway. J Mol Cell Cardiol 2015; 82: 153166.CrossRefGoogle ScholarPubMed
Ryan, JJ, Huston, J, Kutty, S, et al. Right ventricular adaptation and failure in pulmonary arterial hypertension. Canadian J Cardiology 2015; 31: 391406.CrossRefGoogle ScholarPubMed