| Inflammatory mechanisms appear to play a major role in pathogenesis of
various types of pulmonary hypertension such as idiopatic PAH (iPAH). Although inflammatory
factors such as IL6 and TNFa play an important role in IPAH, there is limited information about
the relationship between acute phase reactants and pulmonary hypertension occurring secondary
to pulmonary diseases such as chronic obstructive pulmonary diseases (COPD).
Methods: This cross-sectional study was carried out on 94 patients with COPD. Patients
with a recent history of systemic corticosteroid use, infection, trauma or surgery, and
gastrointestinal bleeding were excluded. Body plethysmography and transthoracic
echocardiography were performed. Blood samples were taken from all patients and sent for
complete blood count (CBC) and hsCRP tests.
Results: Twenty patients (28.6%) had pulmonary hypertension. There was a significant
difference between the mean of WBC in patients with and without pulmonary hypertension
(8505 mic/lit vs. 7044 mic/lit) (p=0.04). There was also a significant difference between the
hs.CRP in patients with and without pulmonary hypertension (8.8pg/ml vs. 4.07pg/ml)
(p=0.032). After adjustment of age, sex, serum hemoglobin, hematocrit, O2sat, FEV1 and FVC,
the relationship between the IL6, white blood cell count, HS.CRP and pulmonary hypertension
remained significant (p=0.018, p=0.022).
Conclusion: Inflammatory factors such as white blood cell and HS.CRP are independent
risk factors of pulmonary hypertension in COPD patients. |