D-dimer and pulmonary arterial hypertension in systemic sclerosis.
BACKGROUND
Micro-vascular thrombus is a common pathological finding in pulmonary artery hypertension. The association between plasma D-dimer, a marker of thrombus formation, and pulmonary artery hypertension (PAH) in patients with systemic sclerosis is unknown.


OBJECTIVE
To assess the correlation of the level of plasma D-dimer and pulmonary artery pressure in patients with systemic sclerosis.


METHODS
One hundred and twenty nine patients with systemic sclerosis between 19 and 75 years of age (mean, 48 +/- 11.3) entered the study. Plasma D-dimer was determined using immunoturbidimetric assay (D-dimer plus, Dade Behring Inc., Newark, USA). Pulmonary artery pressure was estimated by Doppler echocardiography. PAH was considered present if the Doppler echocardiography-estimated right ventricular systolic pressure (RVSP) exceeded 36 mmHg.


RESULTS
Forty-seven patients (36.4%) had PAH according to Doppler echocardiography including 32 (68.1 %) mild (RVSP, 36-45 mmHg), nine (19.1%) moderate (RVSP, 46-55 mmHg), and six (12.8%) severe PAH (RVSP > or = 56 mmHg). No significant correlation was found between plasma D-dimer and RVSP (r = 0. 02, p = 0. 82).


CONCLUSIONS
The present study demonstrated that the D-dimmer level is not associated with the level of pulmonary artery pressure in patients with systemic sclerosis, indicating that microvascular thrombosis may not play a significant role in the pathogenesis of PAH in patients with systemic sclerosis.
Division of Cardiology, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand. sonkia@kku.ac.th
Songsak
S
Kiatchoosakun
Wichai
W
Ungkasekvinai
Chaiyasit
C
Wonvipaporn
Pyatat
P
Tatsanavivat
Chingching
C
Foocharoen
Siraphop
S
Suwannaroj
Ratanavadee
R
Nanagara
D000328:Adult; D000368:Aged; D015415:Biomarkers; D018450:Disease Progression; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006305:Health Status Indicators; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D014463:Ultrasonography
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D