title: Plasma 15-F2t-isoprostane in idiopathic pulmonary arterial hypertension.
abstract: BACKGROUND
  15-F2t-isoprostane (15-F2t-IsoP), a prostaglandin F2-like compound, is widely recognized as a biomarker of chronic heart failure. This study investigated the potential role and prognostic significance of plasma 15-F2t-IsoP in patients with idiopathic pulmonary arterial hypertension (IPAH).
  
  
  METHODS
  Plasma 15-F2t-IsoP concentrations were determined in 80 consecutive IPAH patients at the time of their first right heart catheterization, and monitored for 30±12 months. The expression of 15-F2t-IsoP protein in autopsy lung samples was determined by immunohistochemical staining.
  
  
  RESULTS
  Plasma 15-F2t-IsoP concentrations were significantly increased in patients with IPAH compared with healthy controls (91 pg/ml vs. 30 pg/ml, respectively; P<0.001). Patients with baseline 15-F2t-IsoP concentrations≥97 pg/ml had a significantly lower survival rate than those with lower baseline concentrations (P<0.001). During follow-up, 15-F2t-IsoP concentrations in survivors decreased, whereas concentrations in non-surviving patients increased further (P<0.05). Elevated concentrations of 15-F2t-IsoP were correlated with a severity of WHO functional class, lower 6-minute walking distance and mixed venous oxygen saturation, higher mean right atrial pressure and brain natriuretic peptide. Multivariate analysis revealed that the plasma 15-F2t-IsoP concentration was an independent factor associated with mortality. Histological studies showed that the expression of 15-F2t-IsoP was up-regulated in remodeled pulmonary vessels.
  
  
  CONCLUSIONS
  An elevated plasma 15-F2t-IsoP concentration and a further increase during follow-up may be a risk factor for higher mortality in patients with IPAH.
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Sun
authors.affiliation: Department of Pediatrics, Shandong Provincial Hospital, Shandong University, Jinan, China.
authors.forename: You-Fei
authors.initials: YF
authors.lastname: Fan
authors.affiliation: Thrombosis and Vascular Medicine Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Peking Union Medical College and Chinese Academy Medical Science, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Qin-Hua
authors.initials: QH
authors.lastname: Zhao
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: P K
authors.initials: PK
authors.lastname: Shailendra
authors.affiliation: Baylor Pulmonary Hypertension Center, Baylor College of Medicine, TX, USA.
authors.forename: Zeenat
authors.initials: Z
authors.lastname: Safdar
authors.affiliation: Thrombosis and Vascular Medicine Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Peking Union Medical College and Chinese Academy Medical Science, Beijing, China. Electronic address: jingzhicheng@vip.163.com.
authors.forename: Zhi-Cheng
authors.initials: ZC
authors.lastname: Jing
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015237:Dinoprost / Q000031:analogs & derivatives; D065627:Familial Primary Pulmonary Hypertension / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D028421:Isoprostanes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D015415:Biomarkers; D028421:Isoprostanes; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost
keywords: 5-F(2t)-IsoP; Biomarkers; Idiopathic pulmonary arterial hypertension; Prognosis