title: Pentraxin-3 and the right ventricle: the Multi-Ethnic Study of Atherosclerosis-Right Ventricle Study.
abstract: Pentraxin-3 (PTX3) is a protein mediator of innate immunity that is elevated in the setting of left heart disease and pulmonary arterial hypertension. The relationship between PTX3 and right ventricular (RV) structure and function is not known. We included men and women with magnetic resonance imaging assessment of RV structure and function and measurement of PTX3 from the Multi-Ethnic Study of Atherosclerosis, a study of individuals free of clinical cardiovascular disease. Multivariable linear regression estimated associations between PTX3 protein levels and RV measures after adjusting for demographic characteristics, anthropometrics, smoking status, diabetes mellitus, hypertension, and corresponding left ventricular (LV) parameters. Instrumental variable analysis exploiting Mendelian randomization was attempted using two-stage least squares regression. The study sample included 1,779 participants with available PTX3 levels, RV measures, and all covariables. Mean PTX3 level was 2.1 ng/mL. Higher PTX3 was independently associated with greater RV mass and larger RV end-diastolic volume with and without adjustment for the corresponding LV parameters or C-reactive protein (all P < .05). There was no association between PTX3 and RV ejection fraction or stroke volume. Single-nucleotide polymorphisms were not associated with PTX3 protein levels or RV measures after accounting for race. Instrumental variable analysis could not be reliably performed. Higher PTX3 protein levels were associated with greater RV mass and larger RV end-diastolic volume. These associations were independent of common cardiovascular risk factors and LV morphologic changes. Inflammation is associated with differences in the pulmonary circulation-RV axis in adults without clinical cardiovascular disease.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Leary
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont, USA.
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Jenny
authors.affiliation: Departments of Medicine and Epidemiology, Columbia University, New York, New York, USA.
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.affiliation: Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Department of Medicine, Center for Clinical Epidemiology and Biostatistics, and the Penn Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Harhay
authors.affiliation: Departments of Epidemiology and Pharmacy, University of Washington, Seattle, Washington, USA.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.affiliation: Departments of Medicine and Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: João A
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mikacenic
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont, USA.
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.affiliation: Department of Medicine, Center for Clinical Epidemiology and Biostatistics, and the Penn Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
keywords: Mendelian randomization; heart failure; inflammation; pulmonary hypertension; right ventricle