title: Usefulness of circulating amino acid profile and Fischer ratio to predict severity of pulmonary hypertension.
abstract: Plasma amino acid concentrations (aminogram) show distinct patterns under various pathologic conditions. However, the plasma aminogram pattern in patients with pulmonary hypertension (PH) has not been elucidated. We sought to examine whether an aminogram could be predictive of clinical severity in patients with PH. We attained fasting plasma aminograms for 140 patients with PH and then compared the patient plasma amino acid levels with those of age- and gender-matched healthy control subjects. Aminograms revealed that the plasma concentrations of many amino acids were significantly different between patients with PH and healthy control subjects. We focused on the Fischer ratio (branched-chain amino acids/aromatic amino acids) as an integrated parameter. In all enrolled patients, Fischer ratio was negatively correlated with New York Heart Association functional class (ρ = -0.37, p <0.001), plasma B-type natriuretic peptide (ρ = -0.35, p <0.001), and pulmonary vascular resistance (ρ = -0.27, p = 0.002) and positively correlated with venous oxygen saturation (ρ = 0.27, p = 0.002) and 6-minute walk distance (ρ = 0.23, p = 0.016). Time course changes in Fischer ratio and in cardiac output were significantly correlated (ρ = 0.39, p = 0.024). The aminogram is changed in patients with PH, and in these patients, Fischer ratio decreases in proportion to the clinical severity of PH.
authors: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Ryoji
authors: R
authors: Yanagisawa
authors: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: m.kataoka09@z5.keio.jp.
authors: Masaharu
authors: M
authors: Kataoka
authors: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Takumi
authors: T
authors: Inami
authors: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Yuichi
authors: Y
authors: Momose
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Takashi
authors: T
authors: Kawakami
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Makoto
authors: M
authors: Takei
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Mai
authors: M
authors: Kimura
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Sarasa
authors: S
authors: Isobe
authors: Center for Multiphasic Health Testing and Services, Mitsui Memorial Hospital, Tokyo, Japan.
authors: Minoru
authors: M
authors: Yamakado
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Keiichi
authors: K
authors: Fukuda
authors: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Hideaki
authors: H
authors: Yoshino
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Motoaki
authors: M
authors: Sano
authors: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Toru
authors: T
authors: Satoh
mesh_terms: D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000175:diagnosis*; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D045283:Natriuretic Agents / Q000097:blood*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain