Cargando…

The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension

BACKGROUND: To observe different roles of direct bilirubin (Dbil) on portopulmonary hypertension (POPH) and idiopathic pulmonary arterial hypertension (IPAH). METHODS: Thirty incident patients with POPH and 180 with IPAH (matched by the WHO functional classification in a 1 : 6 ratio) between March 2...

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Yuan, Qiu, Hongling, Zhao, Qinhua, He, Jing, Jiang, Rong, Wu, Wenhui, Luo, Cijun, Li, Huiting, Wang, Lan, Liu, Jinming, Gong, Sugang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159212/
https://www.ncbi.nlm.nih.gov/pubmed/35685569
http://dx.doi.org/10.1155/2022/7021178
_version_ 1784719007503351808
author Li, Yuan
Qiu, Hongling
Zhao, Qinhua
He, Jing
Jiang, Rong
Wu, Wenhui
Luo, Cijun
Li, Huiting
Wang, Lan
Liu, Jinming
Gong, Sugang
author_facet Li, Yuan
Qiu, Hongling
Zhao, Qinhua
He, Jing
Jiang, Rong
Wu, Wenhui
Luo, Cijun
Li, Huiting
Wang, Lan
Liu, Jinming
Gong, Sugang
author_sort Li, Yuan
collection PubMed
description BACKGROUND: To observe different roles of direct bilirubin (Dbil) on portopulmonary hypertension (POPH) and idiopathic pulmonary arterial hypertension (IPAH). METHODS: Thirty incident patients with POPH and 180 with IPAH (matched by the WHO functional classification in a 1 : 6 ratio) between March 2010 and December 2020 were included. The receiver operating curve and Kaplan–Meier method were applied to estimate the ability to distinguish between the two and survival, respectively. Univariate and forward multiple stepwise regression analyses were performed to access the relationship between pulmonary vascular resistance (PVR) and clinical indices. RESULTS: Compared to IPAH, the POPH group had better hemodynamics including PVR (7.08 ± 3.95 vs. 14.89 ± 7.11, P < 0.001) and higher total bilirubin (Tbil) and Dbil. Tbil and Dbil had a negative correlation with PVR in the POPH group (r = −0.394, P=0.031; r = −0.364, P=0.048, respectively) but positive correlation in the IPAH group (r = 0.218, P=0.003; r = 0.178, P=0.018, respectively). Increased neutrophil counts (r = 0.394, P=0.031) and elevated NT-proBNP (r = 0.433, P < 0.001) would help predict the elevation of PVR in POPH and IPAH groups independent of Dbil, respectively. Dbil could distinguish POPH from IPAH (AUC = 0.799, P=0.009), and the ability was elevated when taking aspartate aminotransferase together (AUC = 0.835, P < 0.001). The overall survival was better in POPH than in IPAH (7 dead cases of POPH and 96 of IPAH, P=0.002). Survival was better in POPH than in IPAH in the group of Dbil ≥7 μmol/L (P=0.001) but showed no significant difference between POPH and IPAH in the group of Dbil <7 μmol/L (P=0.192). CONCLUSIONS: The POPH group had a better hemodynamic profile than IPAH. Dbil was associated oppositely with the elevation of PVR in POPH and IPAH. Patients with POPH had better survival than those with IPAH in the total cohort and in the group of Dbil ≥7 μmol/L, but limited dead cases of POPH should be noted.
format Online
Article
Text
id pubmed-9159212
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-91592122022-06-07 The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension Li, Yuan Qiu, Hongling Zhao, Qinhua He, Jing Jiang, Rong Wu, Wenhui Luo, Cijun Li, Huiting Wang, Lan Liu, Jinming Gong, Sugang Int J Clin Pract Research Article BACKGROUND: To observe different roles of direct bilirubin (Dbil) on portopulmonary hypertension (POPH) and idiopathic pulmonary arterial hypertension (IPAH). METHODS: Thirty incident patients with POPH and 180 with IPAH (matched by the WHO functional classification in a 1 : 6 ratio) between March 2010 and December 2020 were included. The receiver operating curve and Kaplan–Meier method were applied to estimate the ability to distinguish between the two and survival, respectively. Univariate and forward multiple stepwise regression analyses were performed to access the relationship between pulmonary vascular resistance (PVR) and clinical indices. RESULTS: Compared to IPAH, the POPH group had better hemodynamics including PVR (7.08 ± 3.95 vs. 14.89 ± 7.11, P < 0.001) and higher total bilirubin (Tbil) and Dbil. Tbil and Dbil had a negative correlation with PVR in the POPH group (r = −0.394, P=0.031; r = −0.364, P=0.048, respectively) but positive correlation in the IPAH group (r = 0.218, P=0.003; r = 0.178, P=0.018, respectively). Increased neutrophil counts (r = 0.394, P=0.031) and elevated NT-proBNP (r = 0.433, P < 0.001) would help predict the elevation of PVR in POPH and IPAH groups independent of Dbil, respectively. Dbil could distinguish POPH from IPAH (AUC = 0.799, P=0.009), and the ability was elevated when taking aspartate aminotransferase together (AUC = 0.835, P < 0.001). The overall survival was better in POPH than in IPAH (7 dead cases of POPH and 96 of IPAH, P=0.002). Survival was better in POPH than in IPAH in the group of Dbil ≥7 μmol/L (P=0.001) but showed no significant difference between POPH and IPAH in the group of Dbil <7 μmol/L (P=0.192). CONCLUSIONS: The POPH group had a better hemodynamic profile than IPAH. Dbil was associated oppositely with the elevation of PVR in POPH and IPAH. Patients with POPH had better survival than those with IPAH in the total cohort and in the group of Dbil ≥7 μmol/L, but limited dead cases of POPH should be noted. Hindawi 2022-02-03 /pmc/articles/PMC9159212/ /pubmed/35685569 http://dx.doi.org/10.1155/2022/7021178 Text en Copyright © 2022 Yuan Li et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Li, Yuan
Qiu, Hongling
Zhao, Qinhua
He, Jing
Jiang, Rong
Wu, Wenhui
Luo, Cijun
Li, Huiting
Wang, Lan
Liu, Jinming
Gong, Sugang
The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
title The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
title_full The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
title_fullStr The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
title_full_unstemmed The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
title_short The Different Effects of Direct Bilirubin on Portopulmonary Hypertension and Idiopathic Pulmonary Arterial Hypertension
title_sort different effects of direct bilirubin on portopulmonary hypertension and idiopathic pulmonary arterial hypertension
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159212/
https://www.ncbi.nlm.nih.gov/pubmed/35685569
http://dx.doi.org/10.1155/2022/7021178
work_keys_str_mv AT liyuan thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT qiuhongling thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT zhaoqinhua thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT hejing thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT jiangrong thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT wuwenhui thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT luocijun thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT lihuiting thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT wanglan thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT liujinming thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT gongsugang thedifferenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT liyuan differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT qiuhongling differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT zhaoqinhua differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT hejing differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT jiangrong differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT wuwenhui differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT luocijun differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT lihuiting differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT wanglan differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT liujinming differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension
AT gongsugang differenteffectsofdirectbilirubinonportopulmonaryhypertensionandidiopathicpulmonaryarterialhypertension