Plasma level of antimony correlates with pulmonary arterial hypertension severity

It is unknown if environmental antimony exposure influences pulmonary arterial hypertension (PAH) and right ventricular function. We performed a pilot study to evaluate antimony levels in 20 PAH patients and 10 controls. Also, we explored the correlation of antimony level with PAH prognostic hemodynamic markers. Antimony blood and plasma levels were significantly higher in PAH patients when compared to controls [blood: PAH mean ± SD (95%CI) 1.3 ± 0.6 (1.0–1.5) ng/ml vs. control mean ± SD (95%) 0.7 ± 0.5 (0.4–1.0) ng/ml, p = 0.017] [plasma: PH mean ± SD (95%CI) 2.6 ± 1 (2.2–3.1) ng/ml vs. control mean ± SD (95%CI) 1.5 ± 0.8 (1.0–2.0) ng/ml, p = 0.004]. Also, antimony blood and plasma levels were significantly higher in idiopathic-PAH patients and non-idiopathic PAH when compared to controls. There was a trend for higher blood and plasma antimony levels in idiopathic PAH [blood1.6 ± 0.6 (1.1–2.1) ng/ml and plasma 3.1 ± 1.2 (2.2–4.1) ng/ml] when compared to non-idiopathic PAH [blood 1.1 ± 0.6(0.8–1.4) ng/ml and plasma 2.5 ± 0.9(2–2.9) ng/ml], but it did not reach statistical significance. There was a significant correlation between plasma antimony level and all the prognostic hemodynamic parameters of PAH including mRAP (r = 0.47, p = 0.036), CO (r = −0.50, p = 0.026), CI (r = −0.54, p = 0.014), PVR (r = 0.52, p = 0.019), and SvO2 (r = -0.54, p = 0.016).