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Published in: Heart and Vessels 7/2020

01-07-2020 | Original Article

Lipocalin-type prostaglandin D synthase levels are associated with the severity of pulmonary embolism

Authors: Hüseyin Mutlu, Kamil Kokulu, Ekrem Taha Sert, Ahmet Çağlar

Published in: Heart and Vessels | Issue 7/2020

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Abstract

Pulmonary thromboembolism (PTE) is an acute emergency with high mortality and morbidity rates. This study aimed to investigate the importance of Lipocalin-type prostaglandin D synthase (L-PGDS) in predicting mortality and prognosis in PTE. The study prospectively included 90 patients who were admitted to the emergency department and in whom PTE was confirmed by computed tomographic pulmonary angiography as well as 40 healthy volunteers with no disease. L-PGDS levels in the venous blood were measured and compared. Pulmonary embolism severity index (PESI) prognosis scores of all patients and 1-month mortality rate were calculated. There was a statistically significant difference between the L-PGDS levels of the patient and control groups (P = 0.024), and 1-month mortality of patients diagnosed with PTE was 20% (n = 18). Furthermore, the patients were divided into two groups: patients deceased within 1 month following the diagnosis and survivors. L-PGDS levels of the deceased patients were significantly higher than those of the survivors (P < 0.001). Age, systolic blood pressure, pulse, shock index, lactate, and PESI scores were significantly different between the survivors and deceased patients. The cut-off value for L-PGDS obtained using receiver operating characteristic (ROC) curve analysis for 1-month mortality was 815.26 ng/mL (sensitivity: 83.33%; specificity: 79.17%; area under the curve: 0.851; 95% confidence interval 0.760–0.917; P < 0.001). Based on this cut-off value, logistic regression analysis revealed that increased L-PGDS, together with PESI, was an independent indicator of 1-month mortality. L-PGDS is associated with short-term mortality in patients with PTE; therefore, it can be used to predict mortality risk in patients with PTE.
Literature
1.
go back to reference Furlan A, Aghayev A, Chang CC, Patil A, Jeon KN, Park B, Fetzer DT, Saul M, Roberts MS, Bae KT (2012) Short-term mortality in acute pulmonary embolism: clot burden and signs of right heart dysfunction at CT pulmonary angiography. Radiology 265(1):283–293CrossRef Furlan A, Aghayev A, Chang CC, Patil A, Jeon KN, Park B, Fetzer DT, Saul M, Roberts MS, Bae KT (2012) Short-term mortality in acute pulmonary embolism: clot burden and signs of right heart dysfunction at CT pulmonary angiography. Radiology 265(1):283–293CrossRef
2.
go back to reference Konstantinides SV (2014) (2014) ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35:3145–3146CrossRef Konstantinides SV (2014) (2014) ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35:3145–3146CrossRef
3.
go back to reference Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353:1386–1389CrossRef Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353:1386–1389CrossRef
4.
go back to reference Cipollone F, Fazia M, Iezzi A, Ciabattoni G, Pini B, CuccurulloC US, Spigonardo F, De Luca M, Prontera C, ChiarelliF CF, Mezzetti A (2004) Balance between PGD synthase and PGE synthase is a major determinant of atherosclerotic plaque instability in humans. Arterioscler Thromb Vasc Biol 24:1259–1265CrossRef Cipollone F, Fazia M, Iezzi A, Ciabattoni G, Pini B, CuccurulloC US, Spigonardo F, De Luca M, Prontera C, ChiarelliF CF, Mezzetti A (2004) Balance between PGD synthase and PGE synthase is a major determinant of atherosclerotic plaque instability in humans. Arterioscler Thromb Vasc Biol 24:1259–1265CrossRef
5.
go back to reference Matsumoto T, Eguchi Y, Oda H, Yamane T, Tarutani Y, OzawaT HH, Nakae I, Horie M, Urade Y (2011) Lipocalin-type prostaglandin D synthase is associated with coronary vasospasm and vasomotor reactivity in response to acetylcholine. Circ J 75:897–904CrossRef Matsumoto T, Eguchi Y, Oda H, Yamane T, Tarutani Y, OzawaT HH, Nakae I, Horie M, Urade Y (2011) Lipocalin-type prostaglandin D synthase is associated with coronary vasospasm and vasomotor reactivity in response to acetylcholine. Circ J 75:897–904CrossRef
6.
go back to reference Manzano-Fernández S, López-Cuenca A, Januzzi JL, Parra-Pallares S, Mateo-Martínez A, Sánchez-Martínez M, Pérez-Berbel P, Orenes-Piñero E, Romero-Aniorte AI, Avilés-Plaza F, Valdés-Chavarri M, Marín F (2012) Usefulness of β-trace protein and cystatin C for the prediction of mortality in non ST segment elevation acute coronary syndromes. Am J Cardiol 110:1240–1248CrossRef Manzano-Fernández S, López-Cuenca A, Januzzi JL, Parra-Pallares S, Mateo-Martínez A, Sánchez-Martínez M, Pérez-Berbel P, Orenes-Piñero E, Romero-Aniorte AI, Avilés-Plaza F, Valdés-Chavarri M, Marín F (2012) Usefulness of β-trace protein and cystatin C for the prediction of mortality in non ST segment elevation acute coronary syndromes. Am J Cardiol 110:1240–1248CrossRef
7.
go back to reference Han F, Takeda K, Ishikawa K, Ono M, Date F, YokoyamaS FK, Shinozawa Y, Urade Y, Shibahara S (2009) Induction of lipocalin-type prostaglandin D synthase in mouse heart under hypoxemia. Biochem Biophys Res Commun 385:449–453CrossRef Han F, Takeda K, Ishikawa K, Ono M, Date F, YokoyamaS FK, Shinozawa Y, Urade Y, Shibahara S (2009) Induction of lipocalin-type prostaglandin D synthase in mouse heart under hypoxemia. Biochem Biophys Res Commun 385:449–453CrossRef
8.
go back to reference Vílchez JA, Roldán V, Manzano-Fernández S (2013) β-Trace protein andprognosis in patients with atrial fibrillation receiving anticoagulation treatment. Chest 144(5):1564–1570CrossRef Vílchez JA, Roldán V, Manzano-Fernández S (2013) β-Trace protein andprognosis in patients with atrial fibrillation receiving anticoagulation treatment. Chest 144(5):1564–1570CrossRef
9.
go back to reference Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H, Perrier A (2006) Prediction of pulmonary embolism in the emergency department: the revised Genevascore. Ann Intern Med 144:165–171CrossRef Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H, Perrier A (2006) Prediction of pulmonary embolism in the emergency department: the revised Genevascore. Ann Intern Med 144:165–171CrossRef
10.
go back to reference Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM (2004) Prospectivevalidation of wells criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med 44(5):503–510CrossRef Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM (2004) Prospectivevalidation of wells criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med 44(5):503–510CrossRef
11.
go back to reference Ceriani E, Combescure C, Le Gal G, Nendaz M, Perneger T, Bounameaux H, Perrier A, Righini M (2010) Clinical prediction rules for pulmonary embolism: a systematic review and meta-analysis. J ThrombHaemost 8:957–970 Ceriani E, Combescure C, Le Gal G, Nendaz M, Perneger T, Bounameaux H, Perrier A, Righini M (2010) Clinical prediction rules for pulmonary embolism: a systematic review and meta-analysis. J ThrombHaemost 8:957–970
12.
go back to reference Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M (2014) 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS). Eur Heart J 35:3033–3069CrossRef Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M (2014) 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS). Eur Heart J 35:3033–3069CrossRef
13.
go back to reference Tapson VF (2012) Advances in the diagnosis and treatment of acute pulmonary embolism. F100Med Rep 4:9 Tapson VF (2012) Advances in the diagnosis and treatment of acute pulmonary embolism. F100Med Rep 4:9
14.
go back to reference Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JP (2008) ESC Committee for Practice Guide1ines (CPG). Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 29(18):2276–2315CrossRef Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JP (2008) ESC Committee for Practice Guide1ines (CPG). Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 29(18):2276–2315CrossRef
15.
go back to reference Chung T, Emmett L, Khoury V, Lau GT, Elsik M, Foo F, Allman KC, Kritharides L (2006) Atrial and ventricular echocardiographic correlates of the extent of pulmonary embolism in the elderly. J Am Soc Echocardiogr 19(3):347–353CrossRef Chung T, Emmett L, Khoury V, Lau GT, Elsik M, Foo F, Allman KC, Kritharides L (2006) Atrial and ventricular echocardiographic correlates of the extent of pulmonary embolism in the elderly. J Am Soc Echocardiogr 19(3):347–353CrossRef
16.
go back to reference Barnard JW, Ward RA, Adkins WK, Taylor AE (1992) Characterization of thromboxane and prostacyclin effects on pulmonary vascular resistance. J Appl Physiol 72:1845–1853CrossRef Barnard JW, Ward RA, Adkins WK, Taylor AE (1992) Characterization of thromboxane and prostacyclin effects on pulmonary vascular resistance. J Appl Physiol 72:1845–1853CrossRef
17.
go back to reference Gawaz M, Langer H, May AE (2005) Platelets in inflammation and atherogenesis. J Clin Invest 115:3378–3384CrossRef Gawaz M, Langer H, May AE (2005) Platelets in inflammation and atherogenesis. J Clin Invest 115:3378–3384CrossRef
18.
go back to reference Ghattas A, Griffiths HR, Devitt A, Lip GY, Shantsila E (2013) Monocytes in coronary artery disease and atherosclerosis: where are we now? J Am Coll Cardiol 62:1541–1551CrossRef Ghattas A, Griffiths HR, Devitt A, Lip GY, Shantsila E (2013) Monocytes in coronary artery disease and atherosclerosis: where are we now? J Am Coll Cardiol 62:1541–1551CrossRef
19.
go back to reference Taba Y, Miyagi M, Miwa Y, Inoue H, Takahashi-YanagaF MS, Sasaguri T (2003) 15-deoxy-delta 12,14-prostaglandin J2 and laminar fluid shear stress stabilize c-IAP1 in vascular endothelial cells. Am J Physiol Heart Circ Physiol 285(1):H38–46CrossRef Taba Y, Miyagi M, Miwa Y, Inoue H, Takahashi-YanagaF MS, Sasaguri T (2003) 15-deoxy-delta 12,14-prostaglandin J2 and laminar fluid shear stress stabilize c-IAP1 in vascular endothelial cells. Am J Physiol Heart Circ Physiol 285(1):H38–46CrossRef
20.
go back to reference Negoro H, ShinW S, Hakamada-Taguchi R, Eguchi N, UradeY GA, Toyo-Oka T, Fujita T, Omata M, Uehara Y (2002) Endogenous prostaglandin D2 synthesis reduces an increase in plasminogen activator inhibitor-1 following interleukin stimulation in bovine endothelial cells. J Hypertens 20:1347–1354CrossRef Negoro H, ShinW S, Hakamada-Taguchi R, Eguchi N, UradeY GA, Toyo-Oka T, Fujita T, Omata M, Uehara Y (2002) Endogenous prostaglandin D2 synthesis reduces an increase in plasminogen activator inhibitor-1 following interleukin stimulation in bovine endothelial cells. J Hypertens 20:1347–1354CrossRef
21.
go back to reference Negoro H, Shin WS, Hakamada-Taguchi R, Eguchi N, Urade Y, Goto A, Toyo-Oka T, Fujita T, Omata M, Uehara Y (2005) Endogenous prostaglandin D(2) synthesis decreases vascular cell adhesion molecule-1 expression in human umbilical vein endothelial cells. Life Sci 78:22–29CrossRef Negoro H, Shin WS, Hakamada-Taguchi R, Eguchi N, Urade Y, Goto A, Toyo-Oka T, Fujita T, Omata M, Uehara Y (2005) Endogenous prostaglandin D(2) synthesis decreases vascular cell adhesion molecule-1 expression in human umbilical vein endothelial cells. Life Sci 78:22–29CrossRef
22.
go back to reference Smith WL, Urade Y, Jakobsson PJ (2011) Enzymes of the cyclooxygenase pathways of prostanoid biosynthesis. Chem Rev 111(10):5821–5865CrossRef Smith WL, Urade Y, Jakobsson PJ (2011) Enzymes of the cyclooxygenase pathways of prostanoid biosynthesis. Chem Rev 111(10):5821–5865CrossRef
23.
go back to reference Taba Y, Sasaguri T, Miyagi M, Abumiya T, Miwa Y, IkedaT MM (2000) Fluid shear stress induces lipocalin-type prostaglandin D(2) synthase expression in vascular endothelial cells. Circ Res 86:967–973CrossRef Taba Y, Sasaguri T, Miyagi M, Abumiya T, Miwa Y, IkedaT MM (2000) Fluid shear stress induces lipocalin-type prostaglandin D(2) synthase expression in vascular endothelial cells. Circ Res 86:967–973CrossRef
24.
go back to reference Aujesky D, Roy P, Guy M, Cornuz J, Sanchez O, Perrier A (2006) Prognostic value of D-dimer in patients with pulmonary embolism. Thromb Haemost 96:478–482CrossRef Aujesky D, Roy P, Guy M, Cornuz J, Sanchez O, Perrier A (2006) Prognostic value of D-dimer in patients with pulmonary embolism. Thromb Haemost 96:478–482CrossRef
25.
go back to reference Scridon T, Scridon C, Skali H, Alvarez A, Goldhaber SZ, Solomon SD (2005) Prognostic significance of troponin elevation and right ventricular enlargement in acute pulmonary embolism. Am J Cardiol 96:303–305CrossRef Scridon T, Scridon C, Skali H, Alvarez A, Goldhaber SZ, Solomon SD (2005) Prognostic significance of troponin elevation and right ventricular enlargement in acute pulmonary embolism. Am J Cardiol 96:303–305CrossRef
26.
go back to reference Pruszczyk P, Kostrubiec M, Bochowicz A, Styczyński G, Szulc M, Kurzyna M, Fijałkowska A, Kuch-Wocial A, Chlewicka I, Torbicki A (2003) N-terminal pro-brain natriuretic peptide in patients with acute pulmonary embolism. Eur Respir J 22:649–653CrossRef Pruszczyk P, Kostrubiec M, Bochowicz A, Styczyński G, Szulc M, Kurzyna M, Fijałkowska A, Kuch-Wocial A, Chlewicka I, Torbicki A (2003) N-terminal pro-brain natriuretic peptide in patients with acute pulmonary embolism. Eur Respir J 22:649–653CrossRef
27.
go back to reference Neskovic AN, Hagendorff A, Lancellotti P, Guarracino F, Varga A, Cosyns B, Flachskampf FA, Popescu BA, Gargani L, Zamorano JL, Badano LP (2013) Emergency echocardiography: the European Association of cardiovascular imaging recommendations. Eur Heart J Cardiovasc Imaging 14:1–11CrossRef Neskovic AN, Hagendorff A, Lancellotti P, Guarracino F, Varga A, Cosyns B, Flachskampf FA, Popescu BA, Gargani L, Zamorano JL, Badano LP (2013) Emergency echocardiography: the European Association of cardiovascular imaging recommendations. Eur Heart J Cardiovasc Imaging 14:1–11CrossRef
28.
go back to reference Kucher N, Rossi E, De Rosa M, Goldhaber SZ (2005) Prognostic role of echocardiography among patients with acute pulmonary embolism and a systolic arterial pressure of 90 mmHg or higher. Arch Intern Med 165:1777–1781CrossRef Kucher N, Rossi E, De Rosa M, Goldhaber SZ (2005) Prognostic role of echocardiography among patients with acute pulmonary embolism and a systolic arterial pressure of 90 mmHg or higher. Arch Intern Med 165:1777–1781CrossRef
29.
go back to reference Tapson VF (2013) Thrombolytic therapy for acute pulmonary embolism. Semin Thromb Haemost 39:452–458CrossRef Tapson VF (2013) Thrombolytic therapy for acute pulmonary embolism. Semin Thromb Haemost 39:452–458CrossRef
30.
go back to reference Becattini C, Agnelli G, Vedovati MC, Pruszczyk P, Casazza F, Grifoni S, Salvi A, Bianchi M, Douma R, Konstantinides S, Lankeit M, Duranti M (2011) Multi detector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test. Eur Heart J 32:1657–1663CrossRef Becattini C, Agnelli G, Vedovati MC, Pruszczyk P, Casazza F, Grifoni S, Salvi A, Bianchi M, Douma R, Konstantinides S, Lankeit M, Duranti M (2011) Multi detector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test. Eur Heart J 32:1657–1663CrossRef
Metadata
Title
Lipocalin-type prostaglandin D synthase levels are associated with the severity of pulmonary embolism
Authors
Hüseyin Mutlu
Kamil Kokulu
Ekrem Taha Sert
Ahmet Çağlar
Publication date
01-07-2020
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 7/2020
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-020-01568-2

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