【Circulation】循环内皮细胞：先心病继发不可逆肺动脉高压的一种新的生物标记物 。临床前景预测。

循环内皮细胞：先心病继发不可逆肺动脉高压的一种新的生物标记物
CLINICAL PERSPECTIVE
Pulmonary arterial hypertension (PAH) can complicate several types of congenital heart disease, and its reversibility is often difficult to predict. We postulated that the numbers of circulating endothelial cells (CECs) and circulating progenitor cells (CPCs) might serve as noninvasive biomarkers of endothelial turnover and thus help to identify patients with congenital heart disease who are at risk of irreversible PAH, thereby avoiding the need for lung biopsy. Indeed, we recently observed impaired apoptotic regulation of endothelial cells in lung biopsy samples from patients with irreversible PAH. CEC and CPC numbers were each similar in peripheral vein, pulmonary artery, and pulmonary vein blood samples, whether from patients with reversible PAH (n=16), patients with irreversible PAH (n=10), or control subjects (n=5). CEC numbers were significantly higher in patients with irreversible PAH than in patients with reversible PAH and control subjects, whereas CPC numbers did not differ among the 3 subgroups. The CEC count did not correlate with age or the CPC count. CEC counts could thus be used for individual evaluation of vascular competence and serve as noninvasive biomarkers of endothelial lesions and as treatment decision aids in congenital heart disease patients with irreversible PAH.