Abstract
High incidence of circulating anti-heart antibodies in patients with cor pulmonale caused by chronic pulmonary emphysema has been noticed previously. Correlation of the anti-heart antibody titer with pulmonary arterial mean pressure and with arterial oxygen saturation has also been pointed out.
The present study was conducted to compare the incidence of circulating anti-heart antibodies in pulmonary hypertensive patients of different origens and to study relations between the incidence of anti-heart antibodies and impairment of pulmonary functions. Three groups of patients were studied; namely, patients with mitral valvular disease, congenital heart disease (ventricular septal defect and atrial septal defect) and chronic cor pulmonale caused by chronic pulmonary emphysema.
Direct hemagglutination tests using antigen obtained from normal rabbit heart were performed on the subjects studied. Routine pulmonary function tests and cardiac catheterizations were also conducted.
None of the 15 cases with mitral valvular disease revealed positive hemagglutination test. One among 14 cases with congenital heart disease demonstrated positive reaction. This case with positive reaction had ventricular septal defect and showed pulmonary arterial mean pressure of 21mmHg. Seven out of 17 cases with chronic cor pulmonale showed positive reaction. Statistically significant differences were observed in the results of hemagglutination tests among the three groups (x2=11.07, p<0.05).
Patients with positive reaction in the group with chronic cor pulmonale showed elevated pulmonary arterial mean pressures higher than 22mmHg, decreased arterial oxygen saturation less than 94%, lower FEV1.0% than 55% and arterial blood pH lower than 7.42. Most of the patients with positive reaction in this group demonstrated decreased %VC and elevated arterial acrbon dioxide tension.
The present observations suggested that in addition to the pulmonary hypertension arterial hypoxemia and/or hypercapnea were contributed to the formation of circulating anti-heart antibodies in patients with pulmonary hypertension.
