Circulating acetylcholine serves as a potential biomarker role in pulmonary hypertension

BMC Pulmonary Medicine

Table 1 Baseline characteristics of patients with PH stratified by acetylcholine levels

Variables	Total PH patients N = 408	Low acetylcholine N = 205	High acetylcholine N = 203
Age, years	43.1 ± 16.6	38.3 ± 14.9	48.0 ± 16.8*
Female sex, n (%)	278 (68.1)	173 (84.4)	105 (51.7)*
BMI, kg/m2	22.1 ± 3.9	22.1 ± 4.2	22.2 ± 3.5
6 MWD, m	385.0 ± 120.0	407.4 ± 110.7	363.2 ± 124.8*
WHO-FC, n (%)
I-II	259 (63.5)	143 (69.8)	116 (57.1)*
III	116 (28.4)	49 (23.9)	67 (33.0)*
IV	33 (8.1)	13 (6.3)	20 (9.9)#
Laboratories
Acetylcholine, µmol/L	0.8 ± 0.3	0.6 ± 1.1	1.0 ± 0.3*
NT-proBNP, pg/ml	585.4 (161.5, 1702.3)	395.3 (116.4, 1152.5)	881.0 (278.7, 2258.0)*
Albumin, g	42.0 ± 5.0	42.4 ± 4.6	41.5 ± 5.4
Creatinine, µmol/L	79.5 ± 23.4	70.5 ± 15.0	88.5 ± 26.8*
Echocardiography
LVEF, %	64.8 ± 6.9	64.8 ± 7.8	64.7 ± 5.8
RVD, mm	32.4 ± 7.6	31.5 ± 7.3	33.4 ± 7.9#
TAPSE, mm	16.6 ± 4.1	17.1 ± 4.2	16.3 ± 4.2#
Hemodynamics
mRAP, mmHg	6.0 (3.0, 9.0)	5.0 (3.0, 8.0)	7.0 (4.0, 9.0)*
mPAP, mmHg	55.5 ± 17.1	50.6 ± 16.7	53.9 ± 14.3
Cardiac index, L/min*m2	3.1 ± 0.9	3.3 ± 1.0	2.8 ± 0.8*
PVR, Wu	10.0 ± 5.1	9.4 ± 5.3	10.7 ± 5.0#
PAWP, mmHg	8.2 ± 4.0	8.0 ± 4.2	8.5 ± 3.9
Treatment, n (%)
PDE5i	274 (67.2)	143 (69.8)	131 (64.5)
ERAs	226 (55.4)	126 (61.5)	100 (49.3)#
Prostacyclins	56 (13.7)	24 (11.7)	32 (15.8)
Riociguat	35 (8.6)	14 (6.8)	21 (10.3)
BPA/PEA	35 (8.6)	14 (6.8)	21 (10.3)

Patients were divided into two groups based on the levels of plasma acetylcholine (the cut-off value was 0.76 µmol/L). According to the different data distributions, continuous variables were presented as mean ± standard deviation or median and interquartile ranges. Categorical variables were shown as frequencies with percentages. Student’s t-test or Wilcoxon rank-sum test was utilized for continuous data while Chi-square test was for categorical variables
PH: pulmonary hypertension; BMI: body mass index; 6 MWD: 6-minute walk distance; WHO-FC: world health organization function class; NT-proBNP: N-terminal pro-brain natriuretic peptide; LVEF: left ventricular ejection fraction; RVD: right ventricular diameter; TAPSE: tricuspid annular plane systolic excursion; mRAP: mean right atrial pressure; mPAP: mean pulmonary arterial pressure; PVR: pulmonary vascular resistance; PAWP: pulmonary arterial wedge pressure; PDE5i: phosphodiesterase type 5 inhibitor; ERAs: endothelin receptor agonists; BPA: balloon pulmonary angioplasty; PEA: pulmonary endarterectomy
*P < 0.001; ^#P < 0.05

ISSN: 1471-2466