PLASMA LEVEL OF ANTIMONY CORRELATES WITH PULMONARY HYPERTENSION SEVERITY

TOPIC: Pulmonary Vascular Disease TYPE: Original Investigations PURPOSE: Heavy metals are linked to cardiovascular disease, but the relationship between heavy and pulmonary arterial hypertension (PAH) is not clear. We hypothesized that there may be a correlation metal levels severity of METHODS: A prospective, single center pilot study recruited patients from our over period 3 months. Patients with PAH who were ≥ 18 years old eligible participate. obtained IRB approval all participated signed an informed consent. Blood urine samples collected measure essential non-essential in blood, plasma, using X Series II quadrupole inductively coupled plasma mass spectrometry (ICP-MS, Thermo Fisher Scientific). Also, we demographics, hemodynamics, last 6 minute walk distance (6MWD), available BNP level, REVEAL Lite 2 risk score. Statistical analysis was performed statistical software R p value<0.05 considered significant. RESULTS: total 20 included study. The mean age 57.6±11.8 years, 80% female had idiopathic PAH. All receiving combination therapies including prostanoid agent (13 on parenteral treprostinil, 1 epoprostenol, 5 inhaled selexipag) treprostinil dose 67.8±28.9 ng/kg/min. Mean 6MWD 312.7m±96.2 level 118.3±129.6 pg/ml. RVEAL score low 9 patients, intermediate 6, high 4 patients. hemodynamic values mRAP 5.9±4.4 mmHg, mPAP 45.6±13.9 PAWP 8±3.5 CO 5.1±1.4L/min, CI 2.86±1.1 L/min/m2, PVR 8.32±4.4 WU. There significant 121Sb (Antimony) (r=0.47, p=0.036), (r=-0.50, p=0.026), (r=-0.54, p=0.014), (r=0.52, p=0.019), PA saturation p=0.016). CONCLUSIONS: found correlations prognostic markers disease without known prior history occupational exposure. CLINICAL IMPLICATIONS: Antimonial compounds still used treatment Leishmaniasis cardiac toxicity being one potential side effects. Ventricular myocytes guinea-pigs treated trivalent antimony showed impaired contraction responses changes stimulus frequency, reduced calcium current, elongated action potential. However, serum has been reported. This finding suggest environmental can have role right ventricular dysfunction. More studies needed further elucidate this its mechanism. DISCLOSURES: No relevant relationships by Ozan Akca, source=Web Response Lu Cai, Oscar Chen, Speaker/Speaker's Bureau United therapeutics Please note: $5001 - $20000 Karim El-Kersh, Response, value=Honoraria Removed 04/21/2021 Advisory Committee Member $1001 $5000 value=Consulting fee Actelion Therapeutics Current Added 04/23/2021 2019 2020 04/29/2021 Consultant Acceleron Pharma C. Danielle Hopkins, GE Healthcare 2019-Present 04/27/2021 Jiapeng Huang, Research grant Gilead Sciences 2020-2022 value=Grant/Research Support Present Funding Caitlin Wessel,