Flavio Fontes Pirozzi
Unilago School of Medicine,Brazil
Title: Metabolic Syndrome and Pulmonary Arterial Hypertension: the relationship between gut and lung
Biography
Biography: Flavio Fontes Pirozzi
Abstract
Pulmonary Arterial Hypertension (PAH) is as unknown complication of metabolic syndrome (MS) and more than half of patients with idiophatic-PAH have criteria for MS. There are several mechanisms for the development of PAH in obeses and diabetic patients such as inflammation, angiogenesis, hypoxia, slepp apnea, insulin resistance, cardiac disorders,... . Theres is a important relationship between glycemic control and PAH; patients with HbA1c>5,7% presented a lower risk to survival and worst pulmonary capacity. When we serach about "weight loss and PAH" in PubMed we find few studies about this (only cases reports and after bariatric surgery). Bariatric surgery promotes weight loss but also increases GLP1 (glucagon like-peptide 1) levels and GLP1 has a unknown pleiotropic effect in the lung, it promotes pulmonary artery vasorelaxation. Our group showed that, using a DDP4 inhibitor (vildagliptin 50mg 2x/day - drug which increases native GLP1 without weight loss) in diabetic patients with obesity and (idiophatic and symptomatic) PAHpromotes important improvement of PAH and dreacreses of systolic pressure of right ventricle in echocardiogram. Maybe increasing GLP1 is better than weight loss in patients with MS and PAH.