Although dysfunctional endothelium, vasoconstriction, and in situ thrombosis are characteristics of primary pulmonary hypertension, the role that plasma vasomotor and coagulation factors play in this phenomenon are not completely understood. The aim of this work was to ascertain the diagnostic value of endothelin-1, thrombomodulin, tissue factor, and tissue factor pathway inhibitor, as well as their correlation with endothelial dysfunction in primary pulmonary hypertension patients. We analyzed the plasmatic concentration and chromogenic of the above-mentioned molecules using immunoenzymatic techniques. Patients were divided into responders and nonresponders on the basis of their hemodynamic response to a vasodilator trial. We found a continuous increase in endothelin-1 levels and a continuous decrease in functional tissue factor in the control group, responders, and nonresponders, respectively. Moreover, the patients showed a moderate decrease in thrombomodulin levels compared with the control group, without statistical significance. These results support a previous description of a decrease in thrombomodulin levels in primary pulmonary hypertension patients and suggests that an alteration of endothelin-1 and functional tissue factor could be related to a worsening of endothelial function and, indirectly, with the clinical severity of primary pulmonary hypertension.
El paso que existe en la literatura contemporánea del desarrollo regional al territorial lleva consigo un cambio importante en el significado de las categorías de espacio, región y territorio que es preciso evidenciar y clarificar para dar sentido a las nuevas orientaciones y posibilidades que tiene la política del desarrollo en la época contemporánea. Con el objetivo de contribuir a esta reflexión, se propone analizar los cambios más importantes ocurridos en el análisis sobre el desarrollo territorial a partir de la redefinición que se ha dado de la categoría de territorio en América Latina, abriendo su dimensión a los múltiples agentes que intervienen en el proceso, para integrar una estrategia que pueda redimensionar el desarrollo territorial a partir de la consideración de la multidimensionalidad que éste tiene en sus diferentes niveles y escalas.
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