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Disproportionate elevation of N-terminal pro-brain natriuretic peptide in scleroderma-related pulmonary hypertension.
Eur Respir J. 2010 Jan; 35(1):95-104.ER

Abstract

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of neurohormonal activation that is useful in the diagnosis and prognosis of various forms of pulmonary arterial hypertension (PAH). We sought to characterise and compare NT-proBNP in a cohort of PAH related to systemic sclerosis (PAH-SSc) and idiopathic PAH (IPAH) patients. NT-proBNP levels, collected from PAH-SSc and IPAH patients followed prospectively, were compared and correlated with haemodynamic variables. Cox proportional hazard models were created to assess the predictive value of NT-proBNP. 98 patients (55 PAH-SSc, 43 IPAH) were included. Haemodynamics were similar, except for lower mean pulmonary arterial pressure in PAH-SSc. NT-proBNP levels were significantly higher in PAH-SSc (3,419+/-3,784 versus 1,393+/-1,633 pg x mL(-1); p<0.01) and were more closely related to haemodynamics in PAH-SSc than IPAH. 28 patients died. NT-proBNP predicted survival (hazard ratio (HR) 3.18; p<0.01) in the overall cohort; however, when stratified by group, predicted survival only in PAH-SSc (HR 3.07, p<0.01 versus 2.02, p = 0.29 in IPAH). This is the first description showing NT-proBNP levels are 1) significantly higher in PAH-SSc than IPAH despite less severe haemodynamic perturbations, and 2) stronger predictors of survival in PAH-SSc, suggesting that neurohormonal regulation may differ between PAH-SSc and IPAH. Future studies to define pertinent mechanisms are warranted.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19643943

Citation

Mathai, S C., et al. "Disproportionate Elevation of N-terminal Pro-brain Natriuretic Peptide in Scleroderma-related Pulmonary Hypertension." The European Respiratory Journal, vol. 35, no. 1, 2010, pp. 95-104.
Mathai SC, Bueso M, Hummers LK, et al. Disproportionate elevation of N-terminal pro-brain natriuretic peptide in scleroderma-related pulmonary hypertension. Eur Respir J. 2010;35(1):95-104.
Mathai, S. C., Bueso, M., Hummers, L. K., Boyce, D., Lechtzin, N., Le Pavec, J., Campo, A., Champion, H. C., Housten, T., Forfia, P. R., Zaiman, A. L., Wigley, F. M., Girgis, R. E., & Hassoun, P. M. (2010). Disproportionate elevation of N-terminal pro-brain natriuretic peptide in scleroderma-related pulmonary hypertension. The European Respiratory Journal, 35(1), 95-104. https://doi.org/10.1183/09031936.00074309
Mathai SC, et al. Disproportionate Elevation of N-terminal Pro-brain Natriuretic Peptide in Scleroderma-related Pulmonary Hypertension. Eur Respir J. 2010;35(1):95-104. PubMed PMID: 19643943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disproportionate elevation of N-terminal pro-brain natriuretic peptide in scleroderma-related pulmonary hypertension. AU - Mathai,S C, AU - Bueso,M, AU - Hummers,L K, AU - Boyce,D, AU - Lechtzin,N, AU - Le Pavec,J, AU - Campo,A, AU - Champion,H C, AU - Housten,T, AU - Forfia,P R, AU - Zaiman,A L, AU - Wigley,F M, AU - Girgis,R E, AU - Hassoun,P M, Y1 - 2009/07/30/ PY - 2009/8/1/entrez PY - 2009/8/1/pubmed PY - 2010/3/4/medline SP - 95 EP - 104 JF - The European respiratory journal JO - Eur. Respir. J. VL - 35 IS - 1 N2 - N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of neurohormonal activation that is useful in the diagnosis and prognosis of various forms of pulmonary arterial hypertension (PAH). We sought to characterise and compare NT-proBNP in a cohort of PAH related to systemic sclerosis (PAH-SSc) and idiopathic PAH (IPAH) patients. NT-proBNP levels, collected from PAH-SSc and IPAH patients followed prospectively, were compared and correlated with haemodynamic variables. Cox proportional hazard models were created to assess the predictive value of NT-proBNP. 98 patients (55 PAH-SSc, 43 IPAH) were included. Haemodynamics were similar, except for lower mean pulmonary arterial pressure in PAH-SSc. NT-proBNP levels were significantly higher in PAH-SSc (3,419+/-3,784 versus 1,393+/-1,633 pg x mL(-1); p<0.01) and were more closely related to haemodynamics in PAH-SSc than IPAH. 28 patients died. NT-proBNP predicted survival (hazard ratio (HR) 3.18; p<0.01) in the overall cohort; however, when stratified by group, predicted survival only in PAH-SSc (HR 3.07, p<0.01 versus 2.02, p = 0.29 in IPAH). This is the first description showing NT-proBNP levels are 1) significantly higher in PAH-SSc than IPAH despite less severe haemodynamic perturbations, and 2) stronger predictors of survival in PAH-SSc, suggesting that neurohormonal regulation may differ between PAH-SSc and IPAH. Future studies to define pertinent mechanisms are warranted. SN - 1399-3003 UR - https://www.unboundmedicine.com/medline/citation/19643943/Disproportionate_elevation_of_N_terminal_pro_brain_natriuretic_peptide_in_scleroderma_related_pulmonary_hypertension_ L2 - http://erj.ersjournals.com/cgi/pmidlookup?view=long&amp;pmid=19643943 DB - PRIME DP - Unbound Medicine ER -