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Left atrial volume and N-terminal pro-B type natriuretic peptide are associated with elevated pulmonary artery pressure in patients with systemic sclerosis.
Clin Rheumatol. 2010 Sep; 29(9):957-64.CR

Abstract

Early detection of pulmonary hypertension (PH) in patients with systemic sclerosis (SSc) is essential as it leads to substantial morbidity and mortality irrespective of its etiology. The aim of our study was to determine whether noninvasive biochemical and/or echocardiographic indices can predict the presence of PH in these patients. We prospectively studied 66 patients (mean age of 57.7 +/- 12.1 years, 63 women) with SSc without clinical manifestations of heart failure. All patients underwent standard and tissue Doppler echocardiography. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) levels were also measured. In 24 (36%) patients, the diagnosis of PH was established by echocardiography (systolic pulmonary artery pressure value > or =40 mmHg). Left atrial (LA) volume, NT-proBNP, ADMA, ratio of early transmitral filling velocity to early diastolic velocity of the mitral annulus (mitral E/E (m)), and right ventricular myocardial performance index (MPI) were univariate predictors of PH. In multivariate analysis, NT-proBNP, LA volume, and right ventricular MPI were independent predictors of PH in SSc patients. LA volume and NT-proBNP may be useful noninvasive markers for the prediction of elevated pulmonary artery pressure in patients with SSc. These parameters should be considered when assessing this population for risk stratification and for identification of patients demanding further investigation and institution of specific therapy for the disease at the time when it is most likely to be effective.

Authors+Show Affiliations

First Department of Internal Medicine, AHEPA University Hospital, Stilp. Kiriakidi 1, 54636, Thessaloniki, Greece. dimitroul@hotmail.comNo 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)

Journal Article

Language

eng

PubMed ID

20526641

Citation

Dimitroulas, Theodoros, et al. "Left Atrial Volume and N-terminal pro-B Type Natriuretic Peptide Are Associated With Elevated Pulmonary Artery Pressure in Patients With Systemic Sclerosis." Clinical Rheumatology, vol. 29, no. 9, 2010, pp. 957-64.
Dimitroulas T, Giannakoulas G, Papadopoulou K, et al. Left atrial volume and N-terminal pro-B type natriuretic peptide are associated with elevated pulmonary artery pressure in patients with systemic sclerosis. Clin Rheumatol. 2010;29(9):957-64.
Dimitroulas, T., Giannakoulas, G., Papadopoulou, K., Sfetsios, T., Karvounis, H., Dimitroula, H., Parcharidou, D., Koliakos, G., Garyfallos, A., Styliadis, I., & Settas, L. (2010). Left atrial volume and N-terminal pro-B type natriuretic peptide are associated with elevated pulmonary artery pressure in patients with systemic sclerosis. Clinical Rheumatology, 29(9), 957-64. https://doi.org/10.1007/s10067-010-1494-3
Dimitroulas T, et al. Left Atrial Volume and N-terminal pro-B Type Natriuretic Peptide Are Associated With Elevated Pulmonary Artery Pressure in Patients With Systemic Sclerosis. Clin Rheumatol. 2010;29(9):957-64. PubMed PMID: 20526641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left atrial volume and N-terminal pro-B type natriuretic peptide are associated with elevated pulmonary artery pressure in patients with systemic sclerosis. AU - Dimitroulas,Theodoros, AU - Giannakoulas,Georgios, AU - Papadopoulou,Klio, AU - Sfetsios,Tilemahos, AU - Karvounis,Haralambos, AU - Dimitroula,Hariklia, AU - Parcharidou,Despina, AU - Koliakos,Georgios, AU - Garyfallos,Alexandros, AU - Styliadis,Ioannis, AU - Settas,Loukas, Y1 - 2010/06/05/ PY - 2010/02/10/received PY - 2010/05/16/accepted PY - 2010/05/08/revised PY - 2010/6/8/entrez PY - 2010/6/8/pubmed PY - 2010/12/14/medline SP - 957 EP - 64 JF - Clinical rheumatology JO - Clin Rheumatol VL - 29 IS - 9 N2 - Early detection of pulmonary hypertension (PH) in patients with systemic sclerosis (SSc) is essential as it leads to substantial morbidity and mortality irrespective of its etiology. The aim of our study was to determine whether noninvasive biochemical and/or echocardiographic indices can predict the presence of PH in these patients. We prospectively studied 66 patients (mean age of 57.7 +/- 12.1 years, 63 women) with SSc without clinical manifestations of heart failure. All patients underwent standard and tissue Doppler echocardiography. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) levels were also measured. In 24 (36%) patients, the diagnosis of PH was established by echocardiography (systolic pulmonary artery pressure value > or =40 mmHg). Left atrial (LA) volume, NT-proBNP, ADMA, ratio of early transmitral filling velocity to early diastolic velocity of the mitral annulus (mitral E/E (m)), and right ventricular myocardial performance index (MPI) were univariate predictors of PH. In multivariate analysis, NT-proBNP, LA volume, and right ventricular MPI were independent predictors of PH in SSc patients. LA volume and NT-proBNP may be useful noninvasive markers for the prediction of elevated pulmonary artery pressure in patients with SSc. These parameters should be considered when assessing this population for risk stratification and for identification of patients demanding further investigation and institution of specific therapy for the disease at the time when it is most likely to be effective. SN - 1434-9949 UR - https://www.unboundmedicine.com/medline/citation/20526641/Left_atrial_volume_and_N_terminal_pro_B_type_natriuretic_peptide_are_associated_with_elevated_pulmonary_artery_pressure_in_patients_with_systemic_sclerosis_ L2 - https://dx.doi.org/10.1007/s10067-010-1494-3 DB - PRIME DP - Unbound Medicine ER -