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MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH.
Lung. 2015 Dec; 193(6):901-10.LUNG

Abstract

PURPOSE

Besides the established biomarker NT-proBNP, the new cardiovascular biomarkers MR-proANP, MR-proADM, Copeptin, and CT-proET-1 are promising to evaluate hemodynamics, exercise parameters, and prognosis in patients with pulmonary hypertension (PH).

METHODS

125 consecutive patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) were prospectively enrolled at five German PH centers. Blood samples were taken during right heart catheterization. The primary study endpoint was the correlation between biomarkers and hemodynamic and exercise parameters. As secondary endpoint, prediction of 1-year mortality was evaluated.

RESULTS

MR-proADM showed the strongest correlations with 6MWD and VO2peak, whereas NT-proBNP showed the strongest correlations with PVR, PAPm, and CI. In multivariate analysis, only MR-proADM was independently associated with exercise variables, whereas only NT-proBNP independently predicted hemodynamic parameters. All biomarkers were associated with 1-year survival, with MR-proADM showing the highest C index of 0.78. In multivariate analysis, MR-proADM predicted survival independent of age, 6-MWD, CI, RAP, and NT-proBNP. The cut-off of 1.08 nmol/l provided a sensitivity of 83 % and specificity of 66 %.

CONCLUSIONS

Different biomarkers reflect distinctive disease aspects in PH. NT-proBNP best predicts hemodynamic impairment while MR-proADM strongly correlates with exercise capacity. Additionally, MR-proADM represents a promising new marker to evaluate prognosis in patients with PAH and CTEPH. Multi-marker strategies should further be evaluated.

Authors+Show Affiliations

Division of Pulmonology, Medical Department I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. martin.kolditz@uniklinikum-dresden.de.Department of Pneumology, University Hospital Leipzig, Leipzig, Germany.Department of Internal Medicine V, Saarland University Medical Center, Homburg, Saarland, Germany.Department of Internal Medicine B, Ernst-Moritz-Arndt Universität Greifswald, Greifswald, Germany.Department of Internal Medicine B, Ernst-Moritz-Arndt Universität Greifswald, Greifswald, Germany.BRAHMS GmbH (Thermo Fisher Scientific), Hennigsdorf, Germany.BRAHMS GmbH (Thermo Fisher Scientific), Hennigsdorf, Germany.Department of Pneumology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.Department of Internal Medicine/Cardiology, DRK Kliniken Berlin Köpenick, Berlin, Germany.Center for Pulmonary Hypertension at Thoraxclinic Heidelberg, Heidelberg, Germany.Division of Pulmonology, Medical Department I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.Division of Pulmonology, Medical Department I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26363916

Citation

Kolditz, Martin, et al. "MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH." Lung, vol. 193, no. 6, 2015, pp. 901-10.
Kolditz M, Seyfarth HJ, Wilkens H, et al. MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH. Lung. 2015;193(6):901-10.
Kolditz, M., Seyfarth, H. J., Wilkens, H., Ewert, R., Bollmann, T., Dinter, C., Hertel, S., Klose, H., Opitz, C., Grünig, E., Höffken, G., & Halank, M. (2015). MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH. Lung, 193(6), 901-10. https://doi.org/10.1007/s00408-015-9802-y
Kolditz M, et al. MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH. Lung. 2015;193(6):901-10. PubMed PMID: 26363916.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH. AU - Kolditz,Martin, AU - Seyfarth,Hans-Jürgen, AU - Wilkens,Heinrike, AU - Ewert,Ralf, AU - Bollmann,Tom, AU - Dinter,Christiane, AU - Hertel,Sabine, AU - Klose,Hans, AU - Opitz,Christian, AU - Grünig,Ekkehard, AU - Höffken,Gert, AU - Halank,Michael, Y1 - 2015/09/12/ PY - 2015/05/26/received PY - 2015/09/07/accepted PY - 2015/9/14/entrez PY - 2015/9/14/pubmed PY - 2016/8/24/medline KW - Biomarker KW - Exercise capacity KW - Prognosis KW - Pulmonary hypertension SP - 901 EP - 10 JF - Lung JO - Lung VL - 193 IS - 6 N2 - PURPOSE: Besides the established biomarker NT-proBNP, the new cardiovascular biomarkers MR-proANP, MR-proADM, Copeptin, and CT-proET-1 are promising to evaluate hemodynamics, exercise parameters, and prognosis in patients with pulmonary hypertension (PH). METHODS: 125 consecutive patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) were prospectively enrolled at five German PH centers. Blood samples were taken during right heart catheterization. The primary study endpoint was the correlation between biomarkers and hemodynamic and exercise parameters. As secondary endpoint, prediction of 1-year mortality was evaluated. RESULTS: MR-proADM showed the strongest correlations with 6MWD and VO2peak, whereas NT-proBNP showed the strongest correlations with PVR, PAPm, and CI. In multivariate analysis, only MR-proADM was independently associated with exercise variables, whereas only NT-proBNP independently predicted hemodynamic parameters. All biomarkers were associated with 1-year survival, with MR-proADM showing the highest C index of 0.78. In multivariate analysis, MR-proADM predicted survival independent of age, 6-MWD, CI, RAP, and NT-proBNP. The cut-off of 1.08 nmol/l provided a sensitivity of 83 % and specificity of 66 %. CONCLUSIONS: Different biomarkers reflect distinctive disease aspects in PH. NT-proBNP best predicts hemodynamic impairment while MR-proADM strongly correlates with exercise capacity. Additionally, MR-proADM represents a promising new marker to evaluate prognosis in patients with PAH and CTEPH. Multi-marker strategies should further be evaluated. SN - 1432-1750 UR - https://www.unboundmedicine.com/medline/citation/26363916/MR_proADM_Predicts_Exercise_Capacity_and_Survival_Superior_to_Other_Biomarkers_in_PH_ L2 - https://dx.doi.org/10.1007/s00408-015-9802-y DB - PRIME DP - Unbound Medicine ER -