High N-Terminal Pro–Brain Natriuretic Peptide Levels and Low Diffusing Capacity for Carbon Monoxide as Independent Predictors of the Occurrence of Precapillary Pulmonary Arterial Hypertension in Patients with Systemic Sclerosis

2009 ◽  
Vol 2009 ◽  
pp. 191-192
Author(s):  
M. Ali Raza
Keyword(s):  
Carbon Monoxide ◽  
Systemic Sclerosis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Diffusing Capacity ◽  
Pulmonary Arterial

N-terminal pro-brain natriuretic peptide in systemic sclerosis related pulmonary arterial hypertension under bosentan treatment

2008 ◽  
Vol 29 (3) ◽  
pp. 347-348 ◽  
Author(s):  
Theodoros Dimitroulas ◽  
Georgios Giannakoulas ◽  
Haralambos Karvounis ◽  
Hara Dimitroula ◽  
Loukas Settas
Keyword(s):  
Systemic Sclerosis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Pulmonary Arterial

A normal diffusing capacity of the lungs for carbon monoxide is rare in incidental pulmonary arterial hypertension in systemic sclerosis: Data from the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma cohort

2018 ◽  
Vol 3 (3) ◽  
pp. 237-241
Author(s):  
Rebecca S Overbury ◽  
Maureen A Murtaugh ◽  
Tracy M Frech ◽  
Virginia D Steen
Keyword(s):  
Carbon Monoxide ◽  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Natriuretic Peptide ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Diffusing Capacity ◽  
Pulmonary Arterial ◽  
Left Atrium Size

Objective: Our purpose was to determine the frequency of normal diffusing capacity for carbon monoxide defined as ⩾70% predicted, in those diagnosed with pulmonary arterial hypertension in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma cohort. We compared those with normal diffusing capacity for carbon monoxide to those with reduced diffusing capacity for carbon monoxide <70% in order to better clarify the role of pulmonary function testing as a screening test for pulmonary arterial hypertension and to better understand this population. Methods: Entry criteria included a right heart catheterization with mean pulmonary artery pressure ⩾25 mm Hg and pulmonary capillary wedge pressure ⩽15 mm Hg. Demographics, echocardiogram variables, B-type natriuretic peptide levels, right heart catheterization findings, and survival were described for both groups. Results: Of (n = 202), 11 (5.4%) had a diffusing capacity for carbon monoxide of ⩾70% versus 191 (94.6%) who had a diffusing capacity for carbon monoxide <70%. There were no identified statistical differences between the groups. Left atrium size was 4.1 cm in the normal diffusing capacity for carbon monoxide patients compared to 3.7 cm in the low diffusing capacity for carbon monoxide group but did not reach statistical significance. There were no statistically significant differences in survival. On repeat testing, seven patients subsequently developed a diffusing capacity for carbon monoxide <70%. Conclusion: Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma data suggest that it is very rare for a patient to develop pulmonary arterial hypertension with a preserved diffusing capacity for carbon monoxide. The data support the importance of obtaining diffusing capacity for carbon monoxide and that a patient with a normal diffusing capacity for carbon monoxide while suspected to have systemic sclerosis-pulmonary arterial hypertension should be considered critically. Diffusing capacity for carbon monoxide >70% was present in too few patients to find significant differences in B-type natriuretic peptide and atrium size. Future research should seek to confirm abnormal B-type natriuretic peptide, increased left atrium size, and other evidence of myocardial involvement on diffusing capacity for carbon monoxide.

Comparison of Brain Natriuretic Peptide (BNP) and NT-proBNP in Screening for Pulmonary Arterial Hypertension in Patients with Systemic Sclerosis

2010 ◽  
Vol 37 (10) ◽  
pp. 2064-2070 ◽  
Author(s):  
LORENZO CAVAGNA ◽  
ROBERTO CAPORALI ◽  
CATHERINE KLERSY ◽  
STEFANO GHIO ◽  
RICCARDO ALBERTINI ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Heart Catheterization ◽  
Multicenter Studies ◽  
Link Type ◽  
Increased Risk ◽  
Pulmonary Arterial

Objective.To compare the performance of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc).Methods.Between January 2008 and March 2009, outpatients referred to our unit and satisfying LeRoy criteria for SSc were assessed for PAH. Doppler echocardiography, BNP measurement, and NT-proBNP measurement were done concomitantly for a complete clinical, instrumental, and biochemical evaluation. Right-heart catheterization was carried out in cases of suspected PAH [estimated pulmonary arterial pressure (PAP) ≥ 36 mm Hg; diffusion capacity for carbon monoxide (DLCO) ≤ 50% of predicted value; 1-year DLCO decline ≥ 20% in absence of pulmonary fibrosis; unexplained dyspnea].Results.One hundred thirty-five patients were enrolled (124 women, 11 men; 96 limited SSc, 39 diffuse SSc); precapillary PAH was found in 20 patients (15 limited SSc, 5 diffuse SSc). The estimated PAP correlated with both BNP (R = 0.3; 95% CI 0.14–0.44) and NT-proBNP (R = 0.3, 95% CI 0.14–0.45). BNP [area under the curve (AUC) 0.74, 95% CI 0.59–0.89] was slightly superior to NT-proBNP (AUC 0.63, 95% CI 0.46–0.80) in identification of PAH, with diagnosis cutoff values of 64 pg/ml (sensitivity 60%, specificity 87%) and 239.4 pg/ml (sensitivity 45%, specificity 90%), respectively. BNP (log-transformed, p = 0.032) and creatinine (p = 0.049) were independent predictors of PAH, while NT-proBNP was not (p = 0.50).Conclusion.In our single-center study, the performance of BNP was slightly superior to that of NT-proBNP in PAH screening of patients with SSc, although normal levels of these markers do not exclude diagnosis. We observed that impaired renal function is associated with an increased risk of PAH in SSc. Further multicenter studies are needed to confirm our results (ClinicalTrials.gov ID NCT00617487).

Sign in / Sign up

Export Citation Format

Share Document