BNP Screening for PAH in Scleroderma PDF Print E-mail
Tuesday, 24 July 2012 19:41
An elevated level of N-terminal pro-brain natriuretic peptide (NT-proBNP) has a high sensitivity and specificity for pulmonary arterial hypertension in patients with systemic sclerosis (SSc-PAH), Australian rheumatologists and cardiologists have suggested.

They investigated a total of 94 patients with systemic sclerosis in four groups: one with SSc-PAH confirmed by right heart catheterisation, another considered at high risk because of findings on trans-thoracic echocardiography, a group with interstitial lung disease, and a group with no cardiopulmonary complications.

“NT-proBNP was highest in the PAH group compared with the other groups, and higher in the risk group compared with controls,” they said.

The marker was positively correlated with systolic and mean pulmonary artery pressure, pulmonary vascular resistance and mean right atrial pressure.

Further analysis defined thresholds for NT-proBNP and/or results on carbon monoxide pulmonary diffusion tests that should prompt investigation for possible PAH, for example with echocardiography, high-resolution CT, 6-minute walk test, and definitive right heart catheterisation when indicated.

PAH accounted for about 30% of deaths related to systemic sclerosis, the researchers said. In its earliest stages, patients were often asymptomatic or minimally symptomatic but early detection and treatment could delay progression and improve survival.

Annual echocardiography was recommended to screen for early PAH, but this strategy had limitations including technical challenges, insufficient reliability in the presence of coexisting lung disease, poor acoustic windows in some patients, the need for expertise, and issues of cost and resource allocation.

NT-proBNP was released by cardiac myocytes in response to increased ventricular wall stress. The blood test was now widely available given its importance in the diagnosis, prognosis and risk stratification of congestive cardiac failure, they said.

Source: James, T. (2012), "BNP screening for pulmonary arterial hypertension in systemic sclerosis"; Rheumatology Update; original article can be viewed here.

 
More articles :

» Identification of New Autoantibody Specificities Directed at Proteins Involved in the Transforming Growth Factor Beta Pathway in Patients with Systemic Sclerosis

Guillaume BussoneHanadi DibMathieu TambyCedric BroussardChristian FedericiGenevieve WoimantLuc CamoinLoic GuillevinLuc MouthonArthritis Research &Therapy 2011, 13:R74IntroductionAntinuclear antibodies (ANA), usually detected by indirect...

» A New Marker of Silent Cardiovascular Disease in Diffuse Scleroderma

Patients with diffuse systemic sclerosis (SSc) and no clinical evidence of (CVD) may, in fact, have subclinical CVD and , and it is detectable. This is the conclusion of a small pilot study from Italy, which showed that elevated plasma levels of ...

» Sildenafil Reduces Raynaud's Frequency in Systemic Sclerosis Patients

Researchers in Europe reported that treatment with modified-release sildenafil significantly reduced the frequency of attacks of in patients with limited cutaneous systemic sclerosis (lcSSc), also known as . The double-blind, placebo-controlled...

» Study Indicates Scleroderma Mortality Rates Being Underestimated

patients have a significantly reduced life expectancy that is most likely being underestimated, delegates have heard. Most studies on scleroderma survival are based on prevalent cohorts, where no limit is placed on disease duration at the time of...

» Rare Disease Research Teams Receive Over $17m In Funding

(CIHR) has formed 9 new research teams that will focus on rare diseases. Funding from the CIHR will total $15.4 million over five years, primarily through the Institute of Genetics and the Institute of Nutrition, Metabolism, and Diabetes, while...

» Scleroderma in Children: Emerging Management Issues

Saumya PandaDepartment of Dermatology, KPC Medical College, Kolkata, IndiaDate of Web Publication: 21-Jul-2010Abstract         Scleroderma is a set of rare connective tissue diseases of unknown etiology. It is...