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 :

» arGentis Continues To Expand

But arGentis grew its drug-development pipeline this month with the acquisition of the rights to a rheumatoid arthritis therapy from the - the terms of which, were not disclosed. The treatment was developed at the University of Tennessee Health...

» Survival In Systemic Sclerosis-Associated Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a severe complication of systemic sclerosis (SSc) and one of the leading causes of morbidity and mortality in this disease. Although several recent studies have suggested an improvement in the prognosis of...

» New Hope for Patients

Pulmonary Fibrosis (PF) and (PAH) are incurable rare lung diseases and are the leading cause of mortality in patients with Systemic Sclerosis (SSc). However patients might have a reason to breathe easier since researchers from the University of...

» Research Vital Statistics and Information On Virtually Any Medicine

is a useful database of information about the prescription and over-the-counter medication, allowing you to look up the possible side effects of specific drugs and see statistics about their reported problems.If you were to look up the allergy...

» Jefferson Researchers Identify Mechanism Behind Fibrotic Disorder

Scientists from the of Thomas Jefferson University are now several steps closer to understanding the mechanism behind a novel systemic fibrotic disorder that affects some patients with renal insufficiency who receive imaging contrast agents for...

» TLR4 Protein Implicated In The Fibrosis Associated With Scleroderma

An international multi-disciplinary research team led by scientists has uncovered a new role for the protein toll-like receptor 4 (TLR4) in the development of tissue fibrosis, or scarring.Recently reported in the , this finding has implications for...