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 :

» Moves Toward Personalized Medicine for Scleroderma

researchers have received two five-year grants totaling $953,000 from the National Institutes of Health's (NIH) National Institute of Arthritis and Musculoskeletal and Skin Diseases to study , an autoimmune disease for which there currently is no...

» Researchers Find Small Group Of ANA & RP Negative Patients

There exists a very small subgroup of patients with (SSc) who lack circulating (ANA) and who do not have Raynaud's phenomenon (RP), research shows. These patients also fail to meet any of the diagnostic criteria for known SSc mimics.The...

» Researchers Gain Deeper Insights Into Causes And New Treatment Strategies For Scleroderma

Using mice, lab-grown cells and clues from a related disorder, Johns Hopkins researchers have greatly increased understanding of the causes of , showing that a critical culprit is a defect in the way certain cells communicate with their structural...

» Aspirin, Simvastatin Not Effective for Pulmonary Arterial Hypertension

Neither aspirin nor simvastatin improved outcomes for patients with in a phase II safety and efficacy trial recently published online in and simultaneously presented at the annual meeting of the .The primary end point of 6-minute walk distance did...

» Study Suggests Link Between Scleroderma, Cancer in Certain Patients

Patients with a certain type of may get cancer and scleroderma simultaneously, Johns Hopkins researchers have found, suggesting that in some diseases, autoimmunity and cancer may be linked.These findings could lead researchers closer to discovering...

» Recent Study Shows 32 Million Americans Have Autoantibodies That Target Their Own Tissues

A recent NIH study says more than 32 million people in the United States have autoantibodies, which are proteins produced in the immune system that attack the body's tissues, defining a condition known as . It also looked at the prevalence of the...