Document Detail


Left atrial volume and N-terminal pro-B type natriuretic peptide are associated with elevated pulmonary artery pressure in patients with systemic sclerosis.
MedLine Citation:
PMID:  20526641     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early detection of pulmonary hypertension (PH) in patients with systemic sclerosis (SSc) is essential as it leads to substantial morbidity and mortality irrespective of its etiology. The aim of our study was to determine whether noninvasive biochemical and/or echocardiographic indices can predict the presence of PH in these patients. We prospectively studied 66 patients (mean age of 57.7 +/- 12.1 years, 63 women) with SSc without clinical manifestations of heart failure. All patients underwent standard and tissue Doppler echocardiography. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) levels were also measured. In 24 (36%) patients, the diagnosis of PH was established by echocardiography (systolic pulmonary artery pressure value > or =40 mmHg). Left atrial (LA) volume, NT-proBNP, ADMA, ratio of early transmitral filling velocity to early diastolic velocity of the mitral annulus (mitral E/E (m)), and right ventricular myocardial performance index (MPI) were univariate predictors of PH. In multivariate analysis, NT-proBNP, LA volume, and right ventricular MPI were independent predictors of PH in SSc patients. LA volume and NT-proBNP may be useful noninvasive markers for the prediction of elevated pulmonary artery pressure in patients with SSc. These parameters should be considered when assessing this population for risk stratification and for identification of patients demanding further investigation and institution of specific therapy for the disease at the time when it is most likely to be effective.
Authors:
Theodoros Dimitroulas; Georgios Giannakoulas; Klio Papadopoulou; Tilemahos Sfetsios; Haralambos Karvounis; Hariklia Dimitroula; Despina Parcharidou; Georgios Koliakos; Alexandros Garyfallos; Ioannis Styliadis; Loukas Settas
Publication Detail:
Type:  Journal Article     Date:  2010-06-05
Journal Detail:
Title:  Clinical rheumatology     Volume:  29     ISSN:  1434-9949     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  957-64     Citation Subset:  IM    
Affiliation:
First Department of Internal Medicine, AHEPA University Hospital, Stilp. Kiriakidi 1, 54636, Thessaloniki, Greece. dimitroul@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Arginine / analogs & derivatives,  blood
Biological Markers / blood
Blood Pressure / physiology
Cross-Sectional Studies
Female
Follow-Up Studies
Heart Atria / pathology*,  ultrasonography
Humans
Hypertension, Pulmonary / blood*,  etiology,  physiopathology*
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Prospective Studies
Pulmonary Artery / physiopathology
Scleroderma, Systemic / complications*
Ventricular Dysfunction, Right / physiopathology
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 30315-93-6/N,N-dimethylarginine; 74-79-3/Arginine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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