Document Detail


N-terminal pro-brain natriuretic peptide in systemic sclerosis: a new cornerstone of cardiovascular assessment?
MedLine Citation:
PMID:  19054819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac involvement, a common and often fatal complication of systemic sclerosis (SSc), is currently detected by standard echocardiography enhanced by tissue Doppler echocardiography (TDE). OBJECTIVE: The performance of the biomarker of cardiovascular disease, N-terminal pro-brain natriuretic peptide (NT-proBNP), in the detection of cardiac involvement by SSc was examined. METHODS: A total of 69 consecutive patients with SSc (mean (SD) age 56 (13) years, 56 women) were prospectively studied with standard echocardiography and TDE measurements of longitudinal mitral and tricuspid annular velocities. Plasma NT-proBNP was measured in all patients. RESULTS: Overall, 18 patients had manifestations of cardiac involvement, of whom 7 had depressed left ventricular and 8 depressed right ventricular myocardial contractility, and 8 had elevated systolic pulmonary arterial pressure. Patients with reduced contractility had increased mean (SD) NT-proBNP (704 (878) pg/ml versus 118 (112) pg/ml in patients with normal myocardial contractility, p<0.001). Similarly, NT-proBNP was higher in patients with (607 (758) pg/ml) than in patients without (96 (78) pg/ml) manifestations of overall cardiac involvement (p<0.001). Receiver operating characteristic analysis showed NT-proBNP reliably detected depressed myocardial contractility and overall cardiac involvement (area under the curve 0.905 (95% CI 0.814 to 0.996) and 0.935 (95% CI 0.871 to 0.996), respectively). Considering patients with SSc with normal echocardiography and TDE as controls, and using a 125 pg/ml cut-off concentration, sensitivity and specificity were 92% and 71% in the detection of depressed myocardial contractility, and 94% and 78% for overall cardiac involvement. CONCLUSIONS: NT-proBNP reliably detected the presence of cardiac involvement and appears to be a very useful marker to risk stratify patients presenting with SSc.
Authors:
Y Allanore; K Wahbi; D Borderie; S Weber; A Kahan; C Meune
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-12-03
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  68     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-13     Completed Date:  2009-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1885-9     Citation Subset:  IM    
Affiliation:
Department of Rheumatology A, Paris Descartes University, Cochin Hospital, APHP, 75014 Paris, France. yannick.allanore@cch.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Biological Markers / blood
Echocardiography, Doppler / methods
Female
Heart Diseases / diagnosis*,  physiopathology,  ultrasonography
Humans
Male
Middle Aged
Myocardial Contraction / physiology
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Prospective Studies
Scleroderma, Systemic / diagnosis*,  physiopathology,  ultrasonography
Sensitivity and Specificity
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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