Document Detail


Prognostic significance of sympathetic nervous system activation in pulmonary arterial hypertension.
MedLine Citation:
PMID:  20194810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: The sympathetic nervous system has been reported to be activated in pulmonary arterial hypertension (PAH).
OBJECTIVES: We investigated the prognostic significance of muscle sympathetic nervous system activity (MSNA) in PAH.
METHODS: Thirty-two patients with PAH were included in the study and underwent a measurement of MSNA over a 6-year period of time. They had undergone a concomitant evaluation of New York Heart Association (NYHA) functional class, a 6-minute walk distance (6MWD), an echocardiographic examination, and a right heart catheterization for diagnostic or reevaluation purposes. The median follow-up time was 20.6 months (interquartile range, 45.8 mo). Clinical deterioration was defined by listing for transplantation or death.
MEASUREMENTS AND MAIN RESULTS: Seventeen patients presented with clinical deterioration. As compared with the 15 others, they had an increased MSNA (80 +/- 12 vs. 52 +/- 18 bursts/min; P < 0.001) and heart rate (88 +/- 17 vs. 74 +/- 12 bpm; P = 0.01), a lower 6MWD (324 +/- 119 vs. 434 +/- 88 m; P < 0.01) and a deteriorated NYHA functional class (3.6 +/- 0.5 vs. 2.9 +/- 0.8; P < 0.001). The hemodynamic variables were not different. MSNA was directly related to heart rate and inversely to 6MWD. A univariate analysis revealed that increased MSNA and heart rate, NYHA class IV, lower 6MWD, and pericardial effusion were associated with subsequent clinical deterioration. A multivariate analysis showed that MSNA was an independent predictor of clinical deterioration. For every increase of 1 burst/minute, the risk of clinical deterioration during follow-up increased by 6%.
CONCLUSIONS: Sympathetic nervous system activation is an independent predictor of clinical deterioration in pulmonary arterial hypertension.
Authors:
Agnieszka Ciarka; Vi Doan; Sonia Velez-Roa; Robert Naeije; Philippe van de Borne
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-01
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  181     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-07-15     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1269-75     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Disease Progression
Female
Heart Rate / physiology
Humans
Hypertension, Pulmonary / classification,  mortality,  physiopathology*
Kaplan-Meier Estimate
Male
Middle Aged
Pericardial Effusion / physiopathology
Prognosis
Severity of Illness Index
Sympathetic Nervous System / physiopathology*

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


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