| Prognostic significance of sympathetic nervous system activation in pulmonary arterial hypertension. | |
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MedLine Citation:
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PMID: 20194810 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Agnieszka Ciarka; Vi Doan; Sonia Velez-Roa; Robert Naeije; Philippe van de Borne |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-03-01 |
Journal Detail:
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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:
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Created Date: 2010-06-02 Completed Date: 2010-07-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1269-75 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Department, Erasme Hospital, 808 Route de Lennik, 1070 Brussels, Belgium. aciarka@ulb.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Disease Progression Female Heart Rate / physiology Humans Hypertension, Pulmonary / classification, mortality, physiopathology* Kaplan-Meiers 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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