Document Detail


Significance of plasma NT-proBNP levels as a biomarker in the assessment of cardiac involvement and pulmonary hypertension in patients with sarcoidosis.
MedLine Citation:
PMID:  21086902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac involvement and pulmonary hypertension (PH) are life-threatening complications in sarcoidosis.
OBJECTIVE: This study aimed to investigate the utility of plasma NT-proBNP in the assessment of these conditions in sarcoidosis patients.
STUDY DESIGN AND METHODS: A prospective, observational study was performed on 150 consecutive Japanese sarcoidosis patients. Doppler echocardiography was performed in all subjects, and those who were successfully evaluated for PH status were included in the analysis. Cardiac sarcoidosis was diagnosed based on Japanese guidelines, and PH was defined as estimated systolic pulmonary artery pressure (sPAP) > or = 35 mmHg. The diagnostic accuracy of NT-proBNP according to the presence of cardiac sarcoidosis and PH was assessed based on receiver-operator characteristic (ROC) curves.
RESULTS: 130 subjects were successfully evaluated for PH status. Of these, 29 met the diagnostic criteria of cardiac sarcoidosis, and 21 were diagnosed with PH. Plasma NT-proBNP levels were significantly higher in patients with cardiac sarcoidosis (p < 0.0001). Stepwise regression analysis showed that presence of cardiac sarcoidosis, decreased ejection fraction and increased sPAP were all independently associated with higher plasma NT-proBNP levels. Plasma NT-proBNP showed good accuracy in identifying patients with cardiac sarcoidosis (area under the ROC curve; AURC = 0.913). However, even when patients with cardiac sarcoidosis were excluded, plasma NT-proBNP levels could not be used reliably to identify patients with PH (AURC = 0.681).
CONCLUSION: In patients with sarcoidosis, plasma NT-proBNP levels are a useful biomarker to identify cardiac involvement, but not to identify PH.
Authors:
T Handa; S Nagai; S Ueda; K Chin; Y Ito; K Watanabe; K Tanizawa; M Tamaya; M Mishima; T Izumi
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders     Volume:  27     ISSN:  1124-0490     ISO Abbreviation:  Sarcoidosis Vasc Diffuse Lung Dis     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-11-19     Completed Date:  2010-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610928     Medline TA:  Sarcoidosis Vasc Diffuse Lung Dis     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  27-35     Citation Subset:  IM    
Affiliation:
Department of Rehabilitation Medicine, Kyoto University Hospital, Kyoto, Japan. hanta@kuhp.kyoto-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biological Markers / blood
Blood Pressure
Cardiomyopathies / blood,  etiology*,  physiopathology,  ultrasonography
Chi-Square Distribution
Echocardiography, Doppler
Female
Humans
Hypertension, Pulmonary / blood,  etiology*,  physiopathology,  ultrasonography
Japan
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Prognosis
Prospective Studies
Pulmonary Artery / physiopathology
ROC Curve
Regression Analysis
Sarcoidosis / blood,  complications*,  physiopathology,  ultrasonography
Stroke Volume
Up-Regulation
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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