scholarly journals Limitations of the findings regarding the relationship between N‐terminal pro–brain natriuretic peptide and systemic sclerosis–related pulmonary arterial hypertension: Comment on the article by Allanore et al

2008 ◽  
Vol 58 (7) ◽  
pp. 2215-2216 ◽  
Author(s):  
Theodoros Dimitroulas ◽  
Georgios Giannakoulas ◽  
Haralambos Karvounis ◽  
Loukas Settas
Keyword(s):  
Systemic Sclerosis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Pulmonary Arterial ◽  
The Relationship

N-terminal pro-brain natriuretic peptide in systemic sclerosis related pulmonary arterial hypertension under bosentan treatment

2008 ◽  
Vol 29 (3) ◽  
pp. 347-348 ◽  
Author(s):  
Theodoros Dimitroulas ◽  
Georgios Giannakoulas ◽  
Haralambos Karvounis ◽  
Hara Dimitroula ◽  
Loukas Settas
Keyword(s):  
Systemic Sclerosis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Pulmonary Arterial

Comparison of Brain Natriuretic Peptide (BNP) and NT-proBNP in Screening for Pulmonary Arterial Hypertension in Patients with Systemic Sclerosis

2010 ◽  
Vol 37 (10) ◽  
pp. 2064-2070 ◽  
Author(s):  
LORENZO CAVAGNA ◽  
ROBERTO CAPORALI ◽  
CATHERINE KLERSY ◽  
STEFANO GHIO ◽  
RICCARDO ALBERTINI ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Heart Catheterization ◽  
Multicenter Studies ◽  
Link Type ◽  
Increased Risk ◽  
Pulmonary Arterial

Objective.To compare the performance of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc).Methods.Between January 2008 and March 2009, outpatients referred to our unit and satisfying LeRoy criteria for SSc were assessed for PAH. Doppler echocardiography, BNP measurement, and NT-proBNP measurement were done concomitantly for a complete clinical, instrumental, and biochemical evaluation. Right-heart catheterization was carried out in cases of suspected PAH [estimated pulmonary arterial pressure (PAP) ≥ 36 mm Hg; diffusion capacity for carbon monoxide (DLCO) ≤ 50% of predicted value; 1-year DLCO decline ≥ 20% in absence of pulmonary fibrosis; unexplained dyspnea].Results.One hundred thirty-five patients were enrolled (124 women, 11 men; 96 limited SSc, 39 diffuse SSc); precapillary PAH was found in 20 patients (15 limited SSc, 5 diffuse SSc). The estimated PAP correlated with both BNP (R = 0.3; 95% CI 0.14–0.44) and NT-proBNP (R = 0.3, 95% CI 0.14–0.45). BNP [area under the curve (AUC) 0.74, 95% CI 0.59–0.89] was slightly superior to NT-proBNP (AUC 0.63, 95% CI 0.46–0.80) in identification of PAH, with diagnosis cutoff values of 64 pg/ml (sensitivity 60%, specificity 87%) and 239.4 pg/ml (sensitivity 45%, specificity 90%), respectively. BNP (log-transformed, p = 0.032) and creatinine (p = 0.049) were independent predictors of PAH, while NT-proBNP was not (p = 0.50).Conclusion.In our single-center study, the performance of BNP was slightly superior to that of NT-proBNP in PAH screening of patients with SSc, although normal levels of these markers do not exclude diagnosis. We observed that impaired renal function is associated with an increased risk of PAH in SSc. Further multicenter studies are needed to confirm our results (ClinicalTrials.gov ID NCT00617487).

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