Significance of plasma N-terminal pro-brain natriuretic peptide in patients with systemic sclerosis-related pulmonary arterial hypertension.
OBJECTIVE
A single centre pilot study to investigate the role of the plasma N-terminal pro-brain natriuretic peptide (N-T proBNP) assay to risk stratify patients with suspected pulmonary arterial hypertension (PAH) from a background SSc population.


METHODS
Out of 49 SSc patients, 23 had and 26 did not have PAH. Right ventricular haemodynamic variables, six-minute walk test and plasma N-T proBNP levels were recorded from patients catheterised for suspected PAH (23 with PAH and 11/26 without PAH).


RESULTS
Mean value of N-T proBNP for SSc patients with PAH was 3365 (standard error 1095) pg/ml compared to 347 (174) pg/ml for patients without PAH. There was a statistically significant correlation (P < 0.05) between N-T proBNP values and (i) mean pulmonary artery pressure (r = 0.53), (ii) right ventricular end diastolic pressure (r = 0.59) and (iii) pulmonary vascular resistance (r = 0.49). Receiver operator characteristic curve analysis showed that a cut-off value of 395.34 pg/ml had a sensitivity of 0.69 and specificity of 1.0.


CONCLUSIONS
N-T proBNP estimation in systemic sclerosis-related pulmonary hypertension is a potentially useful diagnostic tool with a high specificity and negative predictive value. This test has the potential to have an important role in risk stratification and monitoring of therapy in the future.
Mukerjee
D
D
Royal Free Campus, Centre for Rheumatology, Pond Street, Rowland Hill Street, London NW32QG, UK. devmukerjee@hotmail.com
Yap
L B
LB
Holmes
A M
AM
Nair
D
D
Ayrton
P
P
Black
C M
CM
Coghlan
J G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015444:Exercise / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000097:blood* / Q000150:complications / Q000503:physiopathology
C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor