Urinary cGMP concentrations in severe primary pulmonary hypertension
- Miron Bogdan,
- Marc Humbert,
- Jeanne Francoual,
- Catherine Claise,
- Pierre Duroux,
- Gérald Simonneau,
- Albert Lindenbaum
- Services de Pneumologie, Réanimation Respiratoire et Biochimie, UPRES “Maladie Vasculaires Pulmonaires”, Hôpital Antoine Béclère, Clamart, France
- Dr M Humbert, Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine Béclère, 157 Rue de la Porte de Trivaux, 92140 Clamart, France.
- Received 26 January 1998
- Revision requested 1 April 1998
- Revised 26 May 1998
- Accepted 9 July 1998
Abstract
BACKGROUND Prognostic evaluation of patients with primary pulmonary hypertension (PPH) requires right heart catheterisation. The development of accurate non-invasive methods for monitoring these patients remains an important task. Cyclic guanosine monophosphate (cGMP) is an indicator of the action of natriuretic peptides and nitric oxide on target cells. Plasma and urinary cGMP concentrations are raised in patients with congestive heart failure in whom they correlate closely with haemodynamic parameters and disease severity. The aim of the present study was to determine whether the urinary concentration of cGMP could be used as a non-invasive marker of haemodynamic impairment in patients with severe PPH.
METHODS Urinary cGMP concentrations were measured in 19 consecutive patients with PPH, seven with acute asthma, and 30 normal healthy controls.
RESULTS Patients with PPH had higher urinary cGMP concentrations than asthmatic patients or normal healthy controls (p = 0.001). Urinary cGMP concentrations were higher in patients with severe haemodynamic impairment—that is, those with a cardiac index (CI) of ≤2 l/min/m2 (p = 0.002)—and urinary cGMP concentrations were inversely correlated with CI (r = –0.69, p = 0.002) and venous oxygen saturation (r = –0.65, p = 0.003).
CONCLUSION Urinary cGMP concentrations may represent a non-invasive indicator of the haemodynamic status of patients with severe PPH.
