MiscellaneousN-Terminal Pro-B-Type Natriuretic Peptide as an Indicator of Disease Severity in a Heterogeneous Group of Patients With Chronic Precapillary Pulmonary Hypertension
Section snippets
Patients
We consecutively recruited 61 patients referred to our center for the characterization of suspected chronic precapillary PH (Table 1). According to the revised clinical classification of PH, 40 patients had pulmonary arterial hypertension (PAH), 16 with IPAH (on the basis of the criteria of the National Institutes of Health Registry4) and 24 associated with the following conditions: connective tissue disease (n = 12; systemic sclerosis [n = 4], systemic lupus erythematosus [n = 4], mixed
Plasma NT–pro-BNP
Plasma levels of NT–pro-BNP were significantly elevated in 61 patients with chronic precapillary PH compared with 10 controls (266 ± 274 vs 7 ± 6 pmol/L, p <0.001). When dividing patients into groups according to cause, the highest levels of NT–pro-BNP were found in those with IPAH (340 ± 284 pmol/L) and chronic precapillary PH associated with other diseases (296 ± 315 pmol/L), with significantly higher levels also in the group with chronic thromboembolic PH (163 ± 169 pmol/L) compared with
Discussion
In the present study, we included patients with various forms of chronic precapillary PH and demonstrated that NT–pro-BNP is (1) enhanced across the spectrum of symptomatic patient groups, (2) closely related to hemodynamics and functional capacity, (3) an independent predictor of mortality on multivariate analysis, and (4) decreased in survivors treated medically. These results suggest that plasma NT–pro-BNP levels increase in proportion to the clinical severity of chronic precapillary PH and
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Advances in treatment of chronic thromboembolic pulmonary hypertension
2022, Thrombosis ResearchCitation Excerpt :A recent French single center prospective study including 184 ineligible for PEA patients who underwent 1006 BPA sessions showed a significant reduction on mPAP, PVR along with a significant improvement in New York Heart Association functional class and an increase in short-term exercise capacity [57]. Two studies by Andreassen et al. showed promising results, finding remarkable improvements in cardiopulmonary exercise testing parameters, such as peak oxygen consumption and VE/VCO2 slope, after 3 months following last BPA session in CTEPH patients who were deemed inoperable for PEA [58,59]. In another prospective single-center study from Japan, refined BPA proved to be effective in reducing and maintaining reduced mPAP during a follow-up period of 1.0 ± 0.9 years, and significantly improved clinical symptomatic status of inoperable CTEPH cohort following 2–8 sessions in each patient [14].
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