Endothelin antagonism and uric acid levels in pulmonary arterial hypertension: Clinical associations

Dhaun, Neeraj; Vachiéry, Jean‐Luc; Benza, Raymond L.; Naeije, Robert; Hwang, Lie-Ju; Liu, Xuexuan; Teal, Simon; Webb, David J.

doi:10.1016/j.healun.2014.01.853

Cited by 35 publications

(27 citation statements)

References 30 publications

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“…In previous studies, uric acid was found to have a positive predictive value in mortality determination of patients with chronic heart failure (20)(21)(22). The uric acid level of our patient group was found to be statistically significant.…”

Section: Discussionsupporting

confidence: 58%

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

Pamukçu¹,

Yılmaz²,

Narın³

et al. 2016

Erciyes Med J

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Objective: Noninvasive methods for follow-up of pulmonary hypertensive children are limited. The main aim of this study was to determine the cutoff levels for uric acid and N-terminal pro-brain natriuretic peptide (NT-proBNP) for follow-up of Eisenmenger patients and their relationships with classical methods. To our best knowledge, this is the first study to investigate the levels of NT-proBNP and uric acid in pediatric Eisenmenger patients. Materials and Methods:Sixteen patients with Eisenmenger syndrome and 37 healthy children as controls were included in the study. The serum NT-proBNP and uric acid levels of the participants were measured. The echocardiography, six-minute walk test, and right cardiac catheterization data of the two groups were compared.Results: NT-proBNP>81.4 pg/mL and uric acid >3.5 mg/dL were found to be the most specific and sensitive points for predicting the severity of pulmonary hypertension in Eisenmenger syndrome. There was no significant difference between mean pulmonary arterial pressure and serum NT-proBNP level; however, the differences between pulmonary vascular resistance and serum NT-proBNP level and between mean pulmonary arterial pressure and serum NT-proBNP level were significant. There was no significant difference between NT-proBNP level and New York Heart Association functional classification or six-minute walk test distance. There was no significant difference between serum uric acid level and pulmonary vascular resistance, right atrial pressure, or mean pulmonary arterial pressure. Conclusion:It is too early to determine if serum biomarkers can replace classical diagnostic methods in Eisenmenger syndrome; further studies are required.

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Section: Discussionsupporting

confidence: 58%

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

Pamukçu¹,

Yılmaz²,

Narın³

et al. 2016

Erciyes Med J

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“…8,20,35,[56][57][58] High levels of serum uric acid correlate with patient outcome, 59,60 as do changes in serum uric acid with therapy (ie, not simply baseline values) in patients with PAH. 61 Changes in albumin and total bilirubin are related to overall survival. 58,62,63 Hyponatremia predicts outcome even after adjusting for FC, diuretic use, right atrial pressure, and cardiac index.…”

Section: Laboratorymentioning

confidence: 99%

Risk Assessment in Pulmonary Arterial Hypertension Patients: The Long and Short of it

Benza

Lohmueller

Kraisangka

et al. 2018

Advances in Pulmonary Hypertension

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Pulmonary arterial hypertension (PAH) is a chronic and rapidly progressive disease that is characterized by extensive narrowing of the pulmonary vasculature, leading to increases in pulmonary vascular resistance, subsequent right ventricular dysfunction, and eventual death. There are currently multiple approved drugs—developed as single or combination therapies in the last few years—that have improved outcome and functionality in PAH. However, despite improvement in short-term survival with these new effective therapies, PAH remains an incurable disease with a median survival of 7 years (Figure 1).1 This chronic disease state may be characterized by morbid events such as hospitalizations that herald rapid disease progression and account for a significant disease burden (Figure 2).23 Physician ability to predict PAH disease progression is critical for determining optimal care of patients. Accurate risk assessment allows clinicians to determine the patient's prognosis, identify treatment goals, and monitor disease progression and the patient's response to treatment. Risk assessment for PAH patients should include a range of clinical, hemodynamic, and exercise parameters, performed in a serial fashion over the treatment course. Patient risk stratification can also help physicians better allocate treatment resources in settings where they are scarce. If widely adopted, risk prediction can enhance the consistency of treatment approaches across PAH practitioners and improve the timeliness of referral for lung transplantation. Hence, along with advancing PAH treatment options, comprehensive risk prediction is essential to make individualized treatment decisions in the current treatment era. Several tools are currently available for assessing risk in PAH (Figure 3). These include the 2015 European Society of Cardiology/European Respiratory Society pulmonary hypertension guidelines' risk variables,4 the French registry equation,5 the National Institutes of Health risk equation,6 or a risk score such as the one derived from the Registry to Evaluate Early And Long-term PAH Disease Management.1 These registries and evaluations of clinical trial sets have provided important insights into the importance of both modifiable (eg, 6-minute walk distance, functional class, brain natriuretic peptide, and nonmodifiable (eg, age, gender, PAH etiology) risk factors that predict survival. The following review explores commonly cited risk factors, both modifiable and nonmodifiable, and their implications for patient outcomes.

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“…Potential confounding factors, however, include renal dysfunction and diuretic use and hence uric acid levels must be interpreted in the context of these factors. The role of uric acid in monitoring PAH severity and treatment responses may be useful although further studies are needed 11 25…”

Section: Methodsmentioning

confidence: 99%

Genetic testing and blood biomarkers in paediatric pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK

Pattathu

Gorenflo

Hilgendorff

et al. 2016

Heart

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Endothelin antagonism and uric acid levels in pulmonary arterial hypertension: Clinical associations

Cited by 35 publications

References 30 publications

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

Risk Assessment in Pulmonary Arterial Hypertension Patients: The Long and Short of it

Genetic testing and blood biomarkers in paediatric pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK

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