Estratificação prognóstica na hipertensão pulmonar: valor acrescido da abordagem multibiomarcadores

Plácido, Rui; Cortez‐Dias, Nuno; Martins, Susana; Almeida, Ana G.; Calisto, C.; Gonçalves, Susana; Sadoune, Malha; Diogo, António Nunes; Mebazaa, Alexandre; Pinto, Fausto J.

doi:10.1016/j.repc.2016.08.005

Cited by 17 publications

(4 citation statements)

References 46 publications

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“…Placido at el. reported increased risk of mortality for patients diagnosed with PH who have sST2 level above 68.6 ng/mL [35]. It is worth emphasizing that in our study we only analyzed early postprocedural complications and not long-term prognosis of patients with PH as conducted by Placido et al…”

Section: Discussionmentioning

confidence: 91%

Soluble ST2 as a Biomarker for Early Complications in Patients with Chronic Thromboembolic Pulmonary Hypertension Treated with Balloon Pulmonary Angioplasty

Banaszkiewicz¹,

Pietrasik

Florczyk³

et al. 2021

Diagnostics

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Background: The aim of the study was to assess soluble ST2 (sST2) concentration and its dynamic changes in the periprocedural period in patients with chronic thromboembolic pulmonary hypertension (CTEPH) treated with balloon pulmonary angioplasty (BPA). Methods: We prospectively analyzed 57 procedures of BPA performed in 37 patients with CTEPH. Biomarkers, such as N-terminal pro B-type natriuretic peptide (NT-proBNP), troponin T (TnT), and sST2 were assessed at four time points: Before the BPA procedure, 24 h and 48 h after the procedure, and at the discharge from hospital. Each postprocedural period was assessed for complications. Results: Before the BPA procedure, median sST2 concentration was 26.56 ng/mL (IQR: 16.66–40.83 ng/mL). sST2 concentration was significantly higher 24 h and 48 h after the BPA compared to the baseline measurements (33.31 ng/mL (IQR: 20.81–62.56), p = 0.000 and 27.45 ng/mL (IQR: 17.66–54.45), p = 0.028, respectively). sST2 level 24 h after the BPA procedure was significantly higher in the group with complications compared to the group without complications in the postprocedural period (97.66 ng/mL (IQR: 53.07–126.18) vs. 26.86 ng/mL (IQR: 19.10–40.12), p = 0.000). Conclusions: sST2 concentration in patients with CTEPH treated with BPA changes significantly in the postprocedural period and is significantly higher in the group with complications in postprocedural period.

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Section: Discussionmentioning

confidence: 91%

Soluble ST2 as a Biomarker for Early Complications in Patients with Chronic Thromboembolic Pulmonary Hypertension Treated with Balloon Pulmonary Angioplasty

Banaszkiewicz¹,

Pietrasik

Florczyk³

et al. 2021

Diagnostics

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“…These patients were followed for a mean follow-up duration of 14 months in which 12 patients experienced clinical worsening [18]. Another study found a significant association between sST2 in 43 patients with various types of PH except due to left heart disease and found higher levels of sST2 in patients who were hospitalized for heart failure or died during follow-up [19]. This is in line with our study, which demonstrated a significant association between sST2 and the transplant-free survival in a large cohort of patients with a longer follow-up duration, whom were prospectively followed since their initial diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Soluble ST2 in Adults with Pulmonary Hypertension

Geenen

Baggen

Kauling

et al. 2019

JCM

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Soluble ST2 (sST2) is upregulated in response to myocardial stress and may serve as biomarker in adults with pulmonary hypertension (PH). This prospective cohort study investigated sST2 levels and its association with echocardiographic and hemodynamic measures, and adverse clinical outcomes in adults with PH of different etiologies. sST2 was measured during the diagnostic right heart catheterization for PH, in adult patients enrolled between May 2012 and October 2016. PH due to left heart failure was excluded. The association between sST2 and a primary endpoint composed of death or lung transplantation and a secondary composite endpoint including death, lung transplantation or heart failure, was investigated using Cox regression with adjustment for NT-proBNP. In total 104 patients were included (median age was 59 years, 66% woman, 51% pulmonary arterial hypertension). Median sST2 was 28 [IQR 20–46] ng/mL. Higher sST2 was associated with worse right ventricular dysfunction and higher mean pulmonary and right atrial pressures. Median follow-up was 3.3 [IQR 2.3–4.6] years. The primary and secondary endpoint occurred in 33 (31.7%) and 43 (41.3%) patients, respectively. sST2 was significantly associated with both endpoints (HR per 2-fold higher value 1.53, 95%CI 1.12–2.07, p = 0.007 and 1.45, 95%CI 1.10–1.90, p = 0.008, respectively). However, after adjustment for NT-proBNP, both associations did not reach statistical significance. In conclusions, higher sST2 levels are associated with more severe PH and right ventricular dysfunction and yields prognostic value in adults with PH, although not independently of NT-proBNP.

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“…No acompanhamento de pacientes com hipertensão pulmonar, diversos aspectos são norteadores de decisões terapêuticas e determinantes do prognóstico (TORRES et al, 2015). Nos últimos anos, vários biomarcadores da HP foram investigados com o intuito de buscar um método eficiente e não invasivo de estratificação e monitorização (PLÁCIDO et al, 2017). Nos anos 1970, a oxigenação por membrana extracorpórea foi usada para administrar a insuficiência respiratória e a hipertensão pulmonar e, de certa forma, posteriormente para assistência cardíaca ventricular (KATTAN et al, 2017).…”

Section: Discussionunclassified

Cuidado De Enfermagem Na Atenção Primária À Criança Com Síndrome De Williams-Beuren: Uma Revisão Integrativa

Nonato¹,

Klodzinski²,

Nadalin³

et al. 2020

Destaques Acadêmicos

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O presente artigo trata-se de uma revisão integrativa tendo como objetivos conhecer a fisiopatologia da síndrome de Williams-Beuren e suas consequências no atraso psicomotor da criança e elaborar um plano de cuidados com base nos diagnósticos reais e potenciais elencados baseando-se na taxonomia NANDA 2018-2020, a partir da emergência do tema numa realidade de atenção primária de Curitiba, vivenciada por acadêmicas de enfermagem, por meio da metodologia da problematização, utilizando o Arco de Maguerez, aplicado a um caso fictício. Para a teorização, realizada busca em base de dados, sendo eleitas BVS, Pubmed e Scielo, resultando no total de 27 artigos. A partir do esclarecimento da complexidade cromossômica envolvida na síndrome e as complicações decorrentes da expressividade dessa alteração, compreende-se que a atuação de enfermagem na atenção primária frente à Síndrome de Williams-Beuren aborda integralmente a criança desde seu nascimento e contínuo acompanhamento do desenvolvimento ao longo da vida, pois por meio da monitorização, faz-se possível a prevenção, identificação e intervenção diante das complicações inerentes à síndrome.

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Estratificação prognóstica na hipertensão pulmonar: valor acrescido da abordagem multibiomarcadores

Abstract: A multi-biomarker approach was superior for risk stratification to any single marker. A score that incorporates NT-proBNP, MR-proANP, renin and sST2 accurately identifies patients at low, intermediate and high risk.

Cited by 17 publications

References 46 publications

Soluble ST2 as a Biomarker for Early Complications in Patients with Chronic Thromboembolic Pulmonary Hypertension Treated with Balloon Pulmonary Angioplasty

Soluble ST2 as a Biomarker for Early Complications in Patients with Chronic Thromboembolic Pulmonary Hypertension Treated with Balloon Pulmonary Angioplasty

The Prognostic Value of Soluble ST2 in Adults with Pulmonary Hypertension

Cuidado De Enfermagem Na Atenção Primária À Criança Com Síndrome De Williams-Beuren: Uma Revisão Integrativa

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