NT-proBNP as a tool to stratify disease severity in pulmonary arterial hypertension

Abstract

The recent development of treatment modalities for patients with idiopathic pulmonary arterial hypertension has been based on the evaluation of many different markers such as functional capacity, addressed by NYHA classification, six-minute walk test (6MWT) and hemodynamic parameters. The aim of this study was to evaluate the correlation of N-terminal fragment (NT-proBNP) with other markers in IPAH and its potential for patient stratification. We studied 42 IPAH patients consecutively evaluated through right heart catheterization in the absence of any specific treatment for pulmonary hypertension. Blood samples, clinical evaluation and 6MWF distance were collected at baseline. The levels of NT-proBNP showed a high correlation with hemodynamic parameters, such as pulmonary vascular resistance (r=0.80, P<0.001). A significant difference was found among patients with different functional classes, addressed by NYHA classification (P< 0.02 for all groups comparison). The discriminant analysis reinforced the ability of NT-proBNP to stratify patients according to NYHA functional class. Compared to the other variables studied (hemodynamics and 6MWT), NT-proBNP had the lowest level of overlap in the stratification of IPAH patients. We conclude that NT-proBNP differs among the different functional classes and correlates with other measures of disease severity, although its role in predicting survival still needs to be addressed.

Pulmonary hypertension in patients with sickle cell/ thalassemia: incidence and correlation with serum N-terminal pro-brain natriuretic peptide concentrations

“…[13][14][15]17 In our patients, an elevated NT-proBNP level largely reflected the severity of PH ( Figures 1A,1B). The NT-proBNP serum level of 153.6 pg/mL had the highest sensitivity and specificity (85% and 94%, respectively) for the detection of PH in our population.…”

“…15 The high stability of NT-pro BNP in the serum and the convenience of assaying the levels of this protein under routine laboratory conditions have made the measurement of NTproBNP a useful tool for patient stratification in PH. 17 In SCD, patients with PH often have lower pulmonary pressures than do patients with primary PH. 5,6,18 In this cohort of patients the measurement of NT-proBNP is of particular value.…”

Correlation of the New York Heart Association Classification and the 6‐Minute Walk Distance: A Systematic Review

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Biomarkers in pulmonary hypertension

“…NT-proBNP has also been evaluated as a tool to stratify disease severity. Results of a small study found significantly different NT-proBNP levels between patients in each functional class, suggesting a potential role for the marker in stratifying patients according to disease severity [31]. These results are yet to be validated in a larger population.…”