NT-proBNP levels in systemic sclerosis: Association with clinical and laboratory abnormalities

Oravec, Rejane Maria; Bredemeier, Markus; Laurino, Claudia Cilene Fernandes Correia; Pinotti, Antonio Fernando Furlan; Rohde, Luís Eduardo Paim; Brenol, João Carlos Tavares; Xavier, Ricardo Machado

doi:10.1016/j.clinbiochem.2010.03.011

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Oravec et al in the group of 119 SSc patients reported that the serum NT-proBNP level 157.8 pg/ml showed 100 % sensitivity, 72.3 % specificity, 39.1 % PPV and 100 % NPV for detected PH [30]. We also revealed using the ROC analysis that serum NT-proBNP level is useful in identification of RV Tei index >0.4.…”

Section: Discussionsupporting

confidence: 51%

Serum endothelin-1 and NT-proBNP, but not ADMA, endoglin and TIMP-1 levels, reflect impaired right ventricular function in patients with systemic sclerosis

et al. 2013

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BackgroundHeart and pulmonary involvement is a leading cause of systemic sclerosis (SSc)-related deaths.ObjectivesThe aim of our study was to assess if biochemical markers of right ventricular (RV) overload, endothelial function and collagen metabolism can predict RV dysfunction assessed by Doppler echocardiography in SSc patients.MethodsWe prospectively studied 111 consecutive patients (101 F, 10 M, age 54.2 ± 13.8 years) with diagnosed SSc (mean disease duration 9.4 ± 11.4 years) and a group of 21 age-matched subjects (18 F, 3 M, age 49.3 + 10.5 years). We performed transthoracic echocardiography (Phillips iE 33) and measured serum endothelin-1 (ET-1), N-terminal pro-brain natriuretic peptide (NT-proBNP), asymmetric dimethylarginine (ADMA), endoglin and human tissue inhibitor of matrix metalloproteinase (TIMP-1) concentration.ResultsMedian serum NT-proBNP level in SSc patients was 133.5 (range 21.86–17,670 pg/ml) and was significantly higher than in controls (p = 0.0002). Moreover, the median serum ET-1 level of 1.49 (range 0.26–8.75 pg/ml) was higher in SSc patients (p = 0.002). However, no significant differences in ADMA, TIMP-1 and endoglin serum concentration between SSc patients and controls were observed. Serum NT-proBNP concentration correlated positively with echocardiographic signs of RV overload: tricuspid regurgitation pressure gradient (r = 0.38, p = 0.0004) and RV Tei index (r = 0.25, p = 0.01). ET-1 serum level correlated negatively with tricuspid annular plane systolic excursion (r = −0.4, p = 0.01) and positively with inferior vena cava diameter measured at expiration (r = 0.38, p = 0.0002). The echocardiographic signs of RV overload were significantly more pronounced in the highest NT-proBNP tertile (>195 pg/ml) group than in the lowest one (<88 pg/ml).ConclusionsSerum ET-1 and NT-proBNP, but not endoglin, ADMA and TIMP-1 levels correlating with the echocardiographic parameters of RV overload, can be considered as noninvasive indicators of RV dysfunction in SSc patients.

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Section: Discussionsupporting

confidence: 51%

Serum endothelin-1 and NT-proBNP, but not ADMA, endoglin and TIMP-1 levels, reflect impaired right ventricular function in patients with systemic sclerosis

et al. 2013

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“…They also showed association of NT-proBNP with severity of PAH and risk of mortality [ 121 ]. Later studies also showed similar correlation of NT-proBNP with increased PAP based on TTE and RHC, as well as negative correlation with DLCO and the presence of ATA [ 122 – 126 ]. More recently, NT-proBNP has been in used as a diagnostic marker in combination with other modalities including TTE and PFT.…”

Section: Biomarkers Involved In Ssc Lung Involvementmentioning

confidence: 75%

Update on biomarkers in systemic sclerosis: tools for diagnosis and treatment

2015

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Systemic sclerosis (SSc) is a complex autoimmune disease in which immune activation, vasculopathy, and extensive fibrosis of the skin and internal organs are among the principal features. SSc is a heterogeneous disease with varying manifestations and clinical outcomes. Currently, patients’ clinical evaluation often relies on subjective measures, non-quantitative methods, or requires invasive procedures as markers able to predict disease trajectory or response to therapy are lacking. Therefore, current research is focusing on the discovery of useful biomarkers reflecting ongoing inflammatory or fibrotic activity in the skin and internal organs, as well as being predictive of future disease course. Recently, remarkable progress has been made towards a better understanding of numerous mechanisms involved in the pathogenesis of SSc. This has opened new possibilities for the development of novel biomarkers and therapy. However, current proposed biomarkers that could reliably describe various aspects of SSc still require further investigation. This review will summarize studies describing the commonly used and validated biomarkers, the newly emerging and promising SSc biomarkers identified to date, and consideration of future directions in this field.

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“…BNP, which is released into the blood from ventricular myocytes and fibroblasts in response to pressure overload and increased myocardial pressure, is synthesized as a longer precursor (proBNP) that is subsequently cleaved into an active C-terminal peptide (BNP), able to stimulate diuresis in order to reduce ventricular preload, and an inactive N-terminal fragment (NT-proBNP) [ 243 ]. Several studies have been conducted to evaluate the utility of NT-proBNP concentrations as a screening tool for SSc-related PAH [ 243 , 244 , 245 , 246 , 247 , 248 , 249 , 250 , 251 , 252 , 253 ]. A systematic review and meta-analysis through PubMed, Embase, and Cochrane Library databases was recently performed to estimate the diagnostic accuracy of serum NT-proBNP measurement in the clinical setting of SSc-PAH [ 254 ].…”

Section: Other Molecules Markers Of Vascular Damagementioning

confidence: 99%

Current Trends in Vascular Biomarkers for Systemic Sclerosis: A Narrative Review

Fioretto

Rosa

Matucci‐Cerinic

et al. 2023

IJMS

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Systemic sclerosis (SSc, scleroderma) is a multifaceted rare connective tissue disease whose pathogenesis is dominated by immune dysregulation, small vessel vasculopathy, impaired angiogenesis, and both cutaneous and visceral fibrosis. Microvascular impairment represents the initial event of the disease, preceding fibrosis by months or years and accounting for the main disabling and/or life-threatening clinical manifestations, including telangiectasias, pitting scars, periungual microvascular abnormalities (e.g., giant capillaries, hemorrhages, avascular areas, ramified/bushy capillaries) clinically detectable by nailfold videocapillaroscopy, ischemic digital ulcers, pulmonary arterial hypertension, and scleroderma renal crisis. Despite a variety of available treatment options, treatment of SSc-related vascular disease remains problematic, even considering SSc etherogenity and the quite narrow therapeutic window. In this context, plenty of studies have highlighted the great usefulness in clinical practice of vascular biomarkers allowing clinicians to assess the evolution of the pathological process affecting the vessels, as well as to predict the prognosis and the response to therapy. The current narrative review provides an up-to-date overview of the main candidate vascular biomarkers that have been proposed for SSc, focusing on their main reported associations with characteristic clinical vascular features of the disease.

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NT-proBNP levels in systemic sclerosis: Association with clinical and laboratory abnormalities

Cited by 6 publications

References 27 publications

Serum endothelin-1 and NT-proBNP, but not ADMA, endoglin and TIMP-1 levels, reflect impaired right ventricular function in patients with systemic sclerosis

Serum endothelin-1 and NT-proBNP, but not ADMA, endoglin and TIMP-1 levels, reflect impaired right ventricular function in patients with systemic sclerosis

Update on biomarkers in systemic sclerosis: tools for diagnosis and treatment

Current Trends in Vascular Biomarkers for Systemic Sclerosis: A Narrative Review

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