Abstract 13521: C-Terminal Pro Endothelin 1 Precursor Fragment Plasma Levels Correlate with Hemodynamic Parameters in Patients with Scleroderma-Associated Pulmonary Arterial Hypertension
PURPOSE: Pulmonary arterial hypertension (PAH) is a devastating disease in patients (pts) with scleroderma (SSc), harbouring a bad prognosis. Biomarkers play an increasing role in the non-invasive workup of SSc patients, regarding initial diagnosis of PAH as well as follow-up evaluations. Endothelin1 (ET1) is involved in the pathobiology of PAH. We hypothesized that plasma levels of the ET1 precursor peptide, C-terminal proEndothelin-1 (CTproET1) are increased in SSc-associated PAH and correlate well with hemodynamics.
METHODS: We prospectively recruited 50 consecutive pts with SSc, 28 without suspicion or invasive exclusion of PAH, and 22 with diagnosed PAH from our local Dermatology Clinic. CTproET1 plasma levels were measured in each patient. Hemodynamic measurements were performed in 32 pts (all PAH pts and 10 SSc pts without PAH). We also correlated N-terminal pro-brain natriuretic peptide (NTproBNP) levels as an established reference biomarker to all hemodynamic measurements.
RESULTS: Both CTproET1 and NTproBNP levels differed significantly between SSc pts with and without PAH (p<0.001 for both parameters). CTproET1 and NTproBNP significantly correlated with most hemodynamic parameters. In all measured parameters, the correlation with CT-pro-ET1 was stronger than the correlation with NTproBNP. Furthermore, CTproET1 levels significantly correlated with cardiac output, however NTproBNP levels did not. Detailed results are shown in table 1.
CONCLUSIONS: CTproET1 levels differ significantly in SSc pts with and without PAH, and correlate with important hemodynamic parameters. CTproET1 levels may provide important additional information to NTproBNP levels in the diagnostic workup and risk assessment in SSc pts.
- © 2012 by American Heart Association, Inc.