特发性肺动脉高压患者靶向药物治疗后 NT-proBNP、hsTnT 和尿酸水平变化与血液动力学变化的关系。

Association of changes in NT-proBNP, hsTnT and uric acid levels with haemodynamic changes after targeted medical therapies in patients with idiopathic pulmonary arterial hypertension.

机构信息

Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People's Republic of China.

Emergency Department, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People's Republic of China.

出版信息

Cardiovasc J Afr. 2022;33(1):10-14. doi: 10.5830/CVJA-2021-018. Epub 2021 Nov 22.

DOI:10.5830/CVJA-2021-018

PMID:34851353

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9198680/

Abstract

BACKGROUND

During pulmonary arterial hypertension (PAH)-targeted therapies for patients with idiopathic pulmonary arterial hypertension (IPAH), regular follow up to evaluate treatment efficacy is essential. Serum biomarkers can reflect various pathobiological processes in IPAH and have the advantages of being non-invasive, simple to carry out and low cost. The aim of our study was to evaluate whether serum biomarkers could serve as non-invasive markers to reflect haemodynamic changes after PAH-targeted therapies in patients with IPAH.

METHODS

A total of 31 eligible patients aged 38.1 ± 12.1 years (25 were female) were included in this study. Changes in haemodynamic parameters and several serum biomarkers (cardiac markers, serum uric acid, high-sensitivity C-reactive protein, hepatic and kidney function markers) were compared before and after at least six months of PAH-targeted therapies. The time interval between the blood assays and right heart catheterisation was within five days.

RESULTS

After at least six months of PAH-targeted therapies, the N-terminal pro-brain natriuretic peptide (NT-proBNP) level decreased from 579 (191-905) to 135 pg/ml (60-395) ( < 0.01), high-sensitivity cardiac troponin T (hsTnT) level decreased from 0.009 (0.006-0.012) to 0.007 ng/ml (0.005-0.01) ( < 0.01), and serum uric acid level decreased from 381.5 ± 131.4 to 327.2 ± 110.0 µmol7sol;l ( = 0.011). The change in NT-proBNP level was positively correlated with changes in pulmonary vascular resistance ( = 0.538, < 0.01) and mean pulmonary arterial pressure ( = 0.440, = 0.013). The change in hsTnT level was positively correlated with the change in mean right atrium pressure ( = 0.504, < 0.01). The change in serum uric acid level was negatively correlated with that of cardiac index ( = -0.471, < 0.01).

CONCLUSION

NT-proBNP, hsTnT and serum uric acid levels can be used as non-invasive tools for evaluating the efficacy of PAH-targeted medications for IPAH patients. The role of these biomarkers in the follow up should be emphasised.

摘要

背景

在特发性肺动脉高压（IPAH）患者的肺动脉高压靶向治疗期间，定期随访以评估治疗效果至关重要。血清生物标志物可以反映 IPAH 中的各种病理生物学过程，具有非侵入性、操作简单和成本低的优点。本研究旨在评估血清生物标志物是否可作为反映 IPAH 患者肺动脉高压靶向治疗后血液动力学变化的无创标志物。

方法

共纳入 31 名年龄 38.1 ± 12.1 岁（25 名女性）的符合条件的患者。比较了至少 6 个月的肺动脉高压靶向治疗前后的血液动力学参数和几种血清生物标志物（心标志物、血清尿酸、高敏 C 反应蛋白、肝肾功能标志物）的变化。血液检测和右心导管检查之间的时间间隔在 5 天内。

结果

经过至少 6 个月的肺动脉高压靶向治疗后，N 端脑利钠肽前体（NT-proBNP）水平从 579（191-905）降至 135pg/ml（60-395）（<0.01），高敏心肌肌钙蛋白 T（hsTnT）水平从 0.009（0.006-0.012）降至 0.007ng/ml（0.005-0.01）（<0.01），血清尿酸水平从 381.5±131.4 降至 327.2±110.0μmol7sol；l（=0.011）。NT-proBNP 水平的变化与肺血管阻力（=0.538，<0.01）和平均肺动脉压（=0.440，=0.013）的变化呈正相关。hsTnT 水平的变化与平均右心房压力的变化呈正相关（=0.504，<0.01）。血清尿酸水平的变化与心指数的变化呈负相关（=0.471，<0.01）。