ABSTRACT
Introduction: Pulmonary arterial hypertension [PAH] is a late progressive sclerodermarelated complication, which can lead to right heart failure and cor pulmonale. Given that cardiac catheterization is a diagnostic method of choice for PAH, and considering the high risks of this method, the purpose of this study was to evaluate the relationship between serum Pro-Brain natriuretic peptide [Pro-BNP] Levels and PAH in patients with limited scleroderma
Materials and Methods: In this cross sectional study, during June 2011- Dec 2013, referring patients to two major educational hospitals, Mashhad- Iran, with scleroderma, who were afflicted with the disease for at least two years [or more], were enrolled in the study if they met the inclusion and exclusion criteria. All the patients underwent echocardiography to determine the pulmonary artery pressure [PAP]. Afterwards, the subjects were referred to a lung center for performing body plethysmography, carbon monoxide diffusing capacity [DLCO], and 6-minute walk test [6MWT]. Pro-BNP Serum level was determined using flourescent immune assay method
Results: The present study included 20 patients [18 female subjects] with the mean age of 43.28 +/- 9.56 yrs, and the mean pro-BNP level of 138 pg/ml. The logarithmic correlation between PAP values, Forced Vital Capacity /DLCO ratio, and pro-BNP level, which was measured using Pearson's correlation coefficient, showed a significant association among these variables[ respectively, r=0.76, P=0.001; r=0.677, P=0.011]. Moreover, the DLCO decrease was associated with increasing pro-BNP level, though this relationship was not significant
Conclusion: This study showed that there was a significant relationship between the serum levels of pro-BNP marker and increased PAP in the echocardiography, DLCO reduction, and FVC/DLCO increase. In fact, this serum marker can be used in patients with systemic scleroderma [SSc] to evaluate the status of PAH