Mid-regional pro-atrial natriuretic peptide and copeptin as indicators of disease severity and therapy response in CTEPH.

Autor:	Kriechbaum SD; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany., Scherwitz L; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany., Wiedenroth CB; Kerckhoff Heart and Thorax Center, Dept of Thoracic Surgery, Bad Nauheim, Germany., Rudolph F; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany., Wolter JS; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany., Haas M; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany., Fischer-Rasokat U; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany., Rolf A; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany.; Justus Liebig University Giessen, Medical Clinic I, Division of Cardiology, Giessen, Germany., Hamm CW; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany.; Justus Liebig University Giessen, Medical Clinic I, Division of Cardiology, Giessen, Germany., Mayer E; Kerckhoff Heart and Thorax Center, Dept of Thoracic Surgery, Bad Nauheim, Germany., Guth S; Kerckhoff Heart and Thorax Center, Dept of Thoracic Surgery, Bad Nauheim, Germany., Keller T; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany.; Justus Liebig University Giessen, Medical Clinic I, Division of Cardiology, Giessen, Germany., Konstantinides SV; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.; Dept of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece., Lankeit M; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.; Dept of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité - University Medicine Berlin, Berlin, Germany.; These authors contributed equally., Liebetrau C; Kerckhoff Heart and Thorax Center, Dept of Cardiology, Bad Nauheim, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Frankfurt am Main, Germany.; Justus Liebig University Giessen, Medical Clinic I, Division of Cardiology, Giessen, Germany.; These authors contributed equally.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2020 Nov 02; Vol. 6 (4). Date of Electronic Publication: 2020 Nov 02 (Print Publication: 2020).
DOI:	10.1183/23120541.00356-2020
Abstrakt:	Background: Chronic thromboembolic pulmonary hypertension (CTEPH) leads to right heart failure. Pulmonary endarterectomy (PEA) or balloon pulmonary angioplasty (BPA) restore pulmonary haemodynamics and allow cardiac recovery. This study examined the relationship of copeptin and mid-regional pro-atrial natriuretic peptide (MR-proANP) levels to disease severity and therapy response. Methods: This observational cohort study included 125 patients (55 PEA/70 BPA) who underwent treatment and completed a 6-/12-month follow-up. Biomarkers, measured at baseline, prior to every BPA and at follow-up, were compared to 1) severe disease at baseline (right atrial pressure (RAP) ≥8 mmHg and cardiac index ≤2.4 L·min -1 ·m -2 ) and 2) optimal therapy response (no persistent pulmonary hypertension combined with a normalised RAP (mean PAP ≤25 mmHg, pulmonary vascular resistance (PVR) ≤3 WU and RAP ≤6 mmHg) or a reduction in mean PAP ≥25%, PVR ≥35% and RAP ≥25%). Results: Severely diseased patients had higher levels of MR-proANP (320 (246-527) pmol·L -1 versus 133 (82-215) pmol·L -1 ; p=0.001) and copeptin (12.7 (7.3-20.6) pmol·L -1 versus 6.8 (4.4-12.8) pmol·L -1 ; p=0.015) at baseline than the rest of the cohort. At baseline, MR-proANP (area under the curve (AUC) 0.91; cut-off value 227 pmol·L -1 ; OR 56, 95% CI 6.9-454.3) and copeptin (AUC 0.70; cut-off value 10.9 pmol·L -1 ; OR 1.5, 95% CI 1.2-1.9) identified severely diseased patients. After PEA/BPA, levels of MR-proANP (99 (58-145) pmol·L -1 ; p<0.001) and copeptin (6.3 (3.7-12.6) pmol·L -1 ; p=0.009) decreased and indicated optimal therapy response (MR-proANP <123 pmol·L -1 (AUC 0.70) and copeptin <10.1 pmol·L -1 (AUC 0.58)). Conclusion: MR-proANP and copeptin levels are affected in CTEPH and decrease after therapy. MR-proANP identifies a severe disease status and optimal therapy response. Competing Interests: Conflict of interest: S.D. Kriechbaum has nothing to disclose. Conflict of interest: L. Scherwitz has nothing to disclose. Conflict of interest: C.B. Wiedenroth reports personal fees from Actelion, Bayer, MSD, Pfizer and BTG outside the submitted work. Conflict of interest: F. Rudolph has nothing to disclose. Conflict of interest: S. Wolter has nothing to disclose. Conflict of interest: M. Haas reports personal fees from Daiichi-Sankyo and Pfizer outside the submitted work. Conflict of interest: U. Fischer-Rasokat has nothing to disclose. Conflict of interest: A. Rolf reports personal fees from Astra Zeneca, Boehringer Ingelheim and Pfizer-Bristol-Myers Squibb outside the submitted work;. Conflict of interest: C.W. Hamm reports personal fees from BRAHMS/Thermo Fisher outside the submitted work. Conflict of interest: E. Mayer reports grants from Deutsche Forschungsgesellschaft during the conduct of the study; and personal fees from Actelion, Bayer, MSD and Pfizer outside the submitted work. Conflict of interest: S. Guth reports personal fees from Actelion, Bayer, GSK, MSD and Pfizer outside the submitted work. Conflict of interest: T. Keller reports personal fees from Abbott and Brahms outside the submitted work. Conflict of interest: S.V. Konstantinides reports grants from German Federal Ministry of Education and Research (BMBF 01EO1503) during the conduct of the study; and grants and personal fees from Bayer, personal fees from Pfizer Bristol Myers Suqibb, grants and personal fees from Boehringer Ingelheim, personal fees from Daiichi Sankyo and MSD, and grants from Actelion, outside the submitted work;. Conflict of interest: M. Lankeit reports grants from German Federal Ministry of Education and Research (BMBF 01EO1503) during the conduct of the study; and grants and personal fees from Bayer, personal fees from Pfizer Bristol Myers Squibb, personal fees from Daiichi Sankyo and MSD, grants and personal fees from Thermo Fisher Scientific, and personal fees from Actelion, outside the submitted work. Conflict of interest: C. Liebetrau reports personal fees from Bayer, Pfizer-Bristol-Myers Squibb, GSK, Abott, AstraZeneca, Berlin Chemie, Daiichi-Sankyo and Boehringer Ingelheim outside the submitted work. (Copyright ©ERS 2020.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu