Rheumatology

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Natriuretic peptides in systemic sclerosis-related pulmonary arterial hypertension
Seminars in Arthritis and Rheumatism, 06/23/09

Dimitroulas T et al. – Study concludes that systemic sclerosis (SSc) patients, particularly those with pulmonary arterial hypertension (PAH), have a derangement of the neurohormonal system, which worsens with disease severity and disease progression. Natriuretic peptides (NP) seem to be suitable noninvasive biomarkers for SSc PAH patients in terms of screening, diagnostic evaluation, risk stratification, and response to therapy, and this merits prospective evaluation.

• Review to examine the evidence for the physiologic, diagnostic, and prognostic role of NP in the context of SSc PAH
• Medline search for articles published between Jan 1999 and Dec 2008
• Keywords: natriuretic peptides, systemic sclerosis or scleroderma, and pulmonary arterial hypertension

• In pts with SSc PAH, NP levels increase in proportion to the extent of right ventricular dysfunction
• They correlate significantly with functional capacity and echocardiographic and hemodynamic parameters
• NP may also provide prognostic information beyond conventional risk markers
• However, their use has to be considered against the background of the parameters that may influence their concentration

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