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Published in: Lung 6/2015

01-12-2015

MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH

Authors: Martin Kolditz, Hans-Jürgen Seyfarth, Heinrike Wilkens, Ralf Ewert, Tom Bollmann, Christiane Dinter, Sabine Hertel, Hans Klose, Christian Opitz, Ekkehard Grünig, Gert Höffken, Michael Halank

Published in: Lung | Issue 6/2015

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Abstract

Purpose

Besides the established biomarker NT-proBNP, the new cardiovascular biomarkers MR-proANP, MR-proADM, Copeptin, and CT-proET-1 are promising to evaluate hemodynamics, exercise parameters, and prognosis in patients with pulmonary hypertension (PH).

Methods

125 consecutive patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) were prospectively enrolled at five German PH centers. Blood samples were taken during right heart catheterization. The primary study endpoint was the correlation between biomarkers and hemodynamic and exercise parameters. As secondary endpoint, prediction of 1-year mortality was evaluated.

Results

MR-proADM showed the strongest correlations with 6MWD and VO2peak, whereas NT-proBNP showed the strongest correlations with PVR, PAPm, and CI. In multivariate analysis, only MR-proADM was independently associated with exercise variables, whereas only NT-proBNP independently predicted hemodynamic parameters. All biomarkers were associated with 1-year survival, with MR-proADM showing the highest C index of 0.78. In multivariate analysis, MR-proADM predicted survival independent of age, 6-MWD, CI, RAP, and NT-proBNP. The cut-off of 1.08 nmol/l provided a sensitivity of 83 % and specificity of 66 %.

Conclusions

Different biomarkers reflect distinctive disease aspects in PH. NT-proBNP best predicts hemodynamic impairment while MR-proADM strongly correlates with exercise capacity. Additionally, MR-proADM represents a promising new marker to evaluate prognosis in patients with PAH and CTEPH. Multi-marker strategies should further be evaluated.
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Metadata
Title
MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH
Authors
Martin Kolditz
Hans-Jürgen Seyfarth
Heinrike Wilkens
Ralf Ewert
Tom Bollmann
Christiane Dinter
Sabine Hertel
Hans Klose
Christian Opitz
Ekkehard Grünig
Gert Höffken
Michael Halank
Publication date
01-12-2015
Publisher
Springer US
Published in
Lung / Issue 6/2015
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-015-9802-y

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