Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension

Intracardiac and transpulmonary levels of natriuretic peptides (NPs) and cyclic guanosine monophosphate (cGMP) provide insight into the pathophysiology of pulmonary hypertension (PH) secondary to left-heart failure but have not been evaluated in established or suspected pulmonary arterial hypertensi...

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Main Authors:	Monahan, Ken, Scott, Theresa A., Su, Yan Ru, Lenneman, Carrie G., Zhao, David X., Robbins, Ivan M., Hemnes, Anna R.
Format:	Online
Language:	English
Published:	Medknow Publications & Media Pvt Ltd 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757828/

id	pubmed-3757828
recordtype	oai_dc
spelling	pubmed-37578282013-09-06 Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension Monahan, Ken Scott, Theresa A. Su, Yan Ru Lenneman, Carrie G. Zhao, David X. Robbins, Ivan M. Hemnes, Anna R. Research Article Intracardiac and transpulmonary levels of natriuretic peptides (NPs) and cyclic guanosine monophosphate (cGMP) provide insight into the pathophysiology of pulmonary hypertension (PH) secondary to left-heart failure but have not been evaluated in established or suspected pulmonary arterial hypertension (PAH). Demonstrating adequate reproducibility of these markers is an important precursor to further study. We hypothesized that the reproducibility of intracardiac and transpulmonary NPs and cGMP is similar to the reproducibility of these markers sampled from the peripheral venous circulation. In outpatients undergoing right-heart catheterization for PH, blood samples were obtained from a peripheral venous site, superior vena cava, inferior vena cava, coronary sinus, pulmonary artery, and pulmonary capillary wedge position. At each site, a repeat sample was collected approximately 60 seconds after the initial measurement. Reproducibility was assessed using the slope of the regression line between initial and follow-up levels. We enrolled 10 patients: Six had PAH, two had pulmonary venous hypertension, and two had normal pulmonary pressure. At all sites, the slopes of the regression lines for BNP were close to identity. BNP was generally more reproducible than NT-pro-BNP. For the NPs and cGMP, reproducibility at intracardiac and transpulmonary sites was similar to the peripheral venous site. Reproducibility of NPs was not influenced by PH severity, access site, or time between measurements. The two patients with the highest transpulmonary pressure gradients had high transpulmonary BNP uptake, but their transpulmonary cGMP gradients were negative. In patients evaluated for PH, reproducibility of NPs and cGMP at intracardiac and transpulmonary sites is high and is comparable to that of peripheral venous measurements. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3757828/ /pubmed/24015334 http://dx.doi.org/10.4103/2045-8932.114762 Text en Copyright: © Pulmonary Circulation http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Monahan, Ken Scott, Theresa A. Su, Yan Ru Lenneman, Carrie G. Zhao, David X. Robbins, Ivan M. Hemnes, Anna R.
spellingShingle	Monahan, Ken Scott, Theresa A. Su, Yan Ru Lenneman, Carrie G. Zhao, David X. Robbins, Ivan M. Hemnes, Anna R. Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
author_facet	Monahan, Ken Scott, Theresa A. Su, Yan Ru Lenneman, Carrie G. Zhao, David X. Robbins, Ivan M. Hemnes, Anna R.
author_sort	Monahan, Ken
title	Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
title_short	Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
title_full	Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
title_fullStr	Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
title_full_unstemmed	Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
title_sort	reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension
description	Intracardiac and transpulmonary levels of natriuretic peptides (NPs) and cyclic guanosine monophosphate (cGMP) provide insight into the pathophysiology of pulmonary hypertension (PH) secondary to left-heart failure but have not been evaluated in established or suspected pulmonary arterial hypertension (PAH). Demonstrating adequate reproducibility of these markers is an important precursor to further study. We hypothesized that the reproducibility of intracardiac and transpulmonary NPs and cGMP is similar to the reproducibility of these markers sampled from the peripheral venous circulation. In outpatients undergoing right-heart catheterization for PH, blood samples were obtained from a peripheral venous site, superior vena cava, inferior vena cava, coronary sinus, pulmonary artery, and pulmonary capillary wedge position. At each site, a repeat sample was collected approximately 60 seconds after the initial measurement. Reproducibility was assessed using the slope of the regression line between initial and follow-up levels. We enrolled 10 patients: Six had PAH, two had pulmonary venous hypertension, and two had normal pulmonary pressure. At all sites, the slopes of the regression lines for BNP were close to identity. BNP was generally more reproducible than NT-pro-BNP. For the NPs and cGMP, reproducibility at intracardiac and transpulmonary sites was similar to the peripheral venous site. Reproducibility of NPs was not influenced by PH severity, access site, or time between measurements. The two patients with the highest transpulmonary pressure gradients had high transpulmonary BNP uptake, but their transpulmonary cGMP gradients were negative. In patients evaluated for PH, reproducibility of NPs and cGMP at intracardiac and transpulmonary sites is high and is comparable to that of peripheral venous measurements.
publisher	Medknow Publications & Media Pvt Ltd
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757828/
_version_	1612007123493847040

Reproducibility of intracardiac and transpulmonary biomarkers in the evaluation of pulmonary hypertension

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