Aims: Systemic sclerosis (SSc) is an autoimmune disease characterized by micro/macrovascular damage due to the underlying fibrosis. Markers able to predict the progression of cardiovascular damage, including digital ulcers, in SSc are warranted. We aimed at characterizing the relevance of N-terminal proatrial natriuretic peptide (NT-proANP) and N-terminal probrain natriuretic peptide plasma levels in relation to cardiovascular damage and digital ulcers in a cohort of Italian SSc patients. Methods: Seventy patients were enrolled (64 women and six men; mean age 56.7 ± 14 years) with a disease duration of 11.1 ± 8.3 years. Clinical, instrumental (nailfold videocapillaroscopy, ECG, transthoracic echocardiography, pulmonary function test with diffusion lung CO), NT-proANP and N-terminal probrain natriuretic peptide plasma levels measurement were performed at baseline. The clinical follow-up lasted 24 months. The statistical approach used to achieve the study objectives included multivariate analysis, receiver operating characteristic curve, Kaplan-Meier and Cox regression analyses. Result: Both NT-proNPs levels correlated with systolic pulmonary arterial pressure, but only the NT-proANP level correlated with right heart dimension. Both NT-proNPs levels were higher in patients experiencing events at follow-up but only the NT-proANP level significantly predicted the progression of cardiovascular damage, including development of pulmonary arterial hypertension (PAH). NT-proANP levels were higher in patients with digital ulcers and strongly predicted their development. Conclusion: Our results show that the NT-proANP plasma level significantly correlates with disease progression such as new onset of PAH, worsening of pulmonary hypertension and development of digital ulcers in a cohort of SSc Italian patients. If future studies will confirm our findings, the plasma NT-proANP level could be used in clinical practice as a novel sensitive marker for PAH and digital ulcers development in SSc.

Atrial natriuretic peptide predicts disease progression and digital ulcers development in systemic sclerosis patients / Romaniello, Antonella; Rubattu, Speranza; Gigante, Antonietta; Simonelli, Francesca; Grimaldi, Maria Chiara; D'Angelo, Adriano; Alunni, Danilo; Sada, Lidia; Gasperini, Maria L; Marchitti, Simona; Volpe, Massimo; Rosato, Edoardo. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - Aug 7(2019), pp. 1-9. [10.2459/JCM.0000000000000852]

Atrial natriuretic peptide predicts disease progression and digital ulcers development in systemic sclerosis patients

Romaniello, Antonella
Conceptualization
;
Rubattu, Speranza
Conceptualization
;
Gigante, Antonietta
Investigation
;
Simonelli, Francesca
Investigation
;
GRIMALDI, MARIA CHIARA
Investigation
;
D'ANGELO, ADRIANO
Investigation
;
Alunni, Danilo
Data Curation
;
SADA, LIDIA
Data Curation
;
Gasperini, Maria L
Data Curation
;
Marchitti, Simona
Methodology
;
Volpe, Massimo
Supervision
;
Rosato, Edoardo
Conceptualization
2019

Abstract

Aims: Systemic sclerosis (SSc) is an autoimmune disease characterized by micro/macrovascular damage due to the underlying fibrosis. Markers able to predict the progression of cardiovascular damage, including digital ulcers, in SSc are warranted. We aimed at characterizing the relevance of N-terminal proatrial natriuretic peptide (NT-proANP) and N-terminal probrain natriuretic peptide plasma levels in relation to cardiovascular damage and digital ulcers in a cohort of Italian SSc patients. Methods: Seventy patients were enrolled (64 women and six men; mean age 56.7 ± 14 years) with a disease duration of 11.1 ± 8.3 years. Clinical, instrumental (nailfold videocapillaroscopy, ECG, transthoracic echocardiography, pulmonary function test with diffusion lung CO), NT-proANP and N-terminal probrain natriuretic peptide plasma levels measurement were performed at baseline. The clinical follow-up lasted 24 months. The statistical approach used to achieve the study objectives included multivariate analysis, receiver operating characteristic curve, Kaplan-Meier and Cox regression analyses. Result: Both NT-proNPs levels correlated with systolic pulmonary arterial pressure, but only the NT-proANP level correlated with right heart dimension. Both NT-proNPs levels were higher in patients experiencing events at follow-up but only the NT-proANP level significantly predicted the progression of cardiovascular damage, including development of pulmonary arterial hypertension (PAH). NT-proANP levels were higher in patients with digital ulcers and strongly predicted their development. Conclusion: Our results show that the NT-proANP plasma level significantly correlates with disease progression such as new onset of PAH, worsening of pulmonary hypertension and development of digital ulcers in a cohort of SSc Italian patients. If future studies will confirm our findings, the plasma NT-proANP level could be used in clinical practice as a novel sensitive marker for PAH and digital ulcers development in SSc.
2019
atrial natriuretic peptide; systemic sclerosis; digital ulcers
01 Pubblicazione su rivista::01a Articolo in rivista
Atrial natriuretic peptide predicts disease progression and digital ulcers development in systemic sclerosis patients / Romaniello, Antonella; Rubattu, Speranza; Gigante, Antonietta; Simonelli, Francesca; Grimaldi, Maria Chiara; D'Angelo, Adriano; Alunni, Danilo; Sada, Lidia; Gasperini, Maria L; Marchitti, Simona; Volpe, Massimo; Rosato, Edoardo. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - Aug 7(2019), pp. 1-9. [10.2459/JCM.0000000000000852]
File allegati a questo prodotto
File Dimensione Formato  
Romaniello_Atrial-natriuretic_2019.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 279.78 kB
Formato Adobe PDF
279.78 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1307707
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 6
social impact