Abstract
Despite the advent of new therapies and improved outcomes in patients with pulmonary arterial hypertension (PAH), it remains a life-shortening disease and the time to diagnosis remains unchanged. Strategies to improve outcomes are therefore currently focused on earlier diagnosis and a treatment approach aimed at moving patients with PAH into a category of low-risk of 1-year mortality. B-type natriuretic peptide (BNP; or brain natriuretic peptide) and N-terminal prohormone of BNP (NT-proBNP) are released from cardiac myocytes in response to mechanical load and wall stress. Elevated levels of BNP and NT-proBNP are incorporated into several PAH risk stratification tools and screening algorithms to aid diagnosis of systemic sclerosis. We have undertaken a systematic review of the literature with respect to the use of BNP and NT-proBNP in PAH and the use of these biomarkers in the diagnosis and risk stratification of PAH, their relation to pulmonary haemodynamics and the potential for point-of-care testing to improve diagnosis and prognosis.
Abstract
Despite the widespread use of BNP and NT-proBNP in pulmonary arterial hypertension there are limited data on the standardisation of sampling and no data on the use of point-of-care testing and its potential value in clinical management https://bit.ly/2Xxm9uV
Footnotes
Provenance: Publication of this peer-reviewed article was sponsored by Janssen Ltd, UK (article sponsor, European Respiratory Review issue 156).
Conflict of interest: R.A. Lewis reports non-financial support from Actelion Pharmaceuticals, outside the submitted work.
Conflict of interest: C. Durrington has nothing to disclose.
Conflict of interest: R. Condliffe reports personal fees and non-financial support from Actelion Pharmaceuticals, Bayer, GlaxoSmithKline and Merck Sharp & Dohme, outside the submitted work.
Conflict of interest: D.G. Kiely reports personal fees and non-financial support from Actelion Pharmaceuticals, Bayer, GlaxoSmithKline and Merck Sharp & Dohme, outside the submitted work.
Support statement: This work was funded by a grant from Janssen Ltd awarded to support manuscript writing. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received January 13, 2020.
- Accepted April 6, 2020.
- Copyright ©ERS 2020.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.