Introduction:

N-terminal B-type natriuretic peptide (NT-proBNP) is an established biomarker in pulmonary hypertension (PH). Data are limited for other biomarkers. We assessed several biomarkers for their diagnostic value in the diagnosis of precapillary PH (pPH).

Methods:

Blood samples were collected from 58 patients with pPH (PAH N=38, Lung Disease N=14, CTEPH N=6) and from 21 healthy individuals. MR-proANP analysis was performed with the automated Kryptor platform, NT-proCNP, DNP, sST2 and sVEGFR-1 via ELISA. The diagnostic value of the individual biomarkers for the diagnosis of PH was investigated using group comparisons and ROC analyses.
In addition, the serum levels of the biomarkers were correlated with various haemodynamic parameters. 

Results:

MR-proANP level differed significantly between the group of PH patients and controls (118,9 [55,5-222,4] vs 26,1 [17,5-54,2] p<0,001). sST2 level differed between the PH and controls (510,3 [327,9-845,3] vs 173,1 [92,3-388,7] p<0,001) too. None of the other biomarkers showed relevant differences between the groups. MR-proANP and sST2 also correlated with haemodynamic parameters such as RAP, PAPm, TPG and SvO2. ROC analyses showed that both MR-proANP and sST2 were indicative of the presence of PH AUC 0,885 and 0,778, respectively, p<0,001 each.

Conclusions:

Of the biomarkers studied, MR-proANP and sST2 in particular were indicators of the presence of PH and disease severity and could therefore be useful for screening and monitoring patients with pPH