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

Antonella Romaniello, Speranza Rubattu, Antonietta Gigante, Francesca Simonelli, Maria C Grimaldi, Adriano D'Angelo, Danilo Alunni, Lidia Sada, Maria L Gasperini, Simona Marchitti, Massimo Volpe, Edoardo Rosato

Research output: Contribution to journalArticle

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.

RESULTS: 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.

Original languageEnglish
Pages (from-to)771-779
Number of pages9
JournalJournal of cardiovascular medicine (Hagerstown, Md.)
Volume20
Issue number11
DOIs
Publication statusPublished - Nov 2019

Fingerprint Dive into the research topics of 'Atrial natriuretic peptide predicts disease progression and digital ulcers development in systemic sclerosis patients'. Together they form a unique fingerprint.

  • Cite this

    Romaniello, A., Rubattu, S., Gigante, A., Simonelli, F., Grimaldi, M. C., D'Angelo, A., Alunni, D., Sada, L., Gasperini, M. L., Marchitti, S., Volpe, M., & Rosato, E. (2019). Atrial natriuretic peptide predicts disease progression and digital ulcers development in systemic sclerosis patients. Journal of cardiovascular medicine (Hagerstown, Md.), 20(11), 771-779. https://doi.org/10.2459/JCM.0000000000000852