Aim Systemic sclerosis (SSc) may be associated with right ventricular overload, secondary to pulmonary hypertension. In heart failure patients, neuroendocrine derangements can influence clinical evolution and prognosis. The aim of this study was to investigate neurohormonal control affected in SSc patients with and without right ventricular impairment. Methods and results A prospective series of 28 patients with SSc was studied. In addition to conventional evaluations, extensive neuroendocrine studies were done, including assays of both the vasoconstrictor system (plasma renin activity [PRA], aldosterone and catecholamines) and vasodilatory molecules (brain natriuretic peptide [BNP] and atrial natriuretic peptide [ANP]). A significant relation was observed between echo-Doppler estimated pulmonary systolic pressure (PAP) and neurohormonal activation, in particular between PAP and BNP (R = 0.58, p = 0.004), ANP (R = 0.65, p < 0.001) and PRA (R = 0.45, p = 0.032). Patients with right ventricular overload (i.e., PAP > 40 mmHg confirmed at cardiac catheterization) had higher levels of ANP and BNP (147 +/- 26 vs 34 +/- 6 pg/mL and 344 86 vs 30 7 pg/mL, respectively, p < 0.001), PRA (6.4 +/- 1.9 vs 1.8 +/- 0.4 ng/ mL/h, p < 0.001) and aldosterone (257 +/- 86 vs 114 +/- 22 pg/mL, p = 0.02). These patients had increased plasma noradrenaline, but not adrenaline (701 87 vs 452 66 pg/mL, p < 0.001). Conclusion SSc patients with right heart failure have a neurohormonal derangement, showing overactivity of the vasoconstrictive system, counteracted by oversecretion of cardiac natriuretic hormones. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Right ventricular overload and cardiovascular neuroendocrine derangement in systemic sclerosis / Michele, Emdin; Carlo, Marini; Claudio, Passino; Dilia, Giuggioli; Bruno, Formichi; Ferri, Clodoveo; Jaleh, Khabirinejad; Roberta, Poletti; Concetta, Prontera; Annalisa, Iervasi; Antonio, L'Abbate. - In: EUROPEAN HEART JOURNAL SUPPLEMENTS. - ISSN 1520-765X. - STAMPA. - 6:F(2004), pp. F68-F73. [10.1016/j.ehjsup.2004.09.010]

Right ventricular overload and cardiovascular neuroendocrine derangement in systemic sclerosis

Dilia Giuggioli;FERRI, Clodoveo;
2004

Abstract

Aim Systemic sclerosis (SSc) may be associated with right ventricular overload, secondary to pulmonary hypertension. In heart failure patients, neuroendocrine derangements can influence clinical evolution and prognosis. The aim of this study was to investigate neurohormonal control affected in SSc patients with and without right ventricular impairment. Methods and results A prospective series of 28 patients with SSc was studied. In addition to conventional evaluations, extensive neuroendocrine studies were done, including assays of both the vasoconstrictor system (plasma renin activity [PRA], aldosterone and catecholamines) and vasodilatory molecules (brain natriuretic peptide [BNP] and atrial natriuretic peptide [ANP]). A significant relation was observed between echo-Doppler estimated pulmonary systolic pressure (PAP) and neurohormonal activation, in particular between PAP and BNP (R = 0.58, p = 0.004), ANP (R = 0.65, p < 0.001) and PRA (R = 0.45, p = 0.032). Patients with right ventricular overload (i.e., PAP > 40 mmHg confirmed at cardiac catheterization) had higher levels of ANP and BNP (147 +/- 26 vs 34 +/- 6 pg/mL and 344 86 vs 30 7 pg/mL, respectively, p < 0.001), PRA (6.4 +/- 1.9 vs 1.8 +/- 0.4 ng/ mL/h, p < 0.001) and aldosterone (257 +/- 86 vs 114 +/- 22 pg/mL, p = 0.02). These patients had increased plasma noradrenaline, but not adrenaline (701 87 vs 452 66 pg/mL, p < 0.001). Conclusion SSc patients with right heart failure have a neurohormonal derangement, showing overactivity of the vasoconstrictive system, counteracted by oversecretion of cardiac natriuretic hormones. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.
2004
6
F
F68
F73
Right ventricular overload and cardiovascular neuroendocrine derangement in systemic sclerosis / Michele, Emdin; Carlo, Marini; Claudio, Passino; Dilia, Giuggioli; Bruno, Formichi; Ferri, Clodoveo; Jaleh, Khabirinejad; Roberta, Poletti; Concetta, Prontera; Annalisa, Iervasi; Antonio, L'Abbate. - In: EUROPEAN HEART JOURNAL SUPPLEMENTS. - ISSN 1520-765X. - STAMPA. - 6:F(2004), pp. F68-F73. [10.1016/j.ehjsup.2004.09.010]
Michele, Emdin; Carlo, Marini; Claudio, Passino; Dilia, Giuggioli; Bruno, Formichi; Ferri, Clodoveo; Jaleh, Khabirinejad; Roberta, Poletti; Concetta, Prontera; Annalisa, Iervasi; Antonio, L'Abbate
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/4039
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 15
  • ???jsp.display-item.citation.isi??? 14
social impact