Bilirubin as a prognostic marker in patients with pulmonary arterial hypertension

BMC Pulmonary Medicine

Research Article

Shigehiro Tomimoto¹  Yutaka Takeda¹  Tomomitsu Tani¹  Genjiro Kimura¹  Yasuko Takeda²  Hitomi Narita³ 

[1] Department of Cardio-renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan;Department of Cardio-renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan;Division of Cardiology, Nagoya City Rehabilitation Center, Nagoya, Aichi, Japan;Division of Cardiology, Nagoya City Rehabilitation Center, Nagoya, Aichi, Japan;

关键词: Pulmonary Arterial Hypertension;    Functional Class;    Brain Natriuretic Peptide;    Glycogen Storage Disease;    Hereditary Hemorrhagic Telangiectasia;   

DOI  :  10.1186/1471-2466-10-22

 received in 2009-10-30, accepted in 2010-04-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundLiver dysfunction reflects the status of heart failure, with congestion and low perfusion of the liver serving as causative mechanisms. Previous studies demonstrated relationship between the results of liver function test and the prognosis in patients with heart failure. However, few studies have examined this relationship in patients with pulmonary arterial hypertension (PAH).MethodsThe subjects were 37 patients with PAH (8 men and 29 women; 18 with idiopathic PAH and 19 with connective tissue disease-associated PAH). A blood test was performed after a 3-month period free from hospitalization and without changes in functional class, treatment, heart sounds, body weight, or heart rate.ResultsIn a mean follow-up period of 635 ± 510 days, 12 patients died due to heart failure, 2 died due to pulmonary hemorrhage, and 23 patients survived. Cox proportional hazard analyses identified functional class (p < 0.001), plasma concentration of brain natriuretic peptide (BNP) (p = 0.001), and hyperbilirubinemia (serum total bilirubin > 1.2 mg/dL; p < 0.001; hazard ratio = 13.31) as predictors of mortality. Patients with hyperbilirubinemia had a worse functional class (P = 0.003), a higher right atrial pressure (p < 0.001), a higher plasma concentration of BNP (p = 0.004), and a larger Doppler right ventricular index of the right ventricle (p = 0.041).ConclusionElevated serum bilirubin is a risk factor for death in patients with PAH.

【 授权许可】

CC BY   
© Takeda et al; licensee BioMed Central Ltd. 2010