Significance of plasma N-terminal pro-brain natriuretic peptide in patients with systemic sclerosis-related pulmonary arterial hypertension

Respir Med. 2003 Nov;97(11):1230-6. doi: 10.1016/s0954-6111(03)00254-3.


Objectives: A single centre pilot study to investigate the role of the plasma N-terminal pro-brain natriuretic peptide (N-T proBNP) assay to risk stratify patients with suspected pulmonary arterial hypertension (PAH) from a background SSc population.

Methods: Out of 49 SSc patients, 23 had and 26 did not have PAH. Right ventricular haemodynamic variables, six-minute walk test and plasma N-T proBNP levels were recorded from patients catheterised for suspected PAH (23 with PAH and 11/26 without PAH).

Results: Mean value of N-T proBNP for SSc patients with PAH was 3365 (standard error 1095) pg/ml compared to 347 (174) pg/ml for patients without PAH. There was a statistically significant correlation (P < 0.05) between N-T proBNP values and (i) mean pulmonary artery pressure (r = 0.53), (ii) right ventricular end diastolic pressure (r = 0.59) and (iii) pulmonary vascular resistance (r = 0.49). Receiver operator characteristic curve analysis showed that a cut-off value of 395.34 pg/ml had a sensitivity of 0.69 and specificity of 1.0.

Conclusions: N-T proBNP estimation in systemic sclerosis-related pulmonary hypertension is a potentially useful diagnostic tool with a high specificity and negative predictive value. This test has the potential to have an important role in risk stratification and monitoring of therapy in the future.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Natriuretic Factor / blood*
  • Exercise / physiology
  • Female
  • Hemodynamics / physiology
  • Humans
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / diagnosis*
  • Hypertension, Pulmonary / physiopathology
  • Male
  • Middle Aged
  • Pilot Projects
  • Protein Precursors / blood*
  • ROC Curve
  • Risk Factors
  • Scleroderma, Systemic / blood*
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / physiopathology


  • N-terminal proatrial natriuretic peptide
  • Protein Precursors
  • Atrial Natriuretic Factor