NT-proBNP in Rheumatoid Arthritis Patients: Interaction of Immuno-inflammatory Process and Cardiovascular System
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
This article describes the data about diagnostic and prognostic value of the N-terminal fragment of the brain natriuretic propeptide (Nt-proBNP) in patients with rheumatoid arthritis (RA) based on the results of international studies, generally accepted international recommendations, modern scientific publications and results of the own research.
Patients with RA are known to have a 2-fold higher mortality rate from cardiovascular disease (CVD) and its complications comparing to the general population. Nt-proBNP is commonly used as a diagnostic criteriafor heart failure (HF) and left ventricular dysfunction, and to monitor the effectiveness of treatment for HF. At the same time, modern studies have shown that in RA patients this marker is elevated without clinical or instrumental signs of CVD or HF, which makes impossible to use the level of Nt-proBNP with sufficient degree of certainty for diagnosis of HF in this cohort of patients. The evaluation of the role of Nt-proBNP as a marker of cardiovascular involvement or as a part of the immuno-inflammatory response in RA patient need further researches.
We conducted the study to determine the level of Nt-proBNP in RA patients without CVD/HF and found its increased level in 75 % of these patients with the mean level of 3090±2710 pg/ml compared to healthy subjects of the same age and gender – 14,2 % and mean level of 565±430 pg/ml (p<0,001).
Among RA patients without clinical an instrumental signs of CVD /HF the increased level of Nt-proBNP is more frequent and increase is grater than in healthy subjects, which could be connected to the role of this peptide in immune inflammation and pathogenesis of RA.##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Коваленко В.М., Шуба Н.М. (2017) Клініко-діагностичне значення імунологічних тестів при ревматичних хворобах. Навчальний посібник. – 105 с.
Кириллова И.Г., Новикова Д.С. и др. (2016) Уровень N-терминального натрийуретического пептида и диастолическая дисфункция у больных ранним ревматоидным артритом до назначения базисных противовоспалительных препаратов. Терапевтический архив. 88(5):19–26.
Кутузова Л.А., Куница В.Н., Гасанова И.Х., Соболева Е.М. (2016) Динамика плазменного пула кардиомаркеров при метаболической коррекции на фоне санаторно-курортной реабилитации у больных ювенильним ревматоидным артритом. Современная медицина: актуальные вопросы № 9 (10), с. 37–45.
«Ревматоїдний артрит» (2014) Адаптована клінічна настанова, заснована на доказах, газета «Новини медицини і фармації» № 516, с. 53–117.
Хіміон Л.В. (2016) Тактика ведення хворих на ревматоїдний артрит лікарем загальної практики-сімейним лікарем. Сімейна медицина № 2 (64).
Хіміон Л.В. (2016) «Оцінка серцево-судинного ризику і профілактика розвитку кардіоваскулярної патологіїпацієнтів із ревматичними захворюваннями»,. Раціональна фармакотерапія №3 (24).
Agca R., Heslinga S., Rollefstad S., Heslinga M. (2017) EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. Jan; 76(1):17–28.
Avina-Zubieta J. (2012) Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies // Annals of rheumatic diseases. Vol. 71. – 1524–1529.
Atchison D.J., Johnston M.G. (2016) Atrial natriuretic peptide attenuates flowin an isolated lymph duct preparation. Pflugers Arch.; 431 (4):618–624.
Allanore Y, Komocsi A, Vettori S. (2016) N-terminal pro-brain natriuretic peptide is a strong predictor of mortality in systemic sclerosis. Int J Cardiol. Nov 15;223:385–389.
Bentzen H., Pedersen R.S., Pedersen H.B. et al. (2017) Abnormal rhythmic oscillations of atrial natriuretic peptide and brain natriuretic peptide in heart failure. Clin Sci (Lond). Mar; 104 (3):303–12.
Chenglong Han, Don W. Robinson Jr, Monica V. (2018) Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and anky-losing spondylitis // The Journal of Rheumatology November 33 (11) 2167–2172.
De Bold A.J., Boerenstein H.B., Veress A.T. et al. (2015) A rapid and potent natriuretic response to intravenous injection of atrial extracts in rats. Life Sci. Jan 5; 28 (1): 89–94.
ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal (2016) 37, 2129–2200 2016.
Epstein M., Loutzenhiser R., Friedland E. et al. (2016) Relationship of increased plasma atrial natriuretic factor and renal sodium handling during immersion-induced central hypervolemia in normal humans. J Clin Invest. Mar; 79 (3): 738–45.
Galasko G.I., Lahiri A., Barnes S.C. et al. (2018) What is the normal range for N-terminal pro-brain natriuretic peptide? How well does this normal range screen for cardiovascular disease? Eur Heart J. Nov; 26 (21): 2269–76.
Hans-Peter Brunner, Sandra Sanders (2019) Natriuretic Peptides in Chronic Heart Failure Card Fail Rev. Feb; 5(1):44–49.
James S.K., Lindahl B., Siegbahn A. et al. (2017) N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: a Global Utilization of Strategies To Open occluded arteries (GUSTO)-IV substudy. Circulation. Jul 22; 108(3):275–81.
Jernberg T., Stridsberg M., Venge P. (2016) N-terminal pro brain natriuretic peptide on admission for early risk stratification of patientswith chest pain and no ST-segment elevation // J. Am.Coll. Cardiol.– Vol. 7, № 40 (3). – P. 437–445.
Kumeda Y1, Inaba M, Goto H. (2016) Increased thickness of the arterial intimamedia detected by ultrasonography in patients with rheumatoid arthritis. Arthritis Rheum. Jun;46(6):1489–97.
Kirstin Bacani, Cynthia S. Crowson (2016) Incidence of Atrial Fibrillation in Patients with Rheumatoid Arthritis // BioMed Research International. Volume, Article ID 809514.
Kobayshi H, Kobayashi Y, Yokoe I, et al. (2016) Magnetic resonancedetected myocardial inflammation and fibrosis in rheumatoid arthritis: associations of disease characteristics and N-terminal pro brain natriuretic peptide levels. Arthritis Care Res.;69(9):1304–11.
Krzesiński P., Uziebło-Życzkowska B. (2017) Echocardiographic assessment and N-terminal pro-brain natriuretic peptide in hypertensives with metabolic syndrome. Adv Clin Exp Med. Mar-Apr;26(2):295–301.
Maack T. (2016) The Broad homeostatic role of natriuretic peptides. Arq. Bras. Endocrinol. Metab.; 50 (2):198–207.
Mirjafari H, Welsh P, Verstappen SM, Wilson P, Marshall T. (2015) N-terminal pro-brain-type natriuretic peptide (NTpro-BNP) and mortality risk in early inflammatory polyarthritis: results from the Norfolk Arthritis Registry (NOAR). Ann Rheum Dis. Apr;73(4):684–90.
Peters MJ, Welsh P, Ms Innes IB, et al. (2017) Tumor necrosis factor alpha blockade reduces circulating N-terminal pro-brain natriuretic peptide levels in patients with active rheumatoid arthritis: results from a prospective cohort study. Ann Rheum Dis. 69:1281–5.
Remme W.J., Swedberg K. (20160 European Society of Cardiology. Comprehensive guidelines for the diagnosis and treatment of chronic heart failure. Task force for the diagnosis and treatment of chronic heart failure of the European Society of Cardiology. Eur J Heart Fail. Jan; 4 (1): 11–22.
Solomon DH, Curhan GC, Rimm EB. (2017) Cardiovascular risk factors in women with and without rheumatoid arthritis. Arthritis Rheum; 50: 3444–3449.
Sarah Skeoch & Ian N. Bruce. (2015) Atherosclerosis in rheumatoid arthritis: is it all about inflammation? Nature Reviews Rheumatology volume 11: 390–400.
Smolen J, Landewé R, Bijlsma J, Burmester G. (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. Jun;76(6):960–977.
Sweitzer N.K., Ky B., French B., Levy W.C., Fang J.C., Wu A.H., Goldberg L.R., Jessup M., Cappola T.P. (2012) Multiple biomarkers for risk prediction in chronic heart failure. Circ Heart Fail.; 5(2):183–90.
Tanaka A, Yoshida H, Kawaguchi A, Oyama J. (2017) N-terminal pro-brain natriuretic peptide and associated factors in the general working population: a baseline survey of the Uranosaki cohort study. Sci Rep. Jul 19;7(1):5810.
