SPARCL1 and NT‐proBNP as biomarkers of right ventricular‐to‐pulmonary artery uncoupling in pulmonary hypertension

Abstract

Abstract Aims SPARCL1 was recently identified as a biomarker of right ventricular (RV) maladaptation in patients with pulmonary hypertension (PH), and N‐terminal pro‐brain natriuretic protein (NT‐proBNP) is an established biomarker of RV failure in PH. The present study investigated whether NT‐proBNP and SPARCL1 concentrations are associated with load‐independent parameters of RV function and RV‐to‐pulmonary artery (RV–PA) coupling as measured using invasive pressure–volume (PV) loops in the RV. Methods SPARCL1 and NT‐proBNP were measured in the plasma of patients with idiopathic pulmonary artery hypertension (IPAH, n = 73). Participants without LV or RV abnormalities served as controls (n = 28). All patients underwent echocardiography and right heart catheterization with invasive PV loop measurements. Results Our cohort had more females with IPAH than the control group (64% vs. 35%; P = 0.01) and was older [69 (interquartile range, IQR 57–76) vs. 51 (IQR 35–62) years; P 42 mm (AUCSPARCL1 = 0.72, AUCNT‐proBNP = 0.65, P = 0.19 for AUCSPARCL1 vs. AUCNT‐proBNP) and RV end‐systolic volume index RVESVI > 31 mL/m2 (AUCSPARCL1 = 0.78, AUCNT‐proBNP = 0.71, PP = 0.10 for AUCSPARCL1 vs. AUCNT‐proBNP). Conclusions SPARCL1 and NT‐proBNP are good predictors of maladaptive RV remodelling and RV–PA uncoupling in IPAH patients. SPARCL1 may be a better predictor of early maladaptive RV remodelling than NT‐proBNP.

Keywords

• RV–PA coupling
• PV loops
• Ees/Ea
• RV dysfunction
• RV remodelling