Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Diastolic dysfunction (DD) in systemic sclerosis (SSc) is a marker of increased risk of death. The N-terminal pro-brain natriuretic peptide (NT-proBNP) is a neurohormone released by ventricular and atrial myocytes and cardiac fibroblasts in response to pressure overload. NT-proBNP is highly associated with pulmonary arterial hypertension in SSc and is a potent vasculogenic agent that enhances bone marrow-derived endothelial progenitor cells (EPC) mobilization to cardiac regeneration. Our purpose was to explore the relationship between NT-proBNP levels and peripheral EPC in SSc patients with and without DD.
Methods: Cross-sectional study in 56 SSc adult patients and 28 matched healthy controls. Exclusion criteria: systolic dysfunction, structural cardiopathy, neoplasms, overlap syndrome, diabetes and hypertension. DD (mild, moderate and severe) was determined according to 2009 EAE/ASE guidelines for the evaluation of diastolic function. EPC were characterized in peripheral blood by flow cytometry according to the expression surface markers CD309, CD34 and CD133 and 7AAD as a viability biomarker. CPE were divided in three phenotypes: 1.CD309+CD34+CD133-,2.CD309+CD133+CD34-, and 3. CD309+CD34+CD133+. Serum levels of NT-proBNP were measured by electroquimioluminiscence. SSc patients were divided according to the severity of DD. Statistical analysis data were expressed in median and range and comparison was made with Wilcoxon, Kruskal Wallis and Pearson correlation tests. P value<0.05 was considered significant.
Results: Results are summarized in Table 1. DD prevalence was 62%. NTproBNP was higher in mild, moderate and severe DD. NT-proBNP showed weak linear relation with CD309+CD34+ EPC cells (R=-0.36, p=0.04)
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Table 1 |
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Healthy controls n= 28 |
SSc without DD n=21 |
SSc with DD n=35 |
P Value |
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Mild (n=20) |
Moderate or severe (n=15) |
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NTproBNP (pg/ml) |
21 (15-50) |
45.01 (17.3-162.6) |
112.5 (35.6-617.5) |
251.1 (84.95-965.6) |
0.0083 |
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EPC subtypes (cells/µl) |
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CD309+CD34+CD133+ |
1.53 (0.05-5.45) |
1.04 (0.07-2.52) |
0.47 (0.07-2.91) |
0.0007 |
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CD309+CD34+CD133- |
0.72 (0.10-3.12) |
0.99 (0.16-4.35) |
0.90 (0.05-5.51) |
0.45 |
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CD309+CD133+CD34- |
1.42 (0.32-6.72) |
1.19 (0.181-4.68) |
1.06 (0.04-3.81) |
0.23 |
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Conclusion: NT–proBNP level is increased in patients with SSc and significantly correlates with severity of DD. On the other hand, the EPC subtype CD309+CD34+CD133+, was significantly diminished in patients with DD compared to patients without DD and healthy controls. These results support the role of NT-proBNP and EPC in the development of cardiac disease in SSc patients. A prospective study is necessary in order to define the prognostic significance of NT-proBNP and EPC alterations in SSc mexican patients.
Disclosure:
J. Sepúlveda,
None;
O. Vera-Lastra,
None;
M. P. Cruz-Dominguez,
None;
L. Montiel-Cervantes,
None;
J. Gómez-León,
None;
L. Robles-Espinoza,
None;
R. Lozano-Morales,
None;
S. Mendoza-Alvarez,
None;
R. Molina-Aguilar,
None;
G. Medina,
None;
J. Vela-Ojeda,
None;
L. J. Jara,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/peripheral-bone-marrow-derived-endothelial-progenitor-cells-and-n-terminal-probrain-natriuretic-peptide-in-scleroderma-mexican-patients-with-and-without-diastolic-dysfunction-a-preliminar/