Bilirubin as a prognostic marker in patients with pulmonary arterial hypertension.

Abstract:

BACKGROUND:Liver 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). METHODS:The 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. RESULTS:In 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). CONCLUSION:Elevated serum bilirubin is a risk factor for death in patients with PAH.

journal_name

BMC Pulm Med

journal_title

BMC pulmonary medicine

authors

Takeda Y,Takeda Y,Tomimoto S,Tani T,Narita H,Kimura G

doi

10.1186/1471-2466-10-22

subject

Has Abstract

pub_date

2010-04-22 00:00:00

pages

22

issn

1471-2466

pii

1471-2466-10-22

journal_volume

10

pub_type

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