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 Medjournal_title
BMC pulmonary medicineauthors
Takeda Y,Takeda Y,Tomimoto S,Tani T,Narita H,Kimura Gdoi
10.1186/1471-2466-10-22subject
Has Abstractpub_date
2010-04-22 00:00:00pages
22issn
1471-2466pii
1471-2466-10-22journal_volume
10pub_type
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