Abstract
Background: Development of standardized predictive blood-derived biomarkers in pulmonary arterial hypertension (PAH) would help to guide therapy decisions for targeted PAH therapies.
Aims: Analysis of predefined longitudinal plasma biomarker levels during long-term treatment of PAH for treatment response and survival.
Patients and Methods: Plasma levels of growth differentiation factor-15 (GDF-15), dehydroepiandrosterone (DHEA), osteopontin and endostatin were assessed in PAH patients who underwent serial right heart catheterizations for clinical follow-up in our center between 2011 and 2019. Association with survival was investigated by univariate Cox regression analysis.
Results: N=39 (n=21 incident and n=18 prevalent) patients were included (m:f=15:24, mPAP=45 mmHg, IQR:35.5-53.5). Median follow-up time was 42 months (IQR: 35.5-63.5). From baseline to follow-up there was a significant decrease of PVR from 8.4 WU (IQR: 6.4-11.2) to 5.5 WU (3.4-9.7). Only DHEA changed significantly from baseline to follow-up (9.9 pg/mL (IQR:5.5-18.7) vs 5.8 pg/mL (IQR:3.8-14.7), p=0.02). Changes in biomarker levels were not correlated with hemodynamic changes. Baseline GDF-15 was significantly correlated with baseline cardiac index (r=-0.35, p<0.05) and values above median were associated with poor survival (HR=5.14 (1.98-13.33), (p=0.001). Follow-up GDF-15 was also significantly associated with survival (HR=4.27 (1.73-10.58), p=0.002).
Conclusion: In PAH patients, among the investigated markers, GDF-15 may serve as a prognostic biomarker both at baseline and during follow-up but prediction of hemodynamic responses to PAH therapy was poor among all investigated markers.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA144.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021