N-terminal pro-brain natriuretic peptide in systemic sclerosis patients: correlation with nailfold capillaroscopy findings

Abstract

Background. Pulmonary arterial hypertension (PAH) is an important cause of morbidity and mortality in patients with systemic sclerosis (SSc). This condition is diagnosed by cardiac Doppler ultrasonography, right-heart catheterization, or by serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP). The aim of this study was to assess the association between serum NT-proBNP and nailfold capillaroscopic patterns in SSc patients. We also analyzed the association between pulmonary function parameters, NT-proBNP, and nailfold capillary findings in patients diagnosed with SSc and PAH. Material and methods. We retrospectively analyzed SSc patients and healthy controls from our institution between July 2016 December 2018. We assessed by chart review: pulmonary artery systolic pressure (PASP), forced vital capacity (FVC), forced expiratory volume in 1 sec/forced vital capacity ratio (FEV1/FVC ratio), the number of nailfold capillaries/mm and NT-proBNP. Statistical analyses were performed using the Student’s t-test, ANOVA test and the Pearson’s correlation. Results. Seventeen patients with SSc and 17 healthy controls matched for age and gender were included. Among SSc patients, 13 had diffuse cutaneous SSc (dcSSc) and 4 patients had limited cutaneous SSc (lcSSc). PAH was identified in 10 SSc patients. In SSc patients, significant correlations have been identified between PASP and NT-proBNP (r=0.9, p<0.0001), nailfold capillaries density and PASP (r=-0.95, p<0.0001), and nailfold capillaries density and NT-proBNP (r=-0.84, p<0.0001). Conclusion. We suggest that in patients with SSc, NT-proBNP is significantly correlated with PASP and nailfold capillaroscopic findings.