Urinary cGMP concentrations in severe primary pulmonary hypertension.

Area of Science:

• Cardiology
• Pulmonology
• Biomarkers

Background:

• Prognostic evaluation of primary pulmonary hypertension (PPH) typically requires invasive right heart catheterisation.
• Non-invasive monitoring methods for PPH patients are crucial for disease management.
• Cyclic guanosine monophosphate (cGMP) reflects natriuretic peptide and nitric oxide activity, and is elevated in heart failure.

Purpose of the Study:

• To investigate urinary cyclic guanosine monophosphate (cGMP) as a potential non-invasive marker for haemodynamic impairment in severe primary pulmonary hypertension (PPH).

Main Methods:

• Urinary cGMP concentrations were measured in 19 patients with PPH.
• Comparative analysis included seven patients with acute asthma and 30 healthy controls.
• Correlation analysis assessed the relationship between urinary cGMP and haemodynamic parameters like cardiac index (CI).

Main Results:

• Patients with PPH exhibited significantly higher urinary cGMP concentrations compared to asthmatic patients and healthy controls (p = 0.001).
• Elevated urinary cGMP was observed in patients with severe haemodynamic impairment (CI < or = 2 l/min/m2) (p = 0.002).
• Urinary cGMP showed an inverse correlation with cardiac index (r = -0.69, p = 0.002) and venous oxygen saturation (r = -0.65, p = 0.003).

Conclusions:

• Urinary cGMP concentration may serve as a valuable non-invasive indicator of haemodynamic status in patients with severe PPH.
• This finding could facilitate simpler and more frequent monitoring of PPH patients.