PMID- 20194810
OWN - NLM
STAT- MEDLINE
DCOM- 20100715
LR  - 20220409
IS  - 1535-4970 (Electronic)
IS  - 1073-449X (Linking)
VI  - 181
IP  - 11
DP  - 2010 Jun 1
TI  - Prognostic significance of sympathetic nervous system activation in pulmonary 
      arterial hypertension.
PG  - 1269-75
LID - 10.1164/rccm.200912-1856OC [doi]
AB  - RATIONALE: The sympathetic nervous system has been reported to be activated in 
      pulmonary arterial hypertension (PAH). OBJECTIVES: We investigated the prognostic 
      significance of muscle sympathetic nervous system activity (MSNA) in PAH. 
      METHODS: Thirty-two patients with PAH were included in the study and underwent a 
      measurement of MSNA over a 6-year period of time. They had undergone a 
      concomitant evaluation of New York Heart Association (NYHA) functional class, a 
      6-minute walk distance (6MWD), an echocardiographic examination, and a right 
      heart catheterization for diagnostic or reevaluation purposes. The median 
      follow-up time was 20.6 months (interquartile range, 45.8 mo). Clinical 
      deterioration was defined by listing for transplantation or death. MEASUREMENTS 
      AND MAIN RESULTS: Seventeen patients presented with clinical deterioration. As 
      compared with the 15 others, they had an increased MSNA (80 +/- 12 vs. 52 +/- 18 
      bursts/min; P < 0.001) and heart rate (88 +/- 17 vs. 74 +/- 12 bpm; P = 0.01), a 
      lower 6MWD (324 +/- 119 vs. 434 +/- 88 m; P < 0.01) and a deteriorated NYHA 
      functional class (3.6 +/- 0.5 vs. 2.9 +/- 0.8; P < 0.001). The hemodynamic 
      variables were not different. MSNA was directly related to heart rate and 
      inversely to 6MWD. A univariate analysis revealed that increased MSNA and heart 
      rate, NYHA class IV, lower 6MWD, and pericardial effusion were associated with 
      subsequent clinical deterioration. A multivariate analysis showed that MSNA was 
      an independent predictor of clinical deterioration. For every increase of 1 
      burst/minute, the risk of clinical deterioration during follow-up increased by 
      6%. CONCLUSIONS: Sympathetic nervous system activation is an independent 
      predictor of clinical deterioration in pulmonary arterial hypertension.
FAU - Ciarka, Agnieszka
AU  - Ciarka A
AD  - Cardiology Department, Erasme Hospital, 808 Route de Lennik, 1070 Brussels, 
      Belgium. aciarka@ulb.ac.be
FAU - Doan, Vi
AU  - Doan V
FAU - Velez-Roa, Sonia
AU  - Velez-Roa S
FAU - Naeije, Robert
AU  - Naeije R
FAU - van de Borne, Philippe
AU  - van de Borne P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100301
PL  - United States
TA  - Am J Respir Crit Care Med
JT  - American journal of respiratory and critical care medicine
JID - 9421642
SB  - IM
MH  - Disease Progression
MH  - Female
MH  - Heart Rate/physiology
MH  - Humans
MH  - Hypertension, Pulmonary/classification/mortality/*physiopathology
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Pericardial Effusion/physiopathology
MH  - Prognosis
MH  - Severity of Illness Index
MH  - Sympathetic Nervous System/*physiopathology
EDAT- 2010/03/03 06:00
MHDA- 2010/07/16 06:00
CRDT- 2010/03/03 06:00
PHST- 2010/03/03 06:00 [entrez]
PHST- 2010/03/03 06:00 [pubmed]
PHST- 2010/07/16 06:00 [medline]
AID - 200912-1856OC [pii]
AID - 10.1164/rccm.200912-1856OC [doi]
PST - ppublish
SO  - Am J Respir Crit Care Med. 2010 Jun 1;181(11):1269-75. doi: 
      10.1164/rccm.200912-1856OC. Epub 2010 Mar 1.