The Role of Noninvasive Endpoints in Predicting Long-Term Outcomes in Pulmonary Arterial Hypertension.

摘要: Until recently, many clinical trials in patients with pulmonary arterial hypertension (PAH) evaluated exercise capacity 6-minute walk distance (6MWD) as the primary endpoint. Common secondary endpoints include PAH functional class (FC), which assesses symptoms, and either brain natriuretic peptide (BNP) or inactive N-terminal cleavage product of its prohormone (NT-proBNP), cardiac function. Examine relationships among 6MWD, FC, BNP/NT-proBNP measured at baseline follow-up long-term outcomes studies. Relevant literature from January 1990 to April 2018 were obtained by searching PubMed, Embase, Cochrane. Articles English reporting on associations between identified. Each endpoint was individually. Prespecified inclusion exclusion criteria applied level 1 (titles/abstracts) 2 (full-text review). The database search yielded 836 unique records; 65 full-text articles reviewed. Twenty-five studies eligible for inclusion. Findings supported importance measuring noninvasive predicting outcomes. Patients shorter decreased poor (III/IV) declining FC (e.g., II III), elevated increasing had a higher risk death costly events hospitalization, lung transplant). also predicted health care resource utilization costs. Collectively, these establish groups that predict likelihood complications death. Assessment provides low-cost, efficient, means economic PAH.