ArticleChest2020
Noninvasive Prognostic Biomarkers for Left-Sided Heart Failure as Predictors of Survival in Pulmonary Arterial Hypertension.
Article in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 36 citations in OpenAlex.
- The association between soluble ST2 and transplant-free survival in precapillary pulmonary hypertension.JHLT open · 2026Article
- Natriuretic Peptides as Predictors for the Diagnosis of Pulmonary Hypertension Secondary to Left Heart Disease and for the Assessment of Its Severity.International journal of molecular sciences · 2026Article
- Evolving Proteomic Biomarkers in Children with Congenital Heart Defects.Journal of cardiovascular development and disease · 2026Review
- The role of soluble suppression of tumorigenicity 2 in pulmonary hypertension: a systematic review and meta-analysis.American heart journal plus : cardiology research and practice · 2026Review
- The NOTCH3 extracellular domain is a serum biomarker for pulmonary arterial hypertension.Nature medicine · 2026Article
- Cellular Communication Network Protein 2 in the Right Ventricle of Pulmonary Arterial Hypertension.Pulmonary circulation · 2025Article
- Equivalency of Multiple Biomarkers to Clinical Pulmonary Arterial Hypertension Survival Risk Models.Chest · 2024Article
- Circulating biomarkers in pulmonary arterial hypertension: State-of-the-art review and future directions.JHLT open · 2024Review
- Risk stratification and treatment goals in pulmonary arterial hypertension.The European respiratory journal · 2024Review
- Resistin predicts disease severity and survival in patients with pulmonary arterial hypertension.Respiratory research · 2024Article
- Circulating Biomarkers in Pulmonary Arterial Hypertension: An Update.Biomolecules · 2024Review
- Kids Mod PAH trial: A multicenter trial comparing mono- versus duo-therapy for initial treatment of pediatric pulmonary hypertension.Pulmonary circulation · 2023Article
- Metabolic profiling of in vivo right ventricular function and exercise performance in pulmonary arterial hypertension.American journal of physiology. Lung cellular and molecular physiology · 2023Article
- Plasma Cell-Free DNA Predicts Survival and Maps Specific Sources of Injury in Pulmonary Arterial Hypertension.Circulation · 2022Article
- Article
- Regular Risk Assessment in Pulmonary Arterial Hypertension - A Whistleblower for Hidden Disease Progression.Acta Cardiologica Sinica · 2022Review
- Biomarkers of Pulmonary Hypertension Are Altered in Children with Down Syndrome and Pulmonary Hypertension.The Journal of pediatrics · 2022Article
- Efficacy of Dialectical Comprehensive Treatment of Traditional Chinese Medicine in Patients with Chronic Stable Heart Failure: A Randomized Controlled Trial.Cardiology research and practice · 2022Article
- Clinical application of pulmonary vascular resistance in patients with pulmonary arterial hypertension.Journal of cardiothoracic surgery · 2021Review
- The angiostatic peptide endostatin enhances mortality risk prediction in pulmonary arterial hypertension.ERJ open research · 2021Article
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThree biomarkers, soluble suppression of tumorigenicity 2 (ST2), galectin 3 (Gal3), and N-terminal brain natriuretic peptide prohormone (NT-proBNP), are approved for noninvasive risk assessment in left-sided heart failure, and small observational studies have shown their prognostic usefulness in heterogeneous pulmonary hypertension cohorts. We examined associations between these biomarkers and disease severity and survival in a large cohort of patients with pulmonary arterial hypertension (PAH) (ie, group 1 pulmonary hypertension). We hypothesized that additive use of biomarkers in combination would improve the prognostic value of survival models.
methodsBiomarker measurements and clinical data were obtained from 2,017 adults with group 1 PAH. Associations among biomarker levels and clinical variables, including survival times, were examined with multivariable regression models. Likelihood ratio tests and the Akaike information criterion were used to compare survival models.
resultsHigher ST2 and NT-proBNP were associated with higher pulmonary pressures and vascular resistance and lower 6-min walk distance. Higher ST2 and NT-proBNP levels were associated with increased risk of death (hazard ratios: 2.79; 95% CI, 2.21-3.53; P < .001 and 1.84; 95% CI, 1.62-2.10; P < .001, respectively). The addition of ST2 to survival models composed of other predictors of survival, including NT-proBNP, significantly improved model fit and predictive capacity.
conclusionsST2 and NT-proBNP are strong, noninvasive prognostic biomarkers in PAH. Despite its prognostic value in left-sided heart failure, Gal3 was not predictive in PAH. Adding ST2 to survival models significantly improves model predictive capacity. Future studies are needed to develop multimarker assays that improve noninvasive risk stratification in PAH.
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