Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study
Background: NT-proBNP and GDF-15 are established blood-derived biomarkers for risk assessment in pulmonary hypertension (PH), despite limited sensitivity and specificity. Apelin has a crucial function in endothelial homeostasis, thus it might represent a new biomarker for PH. However, there are nume...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.986295/full |
| _version_ | 1797961492280115200 |
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| author | Vasile Foris Vasile Foris Gabor Kovacs Gabor Kovacs Alexander Avian Alexander Avian Zoltán Bálint Philipp Douschan Philipp Douschan Bahil Ghanim Walter Klepetko Andrea Olschewski Andrea Olschewski Horst Olschewski Horst Olschewski |
| author_facet | Vasile Foris Vasile Foris Gabor Kovacs Gabor Kovacs Alexander Avian Alexander Avian Zoltán Bálint Philipp Douschan Philipp Douschan Bahil Ghanim Walter Klepetko Andrea Olschewski Andrea Olschewski Horst Olschewski Horst Olschewski |
| author_sort | Vasile Foris |
| collection | DOAJ |
| description | Background: NT-proBNP and GDF-15 are established blood-derived biomarkers for risk assessment in pulmonary hypertension (PH), despite limited sensitivity and specificity. Apelin has a crucial function in endothelial homeostasis, thus it might represent a new biomarker for PH. However, there are numerous circulating apelin isoforms, and their potential role in this setting is unknown. This study evaluated different apelin isoforms in PH patients and prospectively evaluated the role of apelin-17 in comparison with NT-proBNP and GDF-15 as diagnostic marker in idiopathic pulmonary arterial hypertension (IPAH).Methods: Based on our pilot study, we performed a power calculation for apelin-13, apelin-17, apelin-36, as predictor of IPAH vs healthy controls. Apelin-17 provided the best discriminatory power, and accordingly, we enrolled n = 31 patients with IPAH and n = 31 matched healthy controls in a prospective study. NT-proBNP and GDF-15 was determined in all patients. ROC curve analysis was performed to assess the diagnostic value of the markers and their combinations.Results: Apelin-17, NT-proBNP, and GDF-15 were significantly elevated in IPAH patients as compared to controls (p < .001). Apelin-17 detected IPAH with a sensitivity of 68% and a specificity of 93% at a cut-off value of >1,480 pg/ml (AUC 0.86, 95%CI:0.76–0.95) as compared to GDF-15 (sensitivity 86%; specificity 72%, AUC 0.81 (95%CI:0.7–0.92)) and NT-proBNP (sensitivity 86%; specificity 72% (AUC 0.85, 95%CI:0.75–0.95)). Combinations of these markers could be used to increase either specificity or sensitivity.Conclusion: Apelin-17 appears to be suitable blood derived diagnostic marker for idiopathic pulmonary arterial hypertension. |
| first_indexed | 2024-04-11T00:59:03Z |
| format | Article |
| id | doaj.art-9b4ebb590a874cb0a61e6b956be28d58 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-11T00:59:03Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-9b4ebb590a874cb0a61e6b956be28d582023-01-04T19:07:13ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-01-011310.3389/fphys.2022.986295986295Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker studyVasile Foris0Vasile Foris1Gabor Kovacs2Gabor Kovacs3Alexander Avian4Alexander Avian5Zoltán Bálint6Philipp Douschan7Philipp Douschan8Bahil Ghanim9Walter Klepetko10Andrea Olschewski11Andrea Olschewski12Horst Olschewski13Horst Olschewski14Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaLudwig Boltzmann Institute for Lung Vascular Research, Graz, AustriaDivision of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaLudwig Boltzmann Institute for Lung Vascular Research, Graz, AustriaDivision of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaInstitute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, AustriaFaculty of Physics, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca, RomaniaDivision of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaLudwig Boltzmann Institute for Lung Vascular Research, Graz, AustriaDivision of General and Thoracic Surgery, University Hospital Krems, Karl Landsteiner University of Health Sciences, Krems an der Donau, AustriaDivision of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Vienna, AustriaLudwig Boltzmann Institute for Lung Vascular Research, Graz, AustriaExperimental Anesthesiology, Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, AustriaDivision of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaLudwig Boltzmann Institute for Lung Vascular Research, Graz, AustriaBackground: NT-proBNP and GDF-15 are established blood-derived biomarkers for risk assessment in pulmonary hypertension (PH), despite limited sensitivity and specificity. Apelin has a crucial function in endothelial homeostasis, thus it might represent a new biomarker for PH. However, there are numerous circulating apelin isoforms, and their potential role in this setting is unknown. This study evaluated different apelin isoforms in PH patients and prospectively evaluated the role of apelin-17 in comparison with NT-proBNP and GDF-15 as diagnostic marker in idiopathic pulmonary arterial hypertension (IPAH).Methods: Based on our pilot study, we performed a power calculation for apelin-13, apelin-17, apelin-36, as predictor of IPAH vs healthy controls. Apelin-17 provided the best discriminatory power, and accordingly, we enrolled n = 31 patients with IPAH and n = 31 matched healthy controls in a prospective study. NT-proBNP and GDF-15 was determined in all patients. ROC curve analysis was performed to assess the diagnostic value of the markers and their combinations.Results: Apelin-17, NT-proBNP, and GDF-15 were significantly elevated in IPAH patients as compared to controls (p < .001). Apelin-17 detected IPAH with a sensitivity of 68% and a specificity of 93% at a cut-off value of >1,480 pg/ml (AUC 0.86, 95%CI:0.76–0.95) as compared to GDF-15 (sensitivity 86%; specificity 72%, AUC 0.81 (95%CI:0.7–0.92)) and NT-proBNP (sensitivity 86%; specificity 72% (AUC 0.85, 95%CI:0.75–0.95)). Combinations of these markers could be used to increase either specificity or sensitivity.Conclusion: Apelin-17 appears to be suitable blood derived diagnostic marker for idiopathic pulmonary arterial hypertension.https://www.frontiersin.org/articles/10.3389/fphys.2022.986295/fullapelin-17NT-proBNPGDF-15blood derived biomarkerdiagnosisidiopathic pulmonary arterial hypertension |
| spellingShingle | Vasile Foris Vasile Foris Gabor Kovacs Gabor Kovacs Alexander Avian Alexander Avian Zoltán Bálint Philipp Douschan Philipp Douschan Bahil Ghanim Walter Klepetko Andrea Olschewski Andrea Olschewski Horst Olschewski Horst Olschewski Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study Frontiers in Physiology apelin-17 NT-proBNP GDF-15 blood derived biomarker diagnosis idiopathic pulmonary arterial hypertension |
| title | Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study |
| title_full | Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study |
| title_fullStr | Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study |
| title_full_unstemmed | Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study |
| title_short | Apelin-17 to diagnose idiopathic pulmonary arterial hypertension: A biomarker study |
| title_sort | apelin 17 to diagnose idiopathic pulmonary arterial hypertension a biomarker study |
| topic | apelin-17 NT-proBNP GDF-15 blood derived biomarker diagnosis idiopathic pulmonary arterial hypertension |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.986295/full |
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