Increased BMP7 levels predict PAH mortality

By Shreeya Nanda

Elevated levels of circulating bone morphogenetic protein 7 (BMP7) are associated with an increased mortality risk in patients with pulmonary arterial hypertension (PAH), find Chinese researchers.

They believe that BMP7 levels could serve as a biomarker to predict prognosis in patients with hereditary and idiopathic PAH.

The study included 156 treatment-naïve patients diagnosed with PAH from March 2007 to February 2011 and followed up until January 2015, and 51 healthy controls matched for gender and age.

Plasma BMP7 concentrations were significantly higher in the 43 patients with hereditary PAH than in the 113 idiopathic PAH patients and healthy controls, at 20.1 versus 6.5 and 2.5 pg/mL, respectively.

By contrast, BMP2 and BMP4 levels did not vary significantly between groups in a preliminary analysis and were not assessed in the total study cohort.

With a cutoff of 10.55 pg/mL for BMP7 concentration, survival at 1, 3 and 5 years varied significantly between patients with high versus low levels of BMP7, at 88.7% versus 86.8%, 59.5% versus 73.4%, and 42.2% versus 63.4%, respectively.

And in multivariate analysis, circulating BMP7 levels and pulmonary vascular resistance were the only factors significantly predictive of mortality (respective hazard ratios of 1.063 and 1.904) after controlling for other parameters, including 6-minute walk distance, mean right atrial pressure, mean pulmonary arterial pressure and cardiac output.

The prognostic relevance of high BMP7 is not restricted solely to patients with hereditary PAH, say Zhi-Cheng Jing, from Tongji University School of Medicine in Shanghai, and colleagues. When just patients with idiopathic disease were considered, the mortality risk was higher for those with plasma BMP7 levels above compared with below 7.85 pg/mL.

The researchers conclude in CHEST: "BMP7 will hopefully prove to be an early biomarker because of its pulmonary arterial-specific and disease-specific characteristics."

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