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Original Research: PULMONARY VASCULAR DISEASE |

Osteopontin in Patients With Idiopathic Pulmonary Hypertension

Johan M. Lorenzen, MD; Nils Nickel, MD; Robert Krämer, MD; Heiko Golpon, MD; Volker Westerkamp, MD; Karen M. Olsson, MD; Hermann Haller, MD, PhD; Marius M. Hoeper, MD
Author and Funding Information

From the Department of Nephrology and Hypertension (Drs Lorenzen, Krämer, and Haller) and Department of Respiratory Medicine (Drs Nickel, Golpon, Westerkamp, Olsson, and Hoeper), Centre of Internal Medicine, Hannover Medical School, Hannover, Germany.

Correspondence to: Johan M. Lorenzen, MD, Division of Nephrology, Department of Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany; e-mail: J.M.Lorenzen@gmail.com


Drs Lorenzen and Nickel contributed equally to the study.

Funding/Support: This work was supported by the Deutsche Forschungsgemeinschaft [DFG LO 1736/1-1 to J. M. L. and SFB Transregio 37/project B4] and the European Commission under the 6th Framework Program [contract No. LSHM-CT-2005-018725, PULMOTENSION].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(5):1010-1017. doi:10.1378/chest.10-1146
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Background:  Osteopontin (OPN) is a pleiotropic cytokine that has been postulated to play a role in the pathogenesis of idiopathic pulmonary arterial hypertension (IPAH). OPN plasma levels may be related to disease severity and mortality in patients with PAH.

Methods:  OPN plasma levels obtained during right-sided heart catheterization were assessed by a commercially available enzyme-linked immunosorbent assay and related to hemodynamics, exercise capacity, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) level, uric acid level, C-reactive protein level, and survival in two cohorts of patients with IPAH: a 4-year retrospective cohort (n = 70) and a prospective cohort (n = 25) followed for 3 months after initiation of therapy. Forty apparently healthy individuals served as control subjects.

Results:  Baseline OPN levels were elevated in patients with IPAH compared with healthy control subjects (50.2 ± 35.9 vs 23.7 ± 2.8 ng/mL, P < .0001). In the retrospective as well as in the prospective cohort, OPN levels correlated with mean right atrial pressure and NT-BNP. In the retrospective cohort, OPN levels also correlated with age (r = 0.3, P = .02), 6-min walking distance (r=−0.4, P = .05), and New York Heart Association class (r = 0.4, P = .001). Multivariate Cox analysis demonstrated that baseline OPN levels were independent predictors of mortality (P = .02). When patients were divided according to their baseline OPN values, being normal or elevated at baseline (below or above 34.5 ng/mL), proportional survival rates were 100% vs 80% after 1 year and 77% vs 51% after 3 years, respectively.

Conclusion:  Circulating OPN predicts survival in patients with IPAH and is associated with a higher New York Heart Association class. OPN, thus, may be useful as a biomarker in IPAH.

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