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evaluation of disease activity and risk stratification of patients with sarcoidosis has been facilitated by the development of sensitive biomarkers. when compared with noninfectious etiologies of reactive or primary pulmonary hypertension (1pph), patients with vasodilator-responsive 1pph had lower overall ch50 levels and igg, and much higher levels of erythrocyte sedimentation rate and c-reactive protein ( 5 ). the presence of active sarcoidosis on clinical grounds, histopathologic evidence of noncaseating granulomas, or pulmonary parenchymal abnormalities on high-resolution ct scan is the most important determinant of outcome. the prognostic value of bnp, brain natriuretic peptide, is also well documented. biomarkers may be useful for risk stratification in patients with idiopathic pulmonary hypertension, including idiopathic pulmonary arterial hypertension (ipah) and in those with eisenmenger physiology. in a longitudinal study of ipf patients, bnp levels were correlated with hrct abnormalities and pulmonary function tests. one-year levels of bnp were significantly higher in patients with increased carbon monoxide diffusing capacity and lower percent predicted forced vital capacity (fvc) and percent predicted diffusing capacity for carbon monoxide compared with patients with normal ct scans and pulmonary function tests ( 7 ). in a subsequent study of bnp in ipf patients, levels of bnp were significantly associated with a number of clinical, radiologic, and physiological variables, including dyspnea, physical examination findings, cardiac function, and gas exchange. at a median follow-up of 54 months, there was no significant difference in overall survival between patients with bnp levels of less than 200pg/ml and those with higher levels. patients with higher bnp levels had higher nyha functional class, worse lung function, and were more likely to have a history of renal failure and hypercapnea ( 7 ).

Ak Dutta Anatomy Pdf Free 27

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