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Blood Test May Detect Hidden Lung Disease Early, Study Suggests
March 31 (Bloomberg) -- A simple blood test may reveal when people with serious respiratory diseases are silently developing high blood pressure in the lungs and predict its effect on survival, a study of 176 patients suggested.
Pulmonary hypertension narrows lung arteries, making the heart work harder to pump blood and triggering the release of a hormone called brain natriuretic peptide. About a third of patients with high BNP levels survived an average of two years, compared with 33 months for the rest of the group, data showed in the April 1 American Journal of Respiratory and Critical Care Medicine.
The disease may be masked by other lung conditions because the symptoms, such as shortness of breath, are similar. The blood test may be an alternative to a more invasive procedure to diagnose advanced pulmonary hypertension, which can lead to heart failure, and allow patients to get treated sooner, said Juergen Behr, the senior study author, in a telephone interview March 28.
"You have no real clinical symptoms to tell you there is a significant pulmonary hypertension that had developed already,'' said Behr, an associate professor in the Department of Internal Medicine at Ludwig Maximilians University in Munich. "Often, you only find it if patients show signs of right heart failure.''
Heart Failure Risk
The heart produces brain natriuretic peptide in response to changes in pressure in the blood vessels. The BNP test, made by companies such as Abbott Laboratories and Dade Behring Holdings Inc., currently is used to help diagnose heart failure.
The disease is probably underdiagnosed, and estimates of the number of patients with primary pulmonary hypertension, in which the cause isn't known, or with the type that's linked to other lung disorders, are hard to come by, said Rino Aldrighetti, chief executive officer of the Pulmonary Hypertension Association.
``We estimate that there's about 40,000 pulmonary hypertension patients on medication in the U.S.,'' said Aldrighetti in a telephone interview on March 27. ``In 2001, we were estimating about 3,000.''
Investigators looking for advanced pulmonary hypertension with the blood test enrolled patients with lung disorders such as cystic fibrosis between March 2001 and June 2005.
Three Times the Risk
The 54 participants with increased brain natriuretic peptide levels had a risk of death from heart-and lung-related causes three times higher than other patients did, the researchers said.
All were already scheduled for an invasive procedure to diagnose pulmonary hypertension called heart catheterization. In that procedure, doctors insert tubes called catheters into the lung arteries and heart to measure blood flow and pressure.
Thirty-one, or 18 percent, of 176 patients died of heart-and lung-related causes during follow-up. Those patients were more likely to have elevated BNP levels, significant pulmonary hypertension and impaired right heart function, compared with survivors. Forty patients received lung transplants.
``The finding of pulmonary hypertension in addition to a severe lung disease, says that the patient has a bad prognosis and may be a candidate for transplantation, for example,'' Behr said. ``You could also treat that pulmonary hypertension to lower that pressure.''
The researchers wrote that none of them had financial conflicts with commercial groups with an interest in the study.
To contact the reporter on this story:
Theresa Barry in Washington at Tbarry2@bloomberg.net.
The New Fen-Phen
Posted By: CyberBob
10/10/2006 - They were considered the most effective weight loss drugs available, but almost a decade after Fen-Phen was pulled off the shelves, researchers are still looking for a formula to slide the scales toward skinny. Now a new clinical trial shows promise in melting away the pounds.
The shelves are full of promises to slim you down.
“There's a lot of them out there - and believe me - I tried all of them just about,” says Maria Lightford.
Many pills promise that they'll whittle away the weight, yet plenty of people say they've tried and failed.
"Soon as I lose the ten it some way or another finds me double,” says another dieter we spoke to.
“It gets ridiculous,” explains Dr. Priscilla Hollander. “Then it gets depressive and then they don't do it and then they say, ‘oh what the heck, then I'm going to have another snack or whatever.’”
A clinical trial is underway to see if a new drug will create the same success as Fen-Phen – without the deadly consequences.
"Hopefully we'll see a reasonable amount of weight loss,” says Dr. Hollander.
"In 10 weeks I have lost 15 pounds,” says Lightford
Like Fen-Phen this trial combines two drugs already approved by the FDA, where the side benefit has been weight loss. The idea is putting the two together will equal greater benefits for the patient.
"I don't feel as hungry,” says Lightford. “I feel like I'm more in control of when I'm eating instead of trying to eat everything in sight. I get full and I stop."
"Most appetite drugs do affect serotonin because serotonin is a key message to stop eating,” says Dr. Hollander.
In this study, Wellbutrin, an anti-depressant, deals with serotonin, while an anti-seizure drug goes for the dopamine -- another messenger that tells the brain the body's full.
Maria Lightford is one of 45 patients who will be followed for the next year. She says the early results are a boost that's helping her get on track to a healthy lifestyle. And she welcomes whatever help she can get.
“If it'll help you lose weight why not?” asks Lightford.
Doctors say the potential side effects of these drugs could include numbness, tingling and a feeling of fogginess. Another phase of the trial will get underway in a matter of months.
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