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BackgroundPulmonary Hypertension has a poor prognosis and therapy is limited to symptomatic relief. Apelin, a new therapy, has the potential to provide both symptomatic relief and address the underlying pathology. Disease severity, in pulmonary hypertension, is measured using NT-proBNP. This study investigated the effects of apelin on serum NT-proBNP levels in groups of pulmonary hypertension patients and controls.MethodsSerum samples from patients recruited for a haemodynamic investigation of apelin were used. The groups studied were controls, pulmonary arterial hypertension and pulmonary hypertension due to left heart failure. In the haemodynamic study each patient was given an apelin and placebo infusion separately, over a period of several minutes. Serum samples were taken pre and post infusions. NT-proBNP concentration in the samples was determined using the ABNOVA ELISA kit.ResultsAcross all groups there was no significant change in NT-proBNP levels due to apelin infusion (P = 0.830). There was no significant difference in pre-infusion levels between groups (P = 0.287).ConclusionsApelin infusion, over a period of several minutes, has no effect on NT-proBNP levels in serum. This is consistent amongst control and pulmonary hypertension patients. Despite the lack of change in NT-proBNP seen in this study, the haemodynamic results for apelin were positive. These haemodynamic results have been associated with a decrease in NT-proBNP in other drug studies. The main difference in these studies was a longer time period. As a result, investigation of therapy over a longer time period is required to assess if apelin has any effect on NT-proBNP levels.

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BackgroundPulmonary Hypertension has a poor prognosis and therapy is limited to symptomatic relief. Apelin, a new therapy, has the potential to address the underlying pathology whilst also providing relief of symptoms. NT-proBNP a marker of disease severity is commonly used to assess treatment effect.Aims and objectivesThis study aimed to investigate, for the first time, the effects of apelin on serum NT-proBNP concentration in groups of pulmonary hypertension patients and controls. The hypothesis of the study was that apelin would cause a change in NT-proBNP.MethodsSerum samples from patients recruited for a haemodynamic investigation of apelin were used. The groups studied were controls, pulmonary arterial hypertension and pulmonary hypertension due to left heart failure. In the haemodynamic study each patient was given an apelin and placebo infusion separately over a period of several minutes. Serum samples were taken pre and post infusion. NT-proBNP concentration in the samples was determined using the ABNOVA ELISA kit.ResultsThere was no significant change in NT-proBNP levels due to apelin infusion across all groups (P = 0.830). On sub group analysis there was no significant change detected in any group as shown in Figure 1.Abstract P267 Figure 1Mean change in NT-proBNP levels post apelin infusion with 95% C.I. There was no significant change in NT-proBNP levels caused by apelin in any groupConclusionNT-proBNP levels do not immediately change in response to several minutes of apelin infusion. This is consistent amongst control and pulmonary hypertension patients. Despite the lack of change in NT-proBNP levels seen in this study, the haemodynamic response pattern reported for apelin1 has been associated with NT-proBNP changes in other drug studies. The main difference between these studies and this study was investigation of therapy effect over a longer time period. From our results we cannot conclude that apelin has no effect on NT-proBNP levels. Investigation of therapy over a longer time period is required.Reference1 Brash L, Church C, Gibbs JS, Howard LSGE, Johnson MK, Welsh DJ, Wilkins MR, Newby DE, Peacock AJ. Apelin improves cardiac output in patients with pulmonary arterial hypertension. Submitted to ERS 2015 Conference