Elevated levels of circulating BMP7 predict mortality in pulmonary arterial hypertension.

This study aimed to show whether circulating BMPs levels are associated with increased risk of mortality in PAH patients.A total of 156 PAH patients including 43 HPAH and 113 IPAH diagnosed by gene screening were enrolled in the study. Circulating BMPs were measured by ELISA in plasma samples from HPAH (n = 43), IPAH (n = 113) and controls (n = 51). Clinical characteristics at baseline and long-term survival were compared according to the different BMPs levels.HPAH patients had significantly higher BMP7 concentrations than IPAH and controls (20.1 (9.4, 55.2) vs. 6.5 (3.5, 11.7) and 2.5 (0.9, 6.6) pg/ml, respectively; P <0.001). Elevated plasma BMP7 were associated with a higher risk of mortality after adjustment for sex, 6-minute walk distance, mean right atrial pressure, mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac output (HR = 1.904, 95% CI 1.021-3.551; P = 0.043). IPAH patients with a BMP7 level more than 7.85 pg/ml had a higher risk of mortality than those with a low BMP7 concentration (P = 0.042, log rank test).Levels of circulating BMP7 correlate with mortality in PAH, and may be a predictor of disease in HPAH and IPAH patients.