N‐terminal proB‐type natriuretic peptide levels aid the diagnosis of left ventricular dysfunction in patients with severe acute exacerbations of chronic obstructive pulmonary disease and renal dysfunction

Ouanes, Islem; Jalloul, Faten; Ayed, Samia; Dachraoui, Fahmi; Ouanes-Besbes, Lamia; Hassen, M. Fekih; Elatrous, Souheil; Abroug, Fékri

doi:10.1111/j.1440-1843.2012.02153.x

Cited by 16 publications

(13 citation statements)

References 34 publications

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“…These included ischaemic heart disease, [38, 40] pulmonary emboli, [41] arrhythmia, [32] aortic stenosis, [25] pulmonary hypertension, [42] renal impairment [32, 43]. However, these comorbidities were rarely reported or searched for systematically.…”

Section: Resultsmentioning

confidence: 99%

B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

et al. 2017

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BackgroundPatients with chronic obstructive pulmonary disease (COPD) have increased cardiovascular risk. Natriuretic peptides (NP) in other populations are useful in identifying cardiovascular disease, stratifying risk, and guiding therapy.MethodsWe performed a systematic literature review to examine NP in COPD, utilising Medline, EMBASE, and the Cochrane Library.ResultsFifty one studies were identified. NP levels were lower in stable compared to exacerbation of COPD, and significantly increased with concomitant left ventricular systolic dysfunction or cor pulmonale. Elevation occurred in 16 to 60% of exacerbations and persisted in approximately one half of patients at discharge. Cardiovascular comorbidities were associated with increased levels. Levels consistently correlated with pulmonary artery pressure and left ventricular ejection fraction, but not pulmonary function or oxygen saturation. NP demonstrated high negative predictive values (0.80 to 0.98) to exclude left ventricular dysfunction in both stable and exacerbation of COPD, but relatively low positive predictive values. NP elevation predicted early adverse outcomes, but the association with long term mortality was inconsistent.ConclusionNP reflect diverse aspects of the cardiopulmonary continuum which limits utility when applied in isolation. Strategies integrating NP with additional variables, biomarkers and imaging require further investigation.

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Section: Resultsmentioning

confidence: 99%

B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

et al. 2017

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“…In IPAH, NT-proBNP has been shown to correlate with RV function [39] and changes in serial NT-proBNP with treatment have been shown to predict survival [40]. In COPD, NT-proBNP has been shown to predict outcome following acute exacerbations of airways disease [41][42][43], identify those with concurrent left ventricular dysfunction [42,44] and function as a screening tool for PH in COPD [45]. Our study demonstrates that NT-proBNP reflects RV dysfunction in severe PH lung disease patients, predicts survival on univariate analysis and, in addition, change in NT-proBNP predicted survival.…”

Section: Discussionmentioning

confidence: 99%

Severe pulmonary hypertension in lung disease: phenotypes and response to treatment

et al. 2015

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Pulmonary hypertension (PH) due to lung disease (World Health Organization (WHO) group 3) is common, but severe PH, arbitrarily defined as mean pulmonary artery pressure ⩾35 mmHg is reported in only a small proportion. Whether these should be treated as patients in WHO group 1 (i.e. pulmonary arterial hypertension) with PH-targeted therapies is unknown.We compared the phenotypic characteristics and outcomes of 118 incident patients with severe PH and lung disease with 74 idiopathic pulmonary arterial hypertension (IPAH) patients, all treated with pulmonary vasodilators.Lung disease patients were older, more hypoxaemic, and had lower gas transfer, worse New York Heart Association functional class and lower 6-min walking distance (6MWD) than IPAH patients. Poorer survival in those with lung disease was driven by the interstitial lung disease (ILD) cohort.In contrast to IPAH, where significant improvements in 6MWD and N-terminal pro-brain natruiretic peptide (NT-proBNP) occurred, PH therapy in severe PH lung disease did not lead to improvement in 6MWD or functional class, but neither was deterioration seen. NT-proBNP decreased from 2200 to 1596 pg·mL −1 ( p=0.015). Response varied by lung disease phenotype, with poorer outcomes in patients with ILD and emphysema with preserved forced expiratory volume in 1 s. Further study is required to investigate whether vasodilator therapy may delay disease progression in severe PH with lung disease. @ERSpublications Treatment of severe pulmonary hypertension associated with lung disease can improve or stabilise noninvasive outcomes

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“…NTproBNP has been used as a marker of heart failure, 2,8 and NTproBNP levels are elevated in patients with renal failure. 9 We found no significant differences in serum levels of aspartate aminotransferase, creatinine phosphokinase, blood urea nitrogen or creatinine between the E and FS groups. Therefore, we concluded that NTproBNP levels in the 2 different groups of patients were not affected by heart or renal status.…”

Section: Discussionmentioning

confidence: 83%

Serum N-Terminal Pro-B-Type Natriuretic Peptide (NTproBNP) Levels Are Elevated During the Acute Phase of Acute Encephalopathy-Associated Virus Infection

et al. 2014

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Acute virus-associated encephalopathy induces seizures. Serum N-terminal pro-B-type natriuretic peptide (NTproBNP) levels are elevated following febrile and afebrile seizures. However, the role of NTproBNP in acute virus-associated encephalopathy pathology is unknown. We enrolled 10 patients with acute virus-associated encephalopathy and convulsions (E group: 7 boys, 3 girls; median age, 3.10 ± 1.92 years) and 130 patients with febrile seizure (FS group: 80 boys, 50 girls; median age, 3.23 ± 2.44 years). The E group had significantly higher NTproBNP levels (345 ± 141 pg/mL) compared with the FS group (166 ± 228 pg/mL) (P < .0005). Furthermore, subjects with prolonged seizure within the E group had significantly higher NTproBNP levels (303 ± 107 pg/mL) compared with subjects with prolonged seizure within the FS group (134 ± 100 pg/mL) (P < .005). Our findings suggest that serum NTproBNP levels are increased during the acute phase of acute virus-associated encephalopathy associated with convulsion.

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N‐terminal proB‐type natriuretic peptide levels aid the diagnosis of left ventricular dysfunction in patients with severe acute exacerbations of chronic obstructive pulmonary disease and renal dysfunction

Abstract: NT-proBNP remains an accurate biomarker for the diagnosis of left ventricular dysfunction associated with acute exacerbations of COPD. Threshold values of NT-proBNP were higher in patients with impaired renal function than in those with normal renal function.

Cited by 16 publications

References 34 publications

B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

Severe pulmonary hypertension in lung disease: phenotypes and response to treatment

Serum N-Terminal Pro-B-Type Natriuretic Peptide (NTproBNP) Levels Are Elevated During the Acute Phase of Acute Encephalopathy-Associated Virus Infection

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