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N-terminal pro-B-type natriuretic peptide as an indicator of disease severity in a heterogeneous group of patients with chronic precapillary pulmonary hypertension.
Am J Cardiol. 2006 Aug 15; 98(4):525-9.AJ

Abstract

N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) is well established as a predictor of prognosis in patients with left ventricular dysfunction. Although a similar prognostic significance has been suggested in 1 study of right ventricular failure and idiopathic pulmonary arterial hypertension, NT-pro-BNP has not been assessed as a marker of disease severity in a more heterogenous group of patients with chronic precapillary pulmonary hypertension (PH). Hence, this study assessed plasma NT-pro-BNP and other clinical variables in 61 consecutively recruited patients with various forms of chronic precapillary PH. Right-sided cardiac catheterization and cardiopulmonary exercise testing were performed at baseline, and the prognostic significance of NT-pro-BNP was investigated with a mean follow-up of 25 months. Compared with age-matched controls (n = 10), plasma NT-pro-BNP was significantly greater in those with idiopathic pulmonary arterial hypertension (n = 16), chronic precapillary PH associated with other diseases (n = 26), and chronic thromboembolic disease (n = 19) and was correlated with hemodynamic variables and functional capacity. In 17 medically treated patients, the significant decrease in NT-pro-BNP levels correlated with improved hemodynamics. During follow-up, 15 patients died from cardiopulmonary causes. Baseline NT-pro-BNP was an independent predictor of mortality. Kaplan-Meier survival analysis according to the median value of NT-pro-BNP (168 pmol/L) demonstrated a significantly higher mortality rate in those with supramedian values than in those with low plasma levels (p = 0.010). In conclusion, these findings suggest that in a heterogenous group of patients with chronic precapillary PH, plasma NT-pro-BNP can be used to determine the clinical severity of disease and is independently associated with long-term mortality.

Authors+Show Affiliations

Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway. arne.andreassen@rikshospitalet.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16893710

Citation

Andreassen, Arne K., et al. "N-terminal pro-B-type Natriuretic Peptide as an Indicator of Disease Severity in a Heterogeneous Group of Patients With Chronic Precapillary Pulmonary Hypertension." The American Journal of Cardiology, vol. 98, no. 4, 2006, pp. 525-9.
Andreassen AK, Wergeland R, Simonsen S, et al. N-terminal pro-B-type natriuretic peptide as an indicator of disease severity in a heterogeneous group of patients with chronic precapillary pulmonary hypertension. Am J Cardiol. 2006;98(4):525-9.
Andreassen, A. K., Wergeland, R., Simonsen, S., Geiran, O., Guevara, C., & Ueland, T. (2006). N-terminal pro-B-type natriuretic peptide as an indicator of disease severity in a heterogeneous group of patients with chronic precapillary pulmonary hypertension. The American Journal of Cardiology, 98(4), 525-9.
Andreassen AK, et al. N-terminal pro-B-type Natriuretic Peptide as an Indicator of Disease Severity in a Heterogeneous Group of Patients With Chronic Precapillary Pulmonary Hypertension. Am J Cardiol. 2006 Aug 15;98(4):525-9. PubMed PMID: 16893710.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - N-terminal pro-B-type natriuretic peptide as an indicator of disease severity in a heterogeneous group of patients with chronic precapillary pulmonary hypertension. AU - Andreassen,Arne K, AU - Wergeland,Ragnhild, AU - Simonsen,Svein, AU - Geiran,Odd, AU - Guevara,Cecilia, AU - Ueland,Thor, Y1 - 2006/06/28/ PY - 2005/11/08/received PY - 2006/02/16/revised PY - 2006/02/16/accepted PY - 2006/8/9/pubmed PY - 2006/9/22/medline PY - 2006/8/9/entrez SP - 525 EP - 9 JF - The American journal of cardiology JO - Am J Cardiol VL - 98 IS - 4 N2 - N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) is well established as a predictor of prognosis in patients with left ventricular dysfunction. Although a similar prognostic significance has been suggested in 1 study of right ventricular failure and idiopathic pulmonary arterial hypertension, NT-pro-BNP has not been assessed as a marker of disease severity in a more heterogenous group of patients with chronic precapillary pulmonary hypertension (PH). Hence, this study assessed plasma NT-pro-BNP and other clinical variables in 61 consecutively recruited patients with various forms of chronic precapillary PH. Right-sided cardiac catheterization and cardiopulmonary exercise testing were performed at baseline, and the prognostic significance of NT-pro-BNP was investigated with a mean follow-up of 25 months. Compared with age-matched controls (n = 10), plasma NT-pro-BNP was significantly greater in those with idiopathic pulmonary arterial hypertension (n = 16), chronic precapillary PH associated with other diseases (n = 26), and chronic thromboembolic disease (n = 19) and was correlated with hemodynamic variables and functional capacity. In 17 medically treated patients, the significant decrease in NT-pro-BNP levels correlated with improved hemodynamics. During follow-up, 15 patients died from cardiopulmonary causes. Baseline NT-pro-BNP was an independent predictor of mortality. Kaplan-Meier survival analysis according to the median value of NT-pro-BNP (168 pmol/L) demonstrated a significantly higher mortality rate in those with supramedian values than in those with low plasma levels (p = 0.010). In conclusion, these findings suggest that in a heterogenous group of patients with chronic precapillary PH, plasma NT-pro-BNP can be used to determine the clinical severity of disease and is independently associated with long-term mortality. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/16893710/N_terminal_pro_B_type_natriuretic_peptide_as_an_indicator_of_disease_severity_in_a_heterogeneous_group_of_patients_with_chronic_precapillary_pulmonary_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(06)00827-7 DB - PRIME DP - Unbound Medicine ER -