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Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease.
Respir Med. 2009 Sep; 103(9):1337-45.RM

Abstract

BACKGROUND

B-type natriuretic peptide (BNP) is a predictor of death in patients with lung disease. We hypothesised that in patients with lung disease, BNP and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) could predict a peak VO(2)<15 ml/kg/min, which is the proposed cut-off indicating an increased risk of perioperative complications during lung resection surgery.

METHODS

BNP and NT-proBNP were measured in 85 patients with a variety of pulmonary pathologies undergoing cardiopulmonary exercise testing and fulfilling criteria for appropriate effort.

RESULTS

BNP [69 (42-270) vs. 33 (15-65)pg/ml; p=0.001] and NT-proBNP [290 (129-1075) vs. 65 (21-129)pg/ml; p<0.001] were higher in patients with peak VO(2)<15 ml/kg/min (n=27) as compared to those with peak VO(2)> or =15 ml/kg/min (n=58). Apart from the forced expiratory volume within the first second (FEV(1)), body mass index (BMI), diabetes, and the alveolo-arterial oxygen pressure difference [D(A-a)O(2); only in the BNP model], BNP or NT-proBNP respectively were independent predictors of peak VO(2)<15 ml/kg/min. The areas under the receiver-operator-characteristics curve (AUC) for BNP and NT-proBNP to predict a peak VO(2)<15 ml/kg/min were 0.73 and 0.80 respectively. A five-item (BNP) or four-item (NT-proBNP) score including BMI, FEV(1), diabetes, D(A-a)O(2), and BNP/NT-proBNP had an AUC of 0.87 and 0.88 respectively for the prediction of peak VO(2)<15ml/kg/min.

CONCLUSIONS

In patients with lung disease, BNP or NT-proBNP is independently associated with low peak VO(2). A simple score based on spirometry, blood gases and BNP or NT-proBNP has a high accuracy for the prediction of a peak VO(2)<15 ml/kg/min.

Authors+Show Affiliations

Baker IDI Heart and Diabetes Institute, St Kilda Road Central, Melbourne, Victoria 8008, Australia. micha.maeder@bluewin.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19375295

Citation

Maeder, Micha T., et al. "Natriuretic Peptides for the Prediction of Severely Impaired Peak VO2 in Patients With Lung Disease." Respiratory Medicine, vol. 103, no. 9, 2009, pp. 1337-45.
Maeder MT, Brutsche MH, Christ A, et al. Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease. Respir Med. 2009;103(9):1337-45.
Maeder, M. T., Brutsche, M. H., Christ, A., Reichlin, T., Staub, D., Noveanu, M., Breidthardt, T., Potocki, M., & Mueller, C. (2009). Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease. Respiratory Medicine, 103(9), 1337-45. https://doi.org/10.1016/j.rmed.2009.03.015
Maeder MT, et al. Natriuretic Peptides for the Prediction of Severely Impaired Peak VO2 in Patients With Lung Disease. Respir Med. 2009;103(9):1337-45. PubMed PMID: 19375295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease. AU - Maeder,Micha T, AU - Brutsche,Martin H, AU - Christ,Andreas, AU - Reichlin,Tobias, AU - Staub,Daniel, AU - Noveanu,Markus, AU - Breidthardt,Tobias, AU - Potocki,Mihael, AU - Mueller,Christian, Y1 - 2009/04/16/ PY - 2008/07/22/received PY - 2009/03/20/revised PY - 2009/03/20/accepted PY - 2009/4/21/entrez PY - 2009/4/21/pubmed PY - 2010/8/28/medline SP - 1337 EP - 45 JF - Respiratory medicine JO - Respir Med VL - 103 IS - 9 N2 - BACKGROUND: B-type natriuretic peptide (BNP) is a predictor of death in patients with lung disease. We hypothesised that in patients with lung disease, BNP and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) could predict a peak VO(2)<15 ml/kg/min, which is the proposed cut-off indicating an increased risk of perioperative complications during lung resection surgery. METHODS: BNP and NT-proBNP were measured in 85 patients with a variety of pulmonary pathologies undergoing cardiopulmonary exercise testing and fulfilling criteria for appropriate effort. RESULTS: BNP [69 (42-270) vs. 33 (15-65)pg/ml; p=0.001] and NT-proBNP [290 (129-1075) vs. 65 (21-129)pg/ml; p<0.001] were higher in patients with peak VO(2)<15 ml/kg/min (n=27) as compared to those with peak VO(2)> or =15 ml/kg/min (n=58). Apart from the forced expiratory volume within the first second (FEV(1)), body mass index (BMI), diabetes, and the alveolo-arterial oxygen pressure difference [D(A-a)O(2); only in the BNP model], BNP or NT-proBNP respectively were independent predictors of peak VO(2)<15 ml/kg/min. The areas under the receiver-operator-characteristics curve (AUC) for BNP and NT-proBNP to predict a peak VO(2)<15 ml/kg/min were 0.73 and 0.80 respectively. A five-item (BNP) or four-item (NT-proBNP) score including BMI, FEV(1), diabetes, D(A-a)O(2), and BNP/NT-proBNP had an AUC of 0.87 and 0.88 respectively for the prediction of peak VO(2)<15ml/kg/min. CONCLUSIONS: In patients with lung disease, BNP or NT-proBNP is independently associated with low peak VO(2). A simple score based on spirometry, blood gases and BNP or NT-proBNP has a high accuracy for the prediction of a peak VO(2)<15 ml/kg/min. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/19375295/Natriuretic_peptides_for_the_prediction_of_severely_impaired_peak_VO2_in_patients_with_lung_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(09)00097-3 DB - PRIME DP - Unbound Medicine ER -