Document Detail

N-terminal pro-B-type natriuretic peptide as an indicator of disease severity in a heterogeneous group of patients with chronic precapillary pulmonary hypertension.
MedLine Citation:
PMID:  16893710     Owner:  NLM     Status:  MEDLINE    
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.
Arne K Andreassen; Ragnhild Wergeland; Svein Simonsen; Odd Geiran; Cecilia Guevara; Thor Ueland
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-06-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-08     Completed Date:  2006-09-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  525-9     Citation Subset:  AIM; IM    
Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway.
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MeSH Terms
Biological Markers / blood
Chronic Disease
Exercise Test
Follow-Up Studies
Heart Catheterization
Hypertension, Pulmonary / blood*,  mortality,  physiopathology
Middle Aged
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Protein Precursors / blood
Pulmonary Wedge Pressure / physiology
ROC Curve
Severity of Illness Index
Survival Rate
Time Factors
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/Protein Precursors; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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