Diagnostic and prognostic value of N-terminal-proB-type natriuretic peptide (NT-proBNP) in patient with acute exacerbations of COPD
https://doi.org/10.18093/0869-0189-2011-0-6-80-86
Abstract
Summary. Natriuretic peptide is an important marker of the heart failure. NT-proBNP has also been shown to play a role in predicting outcomes in unselected cohort of critically ill patients.
This study was aimed at evaluation the diagnostic and prognostic value of NT-proBNP in patients with acute exacerbation of COPD (AECOPD). This was a prospective observational study enrolled 80 hospitalized patients with AECOPD (age, 65.8 ± 19.9 yrs; FEV1, 38.5 ± 17.3 %pred, PaO2, 53.8 ± 13.0 mmHg, PaCO2, 50.6 ± 15.1 mmHg). The patients underwent a comprehensive diagnostic algorithm including chest radiography, pulmonary function tests, echocardiography and serial measurements of plasma NT-proBNP (Biomedica). Main causes of acute exacerbation of COPD were purulent bronchitis (48.8 %), pneumonia (23.8 %), acute decompensation of chronic heart failure (ADCHF) (17.5 %), and pulmonary embolism (PE) (5 %). Mean plasma concentration of NT-proBNP in COPD patients was 1 057.8 ± 555.3 fmol / ml. NT-proBNP level was elevated in 88.7 % of the cases. Patients with AECOPD and PE had the highest level of NT-proBNP (1 735.9 ± 523.8 fmol / ml). NT-proBNP concentration in COPD patients with ADCHF was 1 405.4 ± 626.8 fmol / ml, in COPD patients with pneumonia – 1 043.5 ± 643.1 fmol / ml, and in COPD patients with purulent bronchitis – 906.6 ± 425.9 fmol / ml. In patients who died during hospital stay (8.4 %), plasma level of NT-proBNP was significantly higher than in survivors (1 484.6 ± 618.7 vs 1 003.7 ± 527.1, respectively, p = 0.013). Conclusions: Plasma level of NT-proBNP may be used as a marker of severity and prognosis in AECOPD.
About the Authors
G. E. Baimakanova
ФГУ "НИИ пульмонологии" ФМБА России
Russian Federation
Russian Federation
S. N. Avdeev
ФГУ "НИИ пульмонологии" ФМБА России
Russian Federation
Russian Federation
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For citations:
Baimakanova G.E., Avdeev S.N. Diagnostic and prognostic value of N-terminal-proB-type natriuretic peptide (NT-proBNP) in patient with acute exacerbations of COPD. PULMONOLOGIYA. 2011;(6):80-86. (In Russ.) https://doi.org/10.18093/0869-0189-2011-0-6-80-86
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