Serum N-Terminal Brain Natriuretic Peptide as a Prognostic Parameter in Patients With Pulmonary Hypertension

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiopulmonary exercise testing (CPET) are useful for severity assessment in patients with pulmonary hypertension (PH). Correlations between these tests in pre-capillary PH patients is less well studied. Methods: We studied 23 patients with pre-capillary PH: 8 with idiopathic pulmonary arterial hypertension (IPAH), 6 with systemic sclerosis-associated PAH (SSc-PAH), and 9 with chronic thromboembolic pulmonary hypertension (CTEPH). Clinical evaluation, NT-proBNP levels, six-minute walking test (6MWT), spirometry, and CPET were evaluated on the same day. Correlation between NT-proBNP levels and CPET parameters were investigated. Results: In all patients, NT-proBNP levels were significantly correlated with peak oxygen uptake (VO2) ( r = −0.47), peak oxygen pulse ( r = −0.43), peak cardiac output (CO) ( r = −0.57), peak end-tidal partial pressure of carbon dioxide (PETCO2) ( r = −0.74), ventilatory equivalent to carbon dioxide (VE/VCO2) at anaerobic threshold (AT) ( r = 0.73), and VE/VCO2 slope ( r = 0.64). Significant correlations between NT-proBNP levels and peak PETCO2 and VE/VCO2 were found in IPAH and CTEPH subgroups, and a significant correlation between NT-proBNP levels and VO2 at AT was found in the CTEPH subgroup. No significant correlation was found in the SSc-PAH subgroup. Conclusion: NT-proBNP levels were significantly correlated with CPET parameters in patients with IPAH and CTEPH subgroups, but not in SSc-PAH subgroup. A further study with larger population is required to confirm these preliminary findings.

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Exercise Dependence of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Precapillary Pulmonary Hypertension

Respiration ◽

10.1159/000334950 ◽

2012 ◽

Vol 84 (6) ◽

pp. 454-460 ◽

Cited By ~ 3

Author(s):

Sabine Grachtrup ◽

Mathias Brügel ◽

Hans Pankau ◽

Michael Halank ◽

Hubert Wirtz ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Exercise Dependence

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Brain Natriuretic Peptide as Noninvasive Marker of the Severity of Right Ventricular Dysfunction in Chronic Thromboembolic Pulmonary Hypertension

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2007.04.006 ◽

2007 ◽

Vol 84 (2) ◽

pp. 537-543 ◽

Cited By ~ 43

Author(s):

Herre J. Reesink ◽

Igor I. Tulevski ◽

J. Tim Marcus ◽

Frans Boomsma ◽

Jaap J. Kloek ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Brain Natriuretic Peptide ◽

Right Ventricular ◽

Natriuretic Peptide ◽

Ventricular Dysfunction ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Right Ventricular Dysfunction ◽

Thromboembolic Pulmonary Hypertension ◽

Noninvasive Marker

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Correlation between changes in brain natriuretic peptide and echocardiographic features in persistent pulmonary hypertension of newborn

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2018.1543392 ◽

2019 ◽

Vol 33 (13) ◽

pp. 2176-2180

Author(s):

Lin Fu ◽

Xiaoshan Zhang

Keyword(s):

Pulmonary Hypertension ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Persistent Pulmonary Hypertension

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Brain natriuretic peptide inhibits hypoxic pulmonary hypertension in rats

Journal of Applied Physiology ◽

10.1152/jappl.1998.84.5.1646 ◽

1998 ◽

Vol 84 (5) ◽

pp. 1646-1652 ◽

Cited By ~ 38

Author(s):

James R. Klinger ◽

Rod R. Warburton ◽

Linda Pietras ◽

Nicholas S. Hill

Keyword(s):

Pulmonary Hypertension ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Systolic Pressure ◽

High Rate ◽

Hypoxic Pulmonary Hypertension ◽

Ventricular Systolic Pressure ◽

Hypoxic Conditions ◽

Pulmonary Vasodilator ◽

The Right

Brain natriuretic peptide (BNP) is a pulmonary vasodilator that is elevated in the right heart and plasma of hypoxia-adapted rats. To test the hypothesis that BNP protects against hypoxic pulmonary hypertension, we measured right ventricular systolic pressure (RVSP), right ventricle (RV) weight-to-body weight (BW) ratio (RV/BW), and percent muscularization of peripheral pulmonary vessels (%MPPV) in rats given an intravenous infusion of BNP, atrial natriuretic peptide (ANP), or saline alone after 2 wk of normoxia or hypobaric hypoxia (0.5 atm). Hypoxia-adapted rats had higher hematocrits, RVSP, RV/BW, and %MPPV than did normoxic controls. Under normoxic conditions, BNP infusion (0.2 and 1.4 μg/h) increased plasma BNP but had no effect on RVSP, RV/BW, or %MPPV. Under hypoxic conditions, low-rate BNP infusion (0.2 μg/h) had no effect on plasma BNP or on severity of pulmonary hypertension. However, high-rate BNP infusion (1.4 μg/h) increased plasma BNP (69 ± 8 vs. 35 ± 4 pg/ml, P < 0.05), lowered RV/BW (0.87 ± 0.05 vs. 1.02 ± 0.04, P < 0.05), and decreased %MPPV (60 vs. 74%, P < 0.05). There was also a trend toward lower RVSP (55 ± 3 vs. 64 ± 2, P = not significant). Infusion of ANP at 1.4 μg/h increased plasma ANP in hypoxic rats (759 ± 153 vs. 393 ± 54 pg/ml, P < 0.05) but had no effect on RVSP, RV/BW, or %MPPV. We conclude that BNP may regulate pulmonary vascular responses to hypoxia and, at the doses used in this study, is more effective than ANP at blunting pulmonary hypertension during the first 2 wk of hypoxia.

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