Journal List > Tuberc Respir Dis > v.60(5) > 1000950

Lee, Lee, Park, Jo, Kim, Kim, Park, Kim, Lee, and Park: The Prognostic Role of B-type Natriuretic Peptide in Acute Pulmonary Thromboembolism

Abstract

Background

Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism.

Methods

Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared.

Results

The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively.

Conclusion

This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.

Figures and Tables

Figure 1
ROC curve for the cut-off level of the BNP level in differentiating between stable and unstable vital sign groups
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Table 1
Demographic characteristics of patients
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*mean ± standard deviation

Table 2
Correlation between the BNP level and Echocardiographic or clinical variables
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Data are Mean ± standard deviation

LVEF: Left ventricular ejection fraction, RVSP: Right ventricular systolic pressure,

Tr: Regurgitation of tricuspid valve

*tPA: tissue Plasminogen Activator

Table 3
Comparisons of patients between stable and unstable vital sign groups
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Data are Mean ± standard deviation

LVEF: Left ventricular ejection fraction, RVSP: Right ventricular systolic pressure,

Tr: Regurgitation of tricuspid valve

*tPA : tissue Plasminogen Activator

Table 4
Multiple logistic regression analysis for the prediction of vital sign stability
trd-60-540-i004

LVEF: Left ventricular ejection fraction, RVSP: Right ventricular systolic pressure,

Tr: Regurgitation of tricuspid valve

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