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

Tuberculosis and Respiratory Diseases 2006; 60(5): 540-547.

Published online: 31 May 2006

DOI: https://doi.org/10.4046/trd.2006.60.5.540

The Prognostic Role of B-type Natriuretic Peptide in Acute Pulmonary Thromboembolism

Su Jin Lee, Jae Hyung Lee, Ji Young Park, Woo Sung Jo, Ji Eun Kim, Ki Uk Kim, Hye Kyung Park, Yun Seong Kim, Min Ki Lee, Soon Kew Park

Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Korea.

Address for correspondence: Soon Kew Park, MD. Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Pusan National University College of Medicine, 1 Ga-10, Ami-Dong, Suh-Gu, Busan 602-739, Korea. Phone: 82-51-240-7875, Fax: 82-51-254-3127, yskimdr@yahoo.co.kr

Received 22 March 2006       Accepted 25 April 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

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.

Keywords: BNP, Echocardiography, Acute pulmonary thromboembolism

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
trd-60-540-g001
Table 1
Demographic characteristics of patients
trd-60-540-i001

*mean ± standard deviation

Table 2
Correlation between the BNP level and Echocardiographic or clinical variables
trd-60-540-i002

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
trd-60-540-i003

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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