N-terminal pro-brain natriuretic peptide reflects pulmonary capillary leakage in patients with acute dyspnea.
Natriuretic peptides have proved useful in the diagnosis of heart failure in patients presenting to the emergency department with shortness of breath. Dyspnea and orthopnea in heart failure are clinical expressions of pulmonary capillary congestion and leakage, which may be assessed by the percentage of pulmonary hemosiderin-laden macrophages (HLM) in induced sputum. We found a significant difference in the percentage of HLM present in sputum among patients with acute heart failure, patients with noncardiac dyspnea with ventricular dysfunction, and patients without heart failure (p = 0.008). N-terminal pro-brain natriuretic peptide (N-BNP) concentrations were also different among these 3 patient groups (p = 0.006). N-BNP concentrations were positively associated with the percentage of HLM in patients with acute dyspnea (r = 0.6; p < 0.0001). N-BNP, in addition to being a ventricular dysfunction marker, may reflect the severity of pulmonary capillary congestion and leakage in patients with acute shortness of breath.
Bayes-Genis
Antoni
A
Cardiology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. abayesgenis@hsp.santpau.es
Bellido-Casado
Jesus
J
Zapico
Edgar
E
Cotes
Carlos
C
Belda
Jose
J
Lopez
Laura
L
Santaló
Miquel
M
Ordoñez-Llanos
Jordi
J
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002196:Capillaries / Q000503:physiopathology*; D004417:Dyspnea / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000503:physiopathology; D008171:Lung Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010865:Pilot Projects; D011446:Prospective Studies
D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain