Usefulness of B-type natriuretic peptide as a predictor of treatment outcome in pulmonary arterial hypertension.
We examined the utility of early modulation B-type natriuretic peptide (BNP) levels in 20 pulmonary arterial hypertension patients as a marker of response to epoprostenol therapy. The baseline BNP level was 828+/-217 pg/mL. A total of 19 hospitalizations and one death occurred in nine patients during 11.0+/-1.8 months. At baseline, a trend toward higher BNP level was observed among the event-free (Group A) as compared with clinical event patients (Group B) (1090+/-372 vs. 510+/-235 pg/mL, respectively; p=0.08). After 3 months on epoprostenol, a significant reduction among Group A occurred while Group B demonstrated an increase (288+/-92 vs. 610+/-121 pg/mL, p=0.04). A comparison of percent reduction in BNP level demonstrated a -70+/-7% change among Group A and an 11+/-19% increase in Group B (p=0.005). A decrease in BNP level of > or =50% during the first 3 months on epoprostenol was strongly predictive of event-free survival (p=0.003). This investigation establishes the utility of BNP for predicting response to epoprostenol therapy in pulmonary arterial hypertension.
Park
Myung H
MH
Cardiomyopathy and Pulmonary Vascular Disease Center, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
Scott
Robert L
RL
Uber
Patricia A
PA
Ventura
Hector O
HO
Mehra
Mandeep R
MR
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000187:drug effects*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D011464:Epoprostenol