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.
Cardiomyopathy and Pulmonary Vascular Disease Center, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
Myung H
MH
Park
Robert L
RL
Scott
Patricia A
PA
Uber
Hector O
HO
Ventura
Mandeep R
MR
Mehra
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