Brain natriuretic peptide is a prognostic parameter in chronic lung disease.
BACKGROUND
The detection of pulmonary hypertension in patients with chronic lung disease has prognostic implications. The brain natriuretic peptide (BNP) has been suggested as a noninvasive marker for the presence and severity of pulmonary hypertension.


OBJECTIVE
We evaluated circulating BNP levels as a parameter for the presence and severity of pulmonary hypertension in patients with chronic lung disease.


METHODS
BNP levels were measured in 176 consecutive patients with various pulmonary diseases. Right heart catheterization, lung functional testing, and a 6-min walk test were performed. The mean follow-up time was nearly 1 yr.


RESULTS
Significant pulmonary hypertension (mean pulmonary artery pressure > 35 mm Hg) was diagnosed in more than one-fourth of patients and led to decreased exercise tolerance and life expectancy. Elevated BNP concentrations identified significant pulmonary hypertension with a sensitivity of 0.85 and specificity of 0.88 and predicted mortality. Moreover, BNP served as a risk factor of death independent of lung functional impairment or hypoxemia in uni- and multivariate analysis.


CONCLUSIONS
We suggest BNP as a prognostic marker and as screening parameter for significant pulmonary hypertension in chronic lung disease.
Leuchte
Hanno H
HH
Division of Pulmonary Diseases, Department of Internal Medicine I, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany.
Baumgartner
Rainer A
RA
Nounou
Michal El
ME
Vogeser
Michael
M
Neurohr
Claus
C
Trautnitz
Michael
M
Behr
Juergen
J
D000328:Adult; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D002302:Cardiac Output / Q000502:physiology; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010991:Plethysmography; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012720:Severity of Illness Index; D013147:Spirometry; D015996:Survival Rate / Q000639:trends
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain