title: One-year prognosis and the role of brain natriuretic peptide levels in patients with chronic cor pulmonale.
abstract: Data on the clinical outcomes and role of brain natriuretic peptide (BNP) levels in patients with chronic cor pulmonale are limited. A total of 69 patients with chronic cor pulmonale, admitted for dyspnea (January 2007 to September 2011) to three university hospitals, were retrospectively reviewed. All of the patients had right ventricular (RV) dysfunction on echocardiography. The median age was 70.0 yr, and chronic obstructive pulmonary disease (40.6%) and tuberculosis-destroyed lung (TDL, 27.5%) were the leading causes of chronic cor pulmonale. At the 1-yr follow-up, the mortality rate was 15.9%, and the readmission rate was 53.7%; patients with TDL had higher mortality (31.6% vs. 10.0%; P=0.059) and readmission rates (78.9% vs. 43.8%; P=0.009) than those with non-TDL diseases. The area under the receiver operating characteristic curve for admission BNP levels to predict readmission was 0.788 (95% confidence interval [CI], 0.673-0.904), and the sensitivity and specificity of the cut-off value were 80.6% and 77.4%, respectively. In multivariate analysis, high admission BNP levels were a significant risk factor for subsequent readmission (hazard ratio, 1.049; 95% CI, 1.005-1.094). Additionally, admission BNP levels were well correlated with cardiac troponin I (r=0.558), and delta BNP also correlated with delta RV systolic pressure (n=25; r=0.562). In conclusion, among hospitalized patients with chronic cor pulmonale, admission high BNP levels are a significant risk factor for subsequent readmission. Therefore, more intensive monitoring and treatment are needed in patients with higher BNP levels.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: So Young
authors.identifier: 0000-0003-2718-0518
authors.initials: SY
authors.lastname: Park
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Chang Youl
authors.identifier: 0000-0002-4088-4993
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Changhwan
authors.initials: C
authors.lastname: Kim
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Jang
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Yong Bum
authors.identifier: 0000-0001-8810-6077
authors.initials: YB
authors.lastname: Park
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Sunghoon
authors.identifier: 0000-0001-7004-6985
authors.initials: S
authors.lastname: Park
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Yong Il
authors.identifier: 0000-0002-3502-5211
authors.initials: YI
authors.lastname: Hwang
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Myung Goo
authors.initials: MG
authors.lastname: Lee
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Ki-Suck
authors.initials: KS
authors.lastname: Jung
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Dong-Gyu
authors.identifier: 0000-0002-9588-8748
authors.initials: DG
authors.lastname: Kim
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010359:Patient Readmission; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D011660:Pulmonary Heart Disease / Q000097:blood* / Q000401:mortality; D012372:ROC Curve; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications
chemical_list: D020097:Natriuretic Peptide, Brain
keywords: Admission; Natriuretic Peptide, Brain; Outcome; Pulmonary Heart Disease
references.citation: J Asthma. 2014 Apr;51(3):294-8
references.pmid: 24188733
references.citation: Eur Respir J. 2012 Apr;39(4):939-44
references.pmid: 21885398
references.citation: Chin Med J (Engl). 2008 Apr 5;121(7):587-91
references.pmid: 18466676
references.citation: J Int Med Res. 2005 Sep-Oct;33(5):537-44
references.pmid: 16222887
references.citation: Respir Med. 1999 Jul;93(7):507-14
references.pmid: 10464838
references.citation: Semin Respir Crit Care Med. 2003 Jun;24(3):233-44
references.pmid: 16088545
references.citation: Chest. 1986 Aug;90(2):185-92
references.pmid: 3731890
references.citation: Int J Tuberc Lung Dis. 2013 Jan;17(1):67-75
references.pmid: 23232006
references.citation: Respir Res. 2011;12:37
references.pmid: 21450080
references.citation: COPD. 2014 Jun;11(3):339-50
references.pmid: 24111903
references.citation: Respir Med. 2009 Feb;103(2):180-6
references.pmid: 19097877
references.citation: Am J Respir Crit Care Med. 2005 Jul 15;172(2):189-94
references.pmid: 15831842
references.citation: Am J Respir Crit Care Med. 2002 Aug 1;166(3):314-22
references.pmid: 12153963
references.citation: Respiration. 2006;73(3):311-7
references.pmid: 16155352
references.citation: J Indian Med Assoc. 1978 Jul 1;71(1):4-7
references.pmid: 731038
references.citation: Circulation. 2010 Jul 13;122(2):164-72
references.pmid: 20585012
references.citation: Circulation. 2000 Aug 22;102(8):865-70
references.pmid: 10952954
references.citation: J Am Coll Cardiol. 1985 Aug;6(2):359-65
references.pmid: 4019921
references.citation: Intern Med. 2009;48(7):503-12
references.pmid: 19336951
references.citation: Heart. 2003 Feb;89(2):225-30
references.pmid: 12527688
references.citation: Am J Respir Crit Care Med. 2003 Mar 1;167(5):735-40
references.pmid: 12480614
references.citation: Chest. 2008 May;133(5):1088-94
references.pmid: 18339792
references.citation: Eur Respir J. 2008 Nov;32(5):1371-85
references.pmid: 18978137
references.citation: Circulation. 2003 Aug 19;108(7):844-8
references.pmid: 12900346
references.citation: Eur Respir J. 2011 Aug;38(2):359-67
references.pmid: 21310884
references.citation: J Clin Invest. 1991 Apr;87(4):1402-12
references.pmid: 1849149
references.citation: Am J Respir Crit Care Med. 2013 Feb 15;187(4):347-65
references.pmid: 22878278
references.citation: Eur J Echocardiogr. 2010 Mar;11(2):81-96
references.pmid: 20124362
references.citation: Int J Tuberc Lung Dis. 2001 Oct;5(10):963-7
references.pmid: 11605892
references.citation: Clin Chim Acta. 2008 May;391(1-2):102-5
references.pmid: 18294456
references.citation: Clin Sci (Lond). 2010 Sep;119(5):207-13
references.pmid: 20412051
references.citation: Eur Respir J. 2007 Nov;30(5):914-21
references.pmid: 17652313
references.citation: Kekkaku. 1989 Dec;64(12):810-4
references.pmid: 2615135
references.citation: Bull Eur Physiopathol Respir. 1984 Nov-Dec;20(6):495-500
references.pmid: 6440605
references.citation: Chest. 2007 Mar;131(3):657-63
references.pmid: 17356077
references.citation: J Hosp Med. 2011 Sep;6(7):383-8
references.pmid: 21915999
references.citation: Am Heart J. 2004 Jan;147(1):60-5
references.pmid: 14691420