The association of N-terminal pro-brain-type natriuretic peptide with hemodynamics and functional capacity in therapy-naive precapillary pulmonary hypertension: results from a cohort study

BMC Pulm Med. 2017 Dec 4;17(1):167. doi: 10.1186/s12890-017-0521-4.

Abstract

Background: N-terminal pro-brain-type natriuretic peptide (NT-proBNP) is currently used as a surrogate marker for disease severity in pulmonary hypertension (PH). However, NT-proBNP tends to have a high variability and may insufficiently correlate with hemodynamics and exercise capacity.

Methods: To investigate the association of NT-proBNP with hemodynamics and cardio-pulmonary exercise testing (CPET) in 84 therapy-naive patients with precapillary PH.

Results: NT-proBNP levels were significantly correlated with hemodynamics and CPET parameters except for cardiac index, diffusion capacity, PaO2 at peak exercise, and peak minute ventilation. NT-proBNP correlated best with hemodynamics and CPET in women and patients >65 years. NT-proBNP correlated better with CPET in pulmonary arterial hypertension compared to chronic thromboembolic PH (CTEPH).

Conclusion: NT-proBNP is associated with disease severity in precapillary PH. The association might be age- and gender-dependent. NT-proBNP may insufficiently correlate with disease severity in CTEPH, possibly due to comorbidity.

Keywords: Age; Chronic thromboembolic pulmonary hypertension (CTEPH); Exercise capacity; Gender; Hemodynamics; N-terminal pro-brain-type natriuretic peptide (NT-proBNP); Pulmonary arterial hypertension (PAH).

MeSH terms

  • Age Factors
  • Aged
  • Exercise Tolerance*
  • Female
  • Hemodynamics*
  • Humans
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / physiopathology*
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Severity of Illness Index
  • Sex Factors
  • Walk Test

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain