Tuberc Respir Dis.  2006 May;60(5):540-547.

The Prognostic Role of B-type Natriuretic Peptide in Acute Pulmonary Thromboembolism

• Lee SJ
• Lee JH
• Park JY
• Jo WS
• Kim JE
• Kim KU
• Park HK
• Kim YS
• Lee MK
• Park SK

Abstract

BACKGROUND: Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism.
METHODS
Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared.
RESULTS
The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively.
CONCLUSION
This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.

Keyword

BNP; Echocardiography; Acute pulmonary thromboembolism

MeSH Terms

Biomarkers
Diagnosis
Echocardiography
Emergency Service, Hospital
Heart Failure
Humans
Medical Records
Natriuretic Peptide, Brain*
Plasma
Prognosis
Pulmonary Artery
Pulmonary Embolism*
ROC Curve
Thrombolytic Therapy
Tricuspid Valve Insufficiency
Vital Signs
Natriuretic Peptide, Brain

Figure

• 

  Figure 1 ROC curve for the cut-off level of the BNP level in differentiating between stable and unstable vital sign groups

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