Korean J Intern Med.  2008 Jun;23(2):78-86. 10.3904/kjim.2008.23.2.78.

N-terminal pro-B-type natriuretic peptide as a marker of disease severity in patients with pericardial effusions

• Kim SJ
• Shin ES
• Lee SG

• KMID: 759960
• DOI: http://doi.org/10.3904/kjim.2008.23.2.78

Abstract

BACKGROUND/AIMS: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has recently been introduced as a useful marker in diagnosing underlying disease in patients with dyspnea and for determining the prognosis of patients with heart failure. The purpose of this study was to evaluate the value of the NT-proBNP as a marker of disease severity in patients with pericardial effusions. METHODS: We enrolled 69 consecutive patients who showed moderate or large pericardial effusion with preserved left ventricular (LV) systolic function; 42 patients finally participated in the study, and 13 (31.0%) of them showed cardiac tamponade. We analyzed the etiologies, the clinical and echocardiographic variables, and the serum NT-proBNP levels in these patients. RESULTS: The mean NT-proBNP level was 751+/-1002 ng/L (range 5 to 5289), and the median level was 385 ng/L (interquartile range 152 to 844). The NT-proBNP levels were higher in those patients with jugular venous distension (p=0.002), pulsus paradoxus (p=0.016), heart rate > or =100/min (p=0.006), cardiac tamponade (p=0.001), large pericardial effusion (p=0.029), exaggerated respiratory variation of the transmitral inflow (p=0.006), or plethora of the inferior vena cava (p=0.01). The NT-proBNP levels showed significant correlation with heart rate (r=0.517, p<0.001) and the diameter of the inferior vena cava (r=0.329, p=0.03). CONCLUSIONS: NT-proBNP may be useful as a marker of disease severity in patients suffering from pericardial effusion, but further prospective studies with more patients will be needed.

Keyword

Pericardial effusion; Natriuretic peptide; Brain; Cardiac tamponade; Echocardiography

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Biological Markers/blood
Cardiac Tamponade/blood/etiology
Diastole
Disease Progression
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain/*blood
Peptide Fragments/*blood
Pericardial Effusion/*blood/complications/*diagnosis/physiopathology/ultrasonography
Predictive Value of Tests
Prognosis
Prospective Studies
Severity of Illness Index
Systole
Ventricular Function, Left