Plasma brain natriuretic peptide as a prognostic indicator in patients with primary pulmonary hypertension.
Plasma brain natriuretic peptide as a prognostic indicator in patients with primary pulmonary hypertension.
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DOI：
10.1161/01.cir.102.8.865
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发表时间：
2000-08
期刊：
影响因子：
37.8
通讯作者：
N. Nagaya;T. Nishikimi;M. Uematsu;T. Satoh;S. Kyotani;F. Sakamaki;M. Kakishita;K. Fukushima;
中科院分区：
文献类型：
--
作者：
N. Nagaya;T. Nishikimi;M. Uematsu;T. Satoh;S. Kyotani;F. Sakamaki;M. Kakishita;K. Fukushima;
背景技术血浆脑钠肽（BNP）水平随肺动脉高压右心室功能障碍的程度成比例增加。我们试图评估血浆 BNP 对原发性肺动脉高压 (PPH) 患者的预后意义。方法和结果 在诊断性导管插入术时，对 60 名 PPH 患者的血浆 BNP 以及心房钠尿肽、去甲肾上腺素和肾上腺素进行了测量。平均随访 3 个月后，对 53 名患者进行了重复测量。其中 49 名患者接受静脉注射或口服前列环素治疗。在平均 24 个月的随访期间，18 名患者死于心肺原因。根据多变量分析，基线血浆 BNP 是死亡率的独立预测因子。根据 Kaplan-Meier 生存曲线 (P/=180 pg/mL)，基线 BNP 高于中值水平 (>/=150 pg/mL) 的患者的生存率显着低于中值水平的患者 (P<0.0001)。结论 高水平的血浆 BNP，特别是随访期间血浆 BNP 的进一步升高，可能与 PPH 患者死亡率的增加有很强的、独立的相关性。
BACKGROUND Plasma brain natriuretic peptide (BNP) level increases in proportion to the degree of right ventricular dysfunction in pulmonary hypertension. We sought to assess the prognostic significance of plasma BNP in patients with primary pulmonary hypertension (PPH). METHODS AND RESULTS Plasma BNP was measured in 60 patients with PPH at diagnostic catheterization, together with atrial natriuretic peptide, norepinephrine, and epinephrine. Measurements were repeated in 53 patients after a mean follow-up period of 3 months. Forty-nine of the patients received intravenous or oral prostacyclin. During a mean follow-up period of 24 months, 18 patients died of cardiopulmonary causes. According to multivariate analysis, baseline plasma BNP was an independent predictor of mortality. Patients with a supramedian level of baseline BNP (>/=150 pg/mL) had a significantly lower survival rate than those with an inframedian level, according to Kaplan-Meier survival curves (P/=180 pg/mL) than for those with an inframedian value (P<0.0001). CONCLUSIONS A high level of plasma BNP, and in particular, a further increase in plasma BNP during follow-up, may have a strong, independent association with increased mortality rates in patients with PPH.