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Brain Natriuretic Peptide: The Canary in the Right Ventricular Mine in PAH

Robert Frantz


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Conference: 2010 International PHA Conference and Scientific Sessions

Release Date: 06.24.2010

Presentation Type: Abstracts

Frantz RP. 
Mayo Clinic, Rochester, MN, USA

BACKGROUNDAssessment of right ventricular (RV) morphology and function by MRI and CT is of increasing interest in pulmonary arterial hypertension (PAH), but is expensive and not routinely available. We examined the relationship between brain natriuretic peptide (BNP) levels, N-terminal pro brain natriuretic peptide (NBNP) levels and RV morphology in patients with PAH.

METHODSRetrospective analysis of relationship between biomarkers and RV morphology in patients with PAH attending the Mayo Pulmonary Hypertension Clinic. Clinical data were collected from medical records. Statistical analyses included correlation between measures of RV size and function and natural log transformed biomarker levels.

RESULTSThe cohort was comprised of 22 patients (18 women, 4 men; 20 Caucasian, 1 Asian, 1 American Indian). PAH etiology included 11 with IPAH, 7 with FPAH, and 1 each with diet drug, lupus, and scleroderma related PAH. Fourteen of the 22 had BNP levels greater than 150 pg/ml, and 100% of those had a right ventricular end diastolic volume index greater than 100 ml/m2. The natural log of BNP (lnBNP) correlated with right ventricular end-diastolic volume index (RVEDVI) (correlation coefficient 0.75). The natural log of NBNP (lnNBNP) correlated with RVEDVI (correlation coefficient 0.77). BNP levels moved in the same direction as RV volume in patients having serial determinations.

CONCLUSIONSBNP and NBNP levels correlate with RV volume and may serve as the “canary in the right ventricular mine” in patients with PAH.

Brain Natriuretic Peptide: The Canary in the Right Ventricular Mine in PAH