Conference: 2008 International PHA Conference and Scientific Sessions
Release Date: 06.20.2008
Presentation Type: Abstracts
Navas V. 1, Rahaghi N.2, Ramirez J. 1, Smolley L.1, Oliveira E.1, Areces M.1, Scridon C.1, Fromkin K.1, Novaro G.1 and Rahaghi F.F.1.
1. Cleveland Clinic Florida, Weston/Fort Lauderdale, FL, USA
2. University of California, San Diego, CA, USA
BACKGROUND: BNP is proven to be a useful marker in heart failure and pulmonary arterial hypertension (PAH). We studied the usefulness of NT-proBNP levels to exclude left sided heart disease in PAH.
METHODS: 24 consecutive patients who were referred for right sided heart catheterization had a measurement of NT-proBNP within a 3 week window. The NT-proBNP and the wedge pressures were plotted along receiver operator characteristic (ROC) curves for wedge of 15 mmHg and 19 mmHg.
RESULTS: The study group comprised 23 patients, 8(35%) men with an average age of 64 15 years, average BMI 28.8 6, 7(30%) were hypertensive, 8 (35%) had COPD, 8(35%) had a history of collagen vascular disease. For a wedge of 15, a cutoff point of 2000 results in true positive rate (TPR) of 80% and a false positive rate (FPR) of 15%, with an area under the curve (AUC) of 0.72. Similarly, for a wedge of 19, a level of 2000, results in a TPR rate of 75% but a 0% FPR, resulting an AUC of 0.79.
CONCLUSIONS: An NT-proBNP of 2000 successfully excludes patients with elevated wedge pressures, with only 15% false positive rate for wedge 15 and 0% for wedge of 19. In certain high-risk patients where right heart catheterization may not be possible, measuring NT-proBNP may be used to solidify the diagnosis of pulmonary arterial hypertension by excluding left sided disease.