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Role of BNP in Identifying Elevated Pulmonary Wedge Pressure in Patients with Pulmonary Hypertension

V. Navas

N. Rahaghi

J. Ramirez

L. Smolley

E. Oliveira

M. Areces

C. Scridon

K. Fromkin

G. Novaro

Franck Rahaghi

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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


BACKGROUNDBNP 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.

METHODS24 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. 

RESULTSThe 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.

Role of BNP in Identifying Elevated Pulmonary Wedge Pressure in Patients with Pulmonary Hypertension

CONCLUSIONSAn 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.