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Published ahead of print on April 15, 2004, doi:10.1164/rccm.200308-1142OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 4, August 2004, 360-365

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Submitted on August 16, 2003
Accepted on April 13, 2004

Brain Natriuretic Peptide and Exercise Capacity in Lung Fibrosis and Pulmonary Hypertension

Hanno H Leuchte1*, Claus Neurohr1, Rainer Baumgartner1, Michael Holzapfel1, Wolfgang Giehrl1, Michael Vogeser1, and Juergen Behr1

1 Department of Internal Medicine 1, Division of Pulmonary Diseases, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany

* To whom correspondence should be addressed. E-mail: hleuchte{at}med.uni-muenchen.de.

Pulmonary hypertension (PH) can develop in lung fibrosis and contributes to increased morbidity and mortality. Non invasive parameters in the evaluation of PH in lung disease could aid in the management of these patients. In this study we aimed to characterize the role of BNP and the 6 minute walk distance (6 MWD) in the assessment of PH in patients with lung fibrosis. Patients with lung fibrosis and elevated BNP levels (n=20) had significantly more severe PH during right heart catheterization, than patients with lung fibrosis and normal BNP levels (mean PAP 40.85±3.2 mmHg versus 23.42±1.44 mmHg, respectively) (n=19) (p<0.001). Significant correlations between lung volumes and BNP concentrations were not observed. A weak correlation existed between capillary pO2 and 6 MWD (R=0.42; p<0.001). The presence of moderate-severe PH was associated with significant reduction of the 6 MWD. BNP concentrations predicted moderate-severe pulmonary hypertension with 100% sensitivity and high specificity (89%). We conclude that BNP is an excellent marker for the presence of PH in patients with lung fibrosis. Additionally, our data suggest that PH contributes significantly to exercise limitation in patients with severe lung fibrosis, raising the possibility that treatment of PH may be beneficial in these patients.
Key words: Natriuretic peptide, Brain; Hypertension, Pulmonary; Fibrosis




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