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Published ahead of print on January 13, 2006, doi:10.1164/rccm.200510-1545OC

Am. J. Respir. Crit. Care Med., Volume 173, Number 7, April 2006, 744-750

A more recent version of this article appeared on April 1, 2006
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Submitted on October 1, 2005
Accepted on January 12, 2006

Brain Natriuretic Peptide is a Prognostic Parameter in Chronic Lung Disease

Hanno H Leuchte1, Rainer A Baumgartner1, Michal El Nounou1, Michael Vogeser2, Claus Neurohr1, Michael Trautnitz1, and Juergen Behr1*

1 Division of Pulmonary Diseases, Department of Internal Medicine I, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany, 2 Department of Clinical Chemistry, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany

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

Rationale: The detection of pulmonary hypertension in patients with chronic lung disease has prognostic implications. The brain natriuretic peptide (BNP) has been suggested as a non-invasive marker for the presence and severity of pulmonary hypertension. Objectives: We evaluated circulating BNP levels as a parameter for the presence and severity of pulmonary hypertension in patients with chronic lung disease. Methods: BNP levels were measured in one hundred seventy six consecutive patients with various pulmonary diseases. Right heart catheterization, lung functional testing and a six minute walk test were performed. The mean follow up time was nearly one year. Measurements and Main results: Significant pulmonary hypertension (mean pulmonary artery pressure > 35 mmHg) was diagnosed in more than one fourth of patients and led to decreased exercise tolerance and life expectancy. Elevated BNP concentrations identified significant pulmonary hypertension with a sensitivity of 0.85 and specificity of 0.88 and predicted mortality. Moreover, BNP served as a risk factor of death independent of lung functional impairment or hypoxemia in uni- and multivariate analysis. Conclusion: We suggest BNP as a prognostic marker and as screening parameter for significant pulmonary hypertension in chronic lung disease.
Key words: Natriuretic peptide, Brain; Hypertension, Pulmonary; Fibrosis, COPD




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