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Elevated brain natriuretic peptide predicts mortality in interstitial lung disease
T J Corte1, S J Wort, M A Gatzoulis
1Royal Brompton Hospital and National Heart and Lung Institute, London, UK.
The European Respiratory Journal
|March 13, 2010
Summary
Elevated brain natriuretic peptide (BNP) and echocardiography markers indicate poor prognosis in interstitial lung disease (ILD). These noninvasive measures predict mortality risk in ILD patients, aiding prognostic assessment.
Area of Science:
- Cardiology
- Pulmonology
- Medical Diagnostics
Background:
- Elevated pulmonary vascular resistance is a poor prognostic indicator in interstitial lung disease (ILD).
- Currently, noninvasive prognostic markers for ILD are lacking.
- Brain natriuretic peptide (BNP) and echocardiography are potential noninvasive markers.
Purpose of the Study:
- To explore the prognostic value of BNP and echocardiography in ILD patients.
- To determine if BNP and echocardiographic parameters correlate with survival outcomes.
- To identify noninvasive markers for predicting mortality in ILD.
Main Methods:
- Retrospective review of 90 ILD patients with recorded BNP concentrations (2005-2007).
- Cardiologist review of echocardiography tapes, blinded to other patient data.
- Analysis of survival outcomes against BNP levels and echocardiographic parameters.
Main Results:
- BNP correlated with right heart echocardiographic indices, including right ventricular systolic pressure (RVSP).
- Nonsurvivors exhibited higher BNP and RVSP levels compared to survivors.
- BNP ≥20 pmol·L(-1) and moderate-severe pulmonary hypertension were independently associated with increased mortality.
Conclusions:
- Increased BNP levels and echocardiographic markers of right ventricular dysfunction are associated with higher mortality in ILD.
- Pulmonary vascular disease contributes to the mortality observed across ILD.
- BNP and echocardiography show promise as noninvasive prognostic markers for ILD.
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