Abstract
Introduction: Pulmonary hypertension (PH) secondary to chronic obstructive pulmonary disease (COPD) is an important cause of death. N-terminal of pro brain natriuretic peptide (NT-proBNP) has been suggested as a noninvasive marker for the presence and severity of PH. The changes in NT-proBNP concentration correlated with clinical symptoms. Specific treatment of PH in the setting of COPD has not been adequately studied. We assessed oral vasodilators' (sildenafil and amlodipine) effect on NT- proBNP level in PH due to COPD.
Methods: Forty clinically-stable patients with the history of COPD who had a normal ejection fraction (EF), RV systolic pressure greater than 45 mmHg and baseline blood NT-proBNP levels above 100pg/ml were enrolled. They were divided into two groups. Patients in the first group received sildenafil 50 mg two times daily (group A) and the second group was given amlodipine 2.5-7.5 mg once daily (group B) for 2 weeks. NT-proBNP levels were measured before and after the 2 week drug administration.
Results: Drug therapy with oral vasodilators (both amlodipine or sildenafil) could significantly reduce NT-proBNP levels in COPD-induced PH patients. Also there were no significant differences between amlodipine and sildenafil on lowering NT-proBNP levels (effectiveness of therapies).
Conclusion: Drug therapy (oral vasodilators) in COPD-induced significantly decreased NT-proBNP levels in this study. Though, no significant difference between amlodipine and sildenafil in reducing NT-proBNP levels was observed. Changes in NT-proBNP levels could be used as an indicator to mirror the effectiveness of therapies.
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