@article {JamesPA3781, author = {Ben James and Neil Greening and Nicole Toms and Michael Steiner and Rachael Evans}, title = {Is there benefit from proactive case-detection of left ventricular systolic dysfunction (LVSD) using BNP in patients with advanced COPD?}, volume = {48}, number = {suppl 60}, elocation-id = {PA3781}, year = {2016}, doi = {10.1183/13993003.congress-2016.PA3781}, publisher = {European Respiratory Society}, abstract = {Aims: Coexistent left ventricular systolic dysfunction (LVSD) is common in patients with COPD and negatively affects outcomes1. However, diagnosis is complicated by the similarities in clinical presentation. We aimed to investigate the routine use of B-type Natriuretic Peptide (BNP) for case-detection of LVSD in patients with advanced COPD.Methods: Patients with advanced COPD were recruited to undertake an annual {\textquoteright}comprehensive respiratory assessment{\textquoteright} as previously described2. Plasma BNP was expressed relative to age and gender-specific reference intervals. Transthoracic echocardiography was considered within clinical context if the BNP exceeded the upper limit of normal (ULN).Results: BNP was measured in 216 patients with advanced COPD (133 male, mean [SD] age 65.6 [9.1] yrs, FEV1 30.8 [10.3]\% predicted). 30 patients (13.9\%) had a prior diagnosis of LVSD and were therefore excluded. Median [range] BNP was 22.2 [0.0-240.6] pg/mL, and was abnormal in 29 individuals (15.6\%) of whom 11 were referred for echocardiography. Reasons for non-referral included if a recent echocardiogram was available, the result was deemed borderline, or a palliative approach was employed. Six new cases of LVSD were identified (median BNP 77.1, x1.8 ULN), right ventricular systolic dysfunction n=1 (201.1, x1.2 ULN), diastolic dysfunction n=1 (112.0, x1.7 ULN) and normal echocardiography n=3 (116.6, x1.4 ULN). Overall LVSD prevalence was at least 16.7\% in this cohort.Conclusions: BNP is a simple blood test which can increase case-detection of LVSD if systematically assessed in patients with advanced COPD.References:1Eur Heart J 2013; 34:27952Thorax 2015; 70:805.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/48/suppl_60/PA3781}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }