PT  - JOURNAL ARTICLE
AU  - K. G. Blyth
AU  - B. A. Groenning
AU  - P. B. Mark
AU  - T. N. Martin
AU  - J. E. Foster
AU  - T. Steedman
AU  - J. J. Morton
AU  - H. J. Dargie
AU  - A. J. Peacock
TI  - NT-proBNP can be used to detect right ventricular systolic dysfunction in pulmonary hypertension
AID  - 10.1183/09031936.00095606
DP  - 2007 Apr 01
TA  - European Respiratory Journal
PG  - 737--744
VI  - 29
IP  - 4
4099  - http://erj.ersjournals.com/content/29/4/737.short
4100  - http://erj.ersjournals.com/content/29/4/737.full
SO  - Eur Respir J2007 Apr 01; 29
AB  - Right ventricular systolic dysfunction (RVSD) at baseline (pre-treatment) predicts early death in patients with pulmonary hypertension (PH). However, RVSD can only be detected reliably by prohibitively invasive or expensive techniques. N-terminal B-type natriuretic peptide concentration ([NT-proBNP]) correlates with RV function in PH; however, an [NT-proBNP] threshold that indicates RVSD in individual patients has not previously been determined. Twenty-five patients with PH (pulmonary arterial hypertension (n = 19) or chronic thromboembolic PH (n = 6)) underwent cardiovascular magnetic resonance (CMR) imaging and NT-proBNP measurement at baseline. [NT-proBNP] was correlated against RV dimensions and ejection fraction (RVEF) measured directly by CMR imaging. The ability of NT-proBNP to detect RVSD (defined as a CMR-derived RVEF >2 sds below control values) was tested and predictors of [NT-proBNP] identified. [NT-proBNP] correlated negatively with RVEF. RVSD was present in nine out of 25 patients. An [NT-proBNP] threshold of 1,685 pg·mL−1 was sensitive (100%) and specific (94%) in detecting RVSD. RVEF and RV mass index independently predicted [NT-proBNP]. In pulmonary hypertension, a baseline N-terminal B-type natriuretic peptide concentration of >1,685 ng·L−1 suggests right ventricular systolic dysfunction, and thus an increased risk of early death. N-terminal B-type natriuretic peptide could prove useful as an objective, noninvasive means of identifying patients with pulmonary hypertension who have right ventricular systolic dysfunction at presentation.