Publikation

Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease

Wissenschaftlicher Artikel/Review - 01.09.2009

Bereiche
PubMed
DOI

Zitation
Maeder M, Brutsche M, Christ A, Reichlin T, Staub D, Noveanu M, Breidthardt T, Potocki M, Mueller C. Natriuretic peptides for the prediction of severely impaired peak VO2 in patients with lung disease. Respiratory medicine 2009; 103:1337-45.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Respiratory medicine 2009; 103
Veröffentlichungsdatum
01.09.2009
eISSN (Online)
1532-3064
Seiten
1337-45
Kurzbeschreibung/Zielsetzung

BACKGROUND: B-type natriuretic peptide (BNP) is a predictor of death in patients with lung disease. We hypothesised that in patients with lung disease, BNP and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) could predict a peak VO(2)<15 ml/kg/min, which is the proposed cut-off indicating an increased risk of perioperative complications during lung resection surgery. METHODS: BNP and NT-proBNP were measured in 85 patients with a variety of pulmonary pathologies undergoing cardiopulmonary exercise testing and fulfilling criteria for appropriate effort. RESULTS: BNP [69 (42-270) vs. 33 (15-65)pg/ml; p=0.001] and NT-proBNP [290 (129-1075) vs. 65 (21-129)pg/ml; p<0.001] were higher in patients with peak VO(2)<15 ml/kg/min (n=27) as compared to those with peak VO(2)> or =15 ml/kg/min (n=58). Apart from the forced expiratory volume within the first second (FEV(1)), body mass index (BMI), diabetes, and the alveolo-arterial oxygen pressure difference [D(A-a)O(2); only in the BNP model], BNP or NT-proBNP respectively were independent predictors of peak VO(2)<15 ml/kg/min. The areas under the receiver-operator-characteristics curve (AUC) for BNP and NT-proBNP to predict a peak VO(2)<15 ml/kg/min were 0.73 and 0.80 respectively. A five-item (BNP) or four-item (NT-proBNP) score including BMI, FEV(1), diabetes, D(A-a)O(2), and BNP/NT-proBNP had an AUC of 0.87 and 0.88 respectively for the prediction of peak VO(2)<15ml/kg/min. CONCLUSIONS: In patients with lung disease, BNP or NT-proBNP is independently associated with low peak VO(2). A simple score based on spirometry, blood gases and BNP or NT-proBNP has a high accuracy for the prediction of a peak VO(2)<15 ml/kg/min.