The value of B-type natriuretic peptide and big endothelin-1 for detection of severe pulmonary hypertension in heart transplant candidates
Background: Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B‐type natriuretic peptide (BNP) and big e...
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| Veröffentlicht in: | European journal of heart failure 2005-12, Vol.7 (7), p.1149-1155 |
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| container_title | European journal of heart failure |
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| creator | Kubánek, Miloš Málek, Ivan Kautzner, Josef Hegarová, Markéta Wiendl, Martin Lupinek, Petr Karasová, Ludmila Lánská, Věra |
| description | Background:
Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B‐type natriuretic peptide (BNP) and big endothelin‐1 (big ET1) for prediction of severe PH in heart transplant candidates.
Methods:
The study population included 43 potential heart transplant candidates (38 males, mean age 52±7 years). All underwent repeated right‐heart catheterizations (2–5 studies) at an interval of 3–4 months, giving a total of 124 examinations, associated with blood sampling for BNP and big ET1 analysis. Severe PH was defined as the mean pulmonary artery pressure (MPAP)>40 mmHg.
Results
Significantly high PVR (PVR>3.0 Wood units and TPG>15 mmHg) was noted on 12 occasions in 10 patients; always in the presence of severe PH. Low BNP levels (30 pg/ml (>40% of initial value) in subjects with a previous MPAP–40 mmHg detected development of severe PH with a 100% sensitivity and an 80–88% specificity. As a total of 58% of patients presented repeatedly with MPAP≤40mmHg, serial BNP testing could reduce the need for hemodynamic studies in this subgroup down to 12–20%.
Conclusions:
Serial BNP testing in hemodynamically stable heart transplant candidates with MPAP–40 mmHg allows reliable detection of development of severe PH, and may significantly reduce the need for repeated right‐heart catheterizations in these patients. |
| doi_str_mv | 10.1016/j.ejheart.2004.12.011 |
| format | Article |
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Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B‐type natriuretic peptide (BNP) and big endothelin‐1 (big ET1) for prediction of severe PH in heart transplant candidates.
Methods:
The study population included 43 potential heart transplant candidates (38 males, mean age 52±7 years). All underwent repeated right‐heart catheterizations (2–5 studies) at an interval of 3–4 months, giving a total of 124 examinations, associated with blood sampling for BNP and big ET1 analysis. Severe PH was defined as the mean pulmonary artery pressure (MPAP)>40 mmHg.
Results
Significantly high PVR (PVR>3.0 Wood units and TPG>15 mmHg) was noted on 12 occasions in 10 patients; always in the presence of severe PH. Low BNP levels (<67 pg/ml) ruled out the presence of severe PH with a 100% sensitivity, however, with a low specificity (34%). An increase in plasma BNP>30 pg/ml (>40% of initial value) in subjects with a previous MPAP–40 mmHg detected development of severe PH with a 100% sensitivity and an 80–88% specificity. As a total of 58% of patients presented repeatedly with MPAP≤40mmHg, serial BNP testing could reduce the need for hemodynamic studies in this subgroup down to 12–20%.
Conclusions:
Serial BNP testing in hemodynamically stable heart transplant candidates with MPAP–40 mmHg allows reliable detection of development of severe PH, and may significantly reduce the need for repeated right‐heart catheterizations in these patients.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1016/j.ejheart.2004.12.011</identifier><identifier>PMID: 15916922</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; B-type natriuretic peptide ; Big endothelin-1 ; Biomarkers - blood ; Cardiac Catheterization ; Congestive heart failure ; Endothelin-1 - blood ; Female ; Heart Transplantation ; Humans ; Hypertension, Pulmonary - blood ; Hypertension, Pulmonary - physiopathology ; Hypertension, Pulmonary - surgery ; Male ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Orthotopic heart transplantation ; Prognosis ; Pulmonary hypertension ; Pulmonary Wedge Pressure ; Radioimmunoassay ; Retrospective Studies ; Severity of Illness Index</subject><ispartof>European journal of heart failure, 2005-12, Vol.7 (7), p.1149-1155</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © 2005 the Authors</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4041-82ee4e285c39660fe6f83edc96bef152be6bcf452f5f28c9f3833b987e7abc523</citedby><cites>FETCH-LOGICAL-c4041-82ee4e285c39660fe6f83edc96bef152be6bcf452f5f28c9f3833b987e7abc523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1016%2Fj.ejheart.2004.12.011$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1016%2Fj.ejheart.2004.12.011$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45553,45554,46387,46811</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15916922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kubánek, Miloš</creatorcontrib><creatorcontrib>Málek, Ivan</creatorcontrib><creatorcontrib>Kautzner, Josef</creatorcontrib><creatorcontrib>Hegarová, Markéta</creatorcontrib><creatorcontrib>Wiendl, Martin</creatorcontrib><creatorcontrib>Lupinek, Petr</creatorcontrib><creatorcontrib>Karasová, Ludmila</creatorcontrib><creatorcontrib>Lánská, Věra</creatorcontrib><title>The value of B-type natriuretic peptide and big endothelin-1 for detection of severe pulmonary hypertension in heart transplant candidates</title><title>European journal of heart failure</title><addtitle>European Journal of Heart Failure</addtitle><description>Background:
Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B‐type natriuretic peptide (BNP) and big endothelin‐1 (big ET1) for prediction of severe PH in heart transplant candidates.
Methods:
The study population included 43 potential heart transplant candidates (38 males, mean age 52±7 years). All underwent repeated right‐heart catheterizations (2–5 studies) at an interval of 3–4 months, giving a total of 124 examinations, associated with blood sampling for BNP and big ET1 analysis. Severe PH was defined as the mean pulmonary artery pressure (MPAP)>40 mmHg.
Results
Significantly high PVR (PVR>3.0 Wood units and TPG>15 mmHg) was noted on 12 occasions in 10 patients; always in the presence of severe PH. Low BNP levels (<67 pg/ml) ruled out the presence of severe PH with a 100% sensitivity, however, with a low specificity (34%). An increase in plasma BNP>30 pg/ml (>40% of initial value) in subjects with a previous MPAP–40 mmHg detected development of severe PH with a 100% sensitivity and an 80–88% specificity. As a total of 58% of patients presented repeatedly with MPAP≤40mmHg, serial BNP testing could reduce the need for hemodynamic studies in this subgroup down to 12–20%.
Conclusions:
Serial BNP testing in hemodynamically stable heart transplant candidates with MPAP–40 mmHg allows reliable detection of development of severe PH, and may significantly reduce the need for repeated right‐heart catheterizations in these patients.</description><subject>Adult</subject><subject>Aged</subject><subject>B-type natriuretic peptide</subject><subject>Big endothelin-1</subject><subject>Biomarkers - blood</subject><subject>Cardiac Catheterization</subject><subject>Congestive heart failure</subject><subject>Endothelin-1 - blood</subject><subject>Female</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - blood</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Hypertension, Pulmonary - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Orthotopic heart transplantation</subject><subject>Prognosis</subject><subject>Pulmonary hypertension</subject><subject>Pulmonary Wedge Pressure</subject><subject>Radioimmunoassay</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9u1DAQhyMEoqXwCCCfuCX4T5zYR1q1XVYryqEIbpbjjFkvWSfYTsu-Qp-6XnYF4tbTzOGbb8b-FcVbgiuCSfNhU8FmDTqkimJcV4RWmJBnxSkRrSyxqOvnuWdClFLU9KR4FeMGY9JiTF8WJ4RL0khKT4uH2zWgOz3MgEaLzsu0mwB5nYKbAyRn0ARTcj0g7XvUuR8IfD-mNQzOlwTZMaAeEpjkRr8XRLiDAGiah-3oddihdfaFBD7uAefRn5NRCtrHadA-IZPFrtcJ4uvihdVDhDfHelZ8vbq8vViUq5vrTxcfV6WpcU1KQQFqoIIbJpsGW2isYNAb2XRgCacdNJ2xNaeWWyqMtEww1knRQqs7wyk7K94fvFMYf80Qk9q6aGDI58A4R9UIwVtKZQb5ATRhjDGAVVNw2_wqRbDah6A26hiC2oegCFU5hDz37rhg7rbQ_5s6_noGzg_AvRtg9zSrulwurv7fUh4kLib4_Veiw0_VtKzl6tvna7XAS7b8vmLqC3sEoXGsRg</recordid><startdate>200512</startdate><enddate>200512</enddate><creator>Kubánek, Miloš</creator><creator>Málek, Ivan</creator><creator>Kautzner, Josef</creator><creator>Hegarová, Markéta</creator><creator>Wiendl, Martin</creator><creator>Lupinek, Petr</creator><creator>Karasová, Ludmila</creator><creator>Lánská, Věra</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200512</creationdate><title>The value of B-type natriuretic peptide and big endothelin-1 for detection of severe pulmonary hypertension in heart transplant candidates</title><author>Kubánek, Miloš ; Málek, Ivan ; Kautzner, Josef ; Hegarová, Markéta ; Wiendl, Martin ; Lupinek, Petr ; Karasová, Ludmila ; Lánská, Věra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4041-82ee4e285c39660fe6f83edc96bef152be6bcf452f5f28c9f3833b987e7abc523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>B-type natriuretic peptide</topic><topic>Big endothelin-1</topic><topic>Biomarkers - blood</topic><topic>Cardiac Catheterization</topic><topic>Congestive heart failure</topic><topic>Endothelin-1 - blood</topic><topic>Female</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - blood</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Hypertension, Pulmonary - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Orthotopic heart transplantation</topic><topic>Prognosis</topic><topic>Pulmonary hypertension</topic><topic>Pulmonary Wedge Pressure</topic><topic>Radioimmunoassay</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kubánek, Miloš</creatorcontrib><creatorcontrib>Málek, Ivan</creatorcontrib><creatorcontrib>Kautzner, Josef</creatorcontrib><creatorcontrib>Hegarová, Markéta</creatorcontrib><creatorcontrib>Wiendl, Martin</creatorcontrib><creatorcontrib>Lupinek, Petr</creatorcontrib><creatorcontrib>Karasová, Ludmila</creatorcontrib><creatorcontrib>Lánská, Věra</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kubánek, Miloš</au><au>Málek, Ivan</au><au>Kautzner, Josef</au><au>Hegarová, Markéta</au><au>Wiendl, Martin</au><au>Lupinek, Petr</au><au>Karasová, Ludmila</au><au>Lánská, Věra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The value of B-type natriuretic peptide and big endothelin-1 for detection of severe pulmonary hypertension in heart transplant candidates</atitle><jtitle>European journal of heart failure</jtitle><addtitle>European Journal of Heart Failure</addtitle><date>2005-12</date><risdate>2005</risdate><volume>7</volume><issue>7</issue><spage>1149</spage><epage>1155</epage><pages>1149-1155</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>Background:
Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B‐type natriuretic peptide (BNP) and big endothelin‐1 (big ET1) for prediction of severe PH in heart transplant candidates.
Methods:
The study population included 43 potential heart transplant candidates (38 males, mean age 52±7 years). All underwent repeated right‐heart catheterizations (2–5 studies) at an interval of 3–4 months, giving a total of 124 examinations, associated with blood sampling for BNP and big ET1 analysis. Severe PH was defined as the mean pulmonary artery pressure (MPAP)>40 mmHg.
Results
Significantly high PVR (PVR>3.0 Wood units and TPG>15 mmHg) was noted on 12 occasions in 10 patients; always in the presence of severe PH. Low BNP levels (<67 pg/ml) ruled out the presence of severe PH with a 100% sensitivity, however, with a low specificity (34%). An increase in plasma BNP>30 pg/ml (>40% of initial value) in subjects with a previous MPAP–40 mmHg detected development of severe PH with a 100% sensitivity and an 80–88% specificity. As a total of 58% of patients presented repeatedly with MPAP≤40mmHg, serial BNP testing could reduce the need for hemodynamic studies in this subgroup down to 12–20%.
Conclusions:
Serial BNP testing in hemodynamically stable heart transplant candidates with MPAP–40 mmHg allows reliable detection of development of severe PH, and may significantly reduce the need for repeated right‐heart catheterizations in these patients.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>15916922</pmid><doi>10.1016/j.ejheart.2004.12.011</doi><tpages>7</tpages></addata></record> |
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| ispartof | European journal of heart failure, 2005-12, Vol.7 (7), p.1149-1155 |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE; Wiley Online Library Free Content; EZB Electronic Journals Library |
| subjects | Adult Aged B-type natriuretic peptide Big endothelin-1 Biomarkers - blood Cardiac Catheterization Congestive heart failure Endothelin-1 - blood Female Heart Transplantation Humans Hypertension, Pulmonary - blood Hypertension, Pulmonary - physiopathology Hypertension, Pulmonary - surgery Male Middle Aged Natriuretic Peptide, Brain - blood Orthotopic heart transplantation Prognosis Pulmonary hypertension Pulmonary Wedge Pressure Radioimmunoassay Retrospective Studies Severity of Illness Index |
| title | The value of B-type natriuretic peptide and big endothelin-1 for detection of severe pulmonary hypertension in heart transplant candidates |
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