Impairment in heart functions and prognostic role of N‑terminal pro‑brain natriuretic peptide in patients with chronic obstructive pulmonary disease exacerbation
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) with comorbidities andcardiovascular disease is the most frequent one. The role of natriuretic peptides in determiningprognosis of COPD exacerbations is not yet clear. The frequency of pathologic findings of transthoracicechocardiography (TTE) during COPD exacerbation showed wide variability. This study aims toevaluate the predictive role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in determiningthe short-term prognosis of patients hospitalized with COPD exacerbation. As a secondary outcome,we aimed to investigate the frequency of TTE findings in these patients.MATERIALS AND METHODS: Eighty-six consecutive patients with COPD exacerbationwere included. NT-proBNP levels were measured and TTE was carried out to whole of theparticipants at administration. The primary outcome was development of “event” (readmissionor rehospitalization or mortality) within 30 days. The predictive role of NT-proBNP level for thedevelopment of “event” was evaluated. As a secondary outcome of the study, the frequency ofTTE findings was recorded.RESULTS: NT-proBNP level of the patients who developed event within 30 days had significantlyhigher than who did not (2343.16 ± 4107.17 pg/mL vs. 843.22 ± 2349.96 pg/mL, P = 0.001).A high negative correlation was found between NT-proBNP level and “time to event” (r =-0.992, P < 0.001). Multivariable logistic regression analysis showed that NT-proBNP levelwas an independent predictor for the development of “event” (P < 0.001) and the cutoff pointof it was found to be 303.5 pg/mL (0.639 sensitivity and 0.720 specificity). The most frequentechocardiographic findings were pulmonary hypertension (54.7%) and left ventricle diastolicdysfunction (39.5%).CONCLUSION: NT-proBNP level is a strong predictor for short-term prognosis of patients hospitalizedwith COPD exacerbation. Further and larger studies are needed to determine exact role of NT-proBNPin long-term prognosis of these patient
