Source: Annual Congress 2008 - Mechanisms of respiratory infections: interaction between the pathogen and the host
Disease area: Airway diseases

Abstract

Background: Brain Natriuretic Peptide (BNP) is mainly synthesised in the ventricular myocardium. The stimulus for BNP production is myocardial stretch. BNP has been shown to be the best discriminatory marker to differentiate cardiac dyspnoea from all other cause of dyspnoea in many studies. BNP has also been shown to be raised in patients with pulmonary hypertension, cor pulmonale and pulmonary embolism. We investigated whether patients admitted with a diagnosis of an acute exacerbation of COPD (AECOPD) had higher levels than during a period of stability, and whether BNP levels could discriminate between AECOPD and congestive cardiac failure (CCF).
Methods: . BNP levels where measured on day 1 of the exacerbation and at 6 weeks. Patients were excluded if they had any of the following – history of CCF, abnormal ECG, CXR showing either congestive cardiac failure or consolidation, and those with cor pulmonale.
Results:58 patients were recruited over a 2 year period admitted with an acute exacerbation of COPD defined using Anthonisens criteria (FEV 1 median – 0.7l). BNP levels during AECOPD were higher (P<0.001) than during the stable state (see fig 1.). BNP levels in only 3/58 patients reached levels associated with CCF.

Conclusion:BNP levels increase during AECOPD and may prove to be a useful biomarker. BNP may also be a useful discriminator between an AECOPD and CCF in this group of patients.

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Citations should be made in the following way:
S. Bourne, J. Fingleton (Southampton, United Kingdom). Brain natriuretic peptide (BNP) levels during acute exacerbations of COPD – a novel biomarker. Eur Respir J 2008; 32: Suppl. 52, 2292

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