Source: Annual Congress 2006 - Pulmonary hypertension: thromo-embolic processes
Disease area: Pulmonary vascular diseases

Abstract

Background: Pulmonary endarterectomy (PEA) offers an effective therapy for proximal Chronic Thromboembolic Pulmonary Hypertension (CTEPH). However some patients continue to have residual pulmonary hypertension (PH) following surgery that can require further medical management. This study assesses the value of both N-Terminal Pro-BNP (NT-proBNP) and 6 minute walking distance (6MWD) in detecting persistent PH.
Methods: 47 subjects undergoing PEA surgery were assessed pre- and 3 months post-operatively with resting haemodynamics, NT-proBNP and 6MWD.
Results: Subjects demonstrated significant postoperative improvements in mean pulmonary artery pressure (29.2mmHg vs 46.8mmHg p<0.01), cardiac output (4.7l/min vs 4.1l/min p<0.05), total pulmonary resistance (TPR) (6.3WU vs 12.0WU p<0.01), NT-proBNP (618pg/mL vs 1944pg/mL p<0.0001) and 6MWD (382m vs 258m p<0.0001). Post-operative TPR correlated well with both NT-proBNP (r=0.71 p<0.0001) (figure 1) and 6MWD (r=-0.52 p<0.0001). An NT-proBNP value >400pg/mL predicted persistent PH (sensitivity 66.7%, specificity 81.2%) as did a 6MWD <380m (sensitivity 79.6%, specificity 62.5%). Combining the two tests did not improve their predictive power.
Conclusions: Both NT-proBNP and 6MWD correlate well with TPR three months after PEA surgery. Using thresholds of 400pg/mL and 380m respectively, these non-invasive markers can help identify patients with persistent PH.

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Citations should be made in the following way:
J. Suntharalingam, N. J. Doughty, L. Sharples, R. J. Hughes, J. Pepke-Zaba (Papworth Everard, Cambridge, United Kingdom). How effective are NT-proBNP and 6MWD in detecting persistent pulmonary hypertension post pulmonary endarterectomy?. Eur Respir J 2006; 28: Suppl. 50, 2372

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