Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 26 P578

ECE2011 Poster Presentations Cardiovascular endocrinology and lipid metabolism (34 abstracts)

Utility of brain natriuretic peptide (BNP) as a biomarker of risk assessment in acute pulmonary embolism

Alina Mihaela Pascu 1 , Mariana Radoi 1 , Elena Bobescu 1 , Mihaela Stanciu 2 , Sebastian Ionut Toma 1 & Olivia Ligia Burta 3


1Transilvania University Brasov, Faculty of Medicine, Brasov, Romania; 2Lucian Blaga University Sibiu, Faculty of Medicine, Sibiu, Romania; 3Faculty of Medicine and Pharmacy Oradea, Oradea, Romania.


Introduction: Acute right ventricular dysfunction (RVD) on echocardiography (ECHO) represents the actual gold standard in risk stratification of patients with pulmonary embolism (PE). We previously demonstrated that plasma BNP above a cut-off level of 50 pg/ml could predict acute RVD in PE.

Aim and objective: Analysis of the utility and accuracy of plasma BNP in detecting acute RVD in PE.

Methods: Seventy patients with confirmed PE, 42 (60%) men, mean age 52.51±8.82 were prospectively investigated. Plasma BNP levels were measured on admission by a quantitative fluorescence immunoassay (Triage BNP). RV function was evaluated by ECHO in the first hour after admission. Patients were divided in two groups: group 1 – with acute RVD on ECHO, n=24 (34.29%) patients; group 2 – without acute RVD on ECHO, n=46 (65.71%) patients. Study protocol was approved by the local Ethics Committee.

Statistics: SPSS 16.0.; MedCalc 11.4.4.

Results: Plasma BNP proved good in discriminating between patients with and without acute RVD – area under the receiver operating characteristic curve (AUC)=0.86 (95% CI (0.77–0.94, P<0.0001). Stepwise multiple regression analysis identified some patients’ characteristics independently and significantly associated with RVD: BNP≥50 pg/ml (R=0.61 (0.44–0.74), P<0.0001), syncope (R=0.57 (0.38–0.71), P<0.0001), a Qr type ventricular complex (a prominent Q wave of ≥0.2 mV and a ventricular depolarisation <120 ms) in V1 lead on electrocardiography (R=0.55 (0.36–0.69), P<0.0001), a heart rate>100 beats/min (R=0.54 (0.35–0.69), P<0.0001). Stepwise logistic regression (meta-analysis) proved BNP≥50 pg/ml to have the best accuracy in detecting RVD: odds ratio (OR) (95% CI)=21.00 (5.55–79.50), compared to: syncope (OR=9.33 (2.87–30.41)), Qr in V1 (OR=6.67 (2.06–21.55)), a heart rate>100 beats/min (OR=5.61 (1.86–16.99)).

Conclusion: Plasma BNP≥50 pg/dl was the best predictor of acute right ventricular dysfunction and a valuable biomarker of risk stratification in the patients with pulmonary embolism from our study group.

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