Impairment in Heart Functions and Prognostic Role of N-Terminal Pro-Brain Natriuretic Peptide in Patients With Chronic Obstructive Pulmonary Disease Exacerbation

Abstract

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) with comorbidities and cardiovascular disease is the most frequent one. The role of natriuretic peptides in determining prognosis of COPD exacerbations is not yet clear. The frequency of pathologic findings of transthoracic echocardiography (TTE) during COPD exacerbation showed wide variability. This study aims to evaluate the predictive role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in determining the 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 exacerbation were included. NT-proBNP levels were measured and TTE was carried out to whole of the participants at administration. The primary outcome was development of "event" (readmission or rehospitalization or mortality) within 30 days. The predictive role of NT-proBNP level for the development of "event" was evaluated. As a secondary outcome of the study, the frequency of TTE findings was recorded. RESULTS: NT-proBNP level of the patients who developed event within 30 days had significantly higher 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 level was an independent predictor for the development of "event" (P < 0.001) and the cutoff point of it was found to be 303.5 pg/mL (0.639 sensitivity and 0.720 specificity). The most frequent echocardiographic findings were pulmonary hypertension (54.7%) and left ventricle diastolic dysfunction (39.5%). CONCLUSION: NT-proBNP level is a strong predictor for short-term prognosis of patients hospitalized with COPD exacerbation. Further and larger studies are needed to determine exact role of NT-proBNP in long-term prognosis of these patients.