Usefulness of bedside testing for brain natriuretic peptide to identify right ventricular dysfunction and outcome in normotensive patients with acute pulmonary embolism

The American Journal of Cardiology
F PieralliG Berni

Abstract

Echocardiographic right ventricular (RV) dysfunction is a well-established prognostic indicator in patients with acute pulmonary embolism. However, the possibility of implementing a rapid and effective triage with biohumoral markers such as brain natriuretic peptide (BNP) may be of value. Sixty-one patients with a first documented episode of acute pulmonary embolism without shock and previous left ventricular dysfunction were prospectively studied. All patients underwent echocardiography and rapid BNP testing on admission. Patients were followed up for in-hospital death, progression to shock, and nonfatal pulmonary embolism recurrence. Overall, 35 patients (57%) had echocardiographic evidence of RV dysfunction on admission, and its prevalence increased progressively with increasing levels of BNP. A BNP level <85 pg/ml was highly accurate in excluding RV dysfunction. No patient in the lower tertile of BNP values (1.1 to 85.0 pg/ml) had RV dysfunction, compared with 75% in the middle tertile (88.7 to 487.0 pg/ml) and 100% in the upper tertile (527 to 1,300 pg/ml). Overall, 11 patients (18%), belonging to the upper tertile, progressed to shock during admission, 4 of whom died. The association of RV dysfunction with a BNP level in ...Continue Reading

References

Sep 1, 1993·Radiology·C L TeigenT J Welch
Jul 19, 2002·The New England Journal of Medicine·Alan S MaiselUNKNOWN Breathing Not Properly Multinational Study Investigators

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Citations

Jul 16, 2008·Intensive Care Medicine·Rodrigo CavallazziPaul E Marik
Mar 9, 2007·Heart Failure Reviews·Michael A Burke, William G Cotts
Jul 11, 2007·Internal and Emergency Medicine·C Becattini, G Agnelli
Apr 17, 2008·International Journal of Hematology·Wen-Juei JengPao-Hsien Chu
Aug 22, 2012·QJM : Monthly Journal of the Association of Physicians·D SpirkN Kucher
Oct 25, 2013·JAAPA : Official Journal of the American Academy of Physician Assistants·Rami N KhouzamVictor Farah
Dec 17, 2009·Cardiology in Review·Farouk MookadamBijoy K Khandheria
Jul 31, 2008·Current Opinion in Pulmonary Medicine·Roham T Zamanian, Michael K Gould
Jun 17, 2008·American Journal of Respiratory and Critical Care Medicine·Frederikus A KlokMenno V Huisman
May 9, 2012·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Mia K LaihoPirjo Mustonen
Mar 30, 2011·Critical Care : the Official Journal of the Critical Care Forum·Guillaume CoutanceMartial Hamon
Aug 30, 2008·Critical Care : the Official Journal of the Critical Care Forum·Guillaume CoutanceMartial Hamon
Aug 4, 2009·Vascular Health and Risk Management·Luca MasottiPatrick Ray
May 19, 2010·Biomarkers in Medicine·Romain PirracchioAlexandre Mebazaa
Feb 26, 2011·Journal of Atherosclerosis and Thrombosis·Ahmet CelikIbrahim Ozdogru
Jan 30, 2014·American Journal of Respiratory and Critical Care Medicine·David Jiménez On Behalf Of The Protect Investigators
Mar 7, 2015·The Kaohsiung Journal of Medical Sciences·Ahmet CelikVeli Gokhan Cin
Feb 14, 2009·The American Journal of the Medical Sciences·José Luis Alonso-MartínezJose Luis Garcia-Sanchotena
Aug 19, 2008·Clinica Chimica Acta; International Journal of Clinical Chemistry·Anna KaczyńskaPiotr Pruszczyk
Oct 31, 2007·European Journal of Internal Medicine·Nikolaos I NikolaouAngeliki Ferti
Jul 10, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Tommy ChungLeonard Kritharides
Jul 28, 2009·Journal of Thrombosis and Haemostasis : JTH·D AujeskyD Jiménez
Jun 12, 2009·European Journal of Heart Failure·Keyur B ShahChristopher R deFilippi
Aug 24, 2010·Clinical Physiology and Functional Imaging·Henrik GutteAndreas Kjaer
Oct 20, 2010·British Journal of Haematology·David JiménezRoger D Yusen
Dec 10, 2014·Anaesthesia·J MacdonaldK Ferguson
Jun 21, 2014·Medicina clínica·José Luis Alonso-MartínezSara Pérez-Ricarte
Sep 12, 2016·The American Journal of Emergency Medicine·Mustafa TopuzMustafa Gur

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