Diagnostic value of N-terminal-pro-brain natriuretic peptide for patients with acute exacerbation of chronic obstructive pulmonary disease complicated with left heart failure / 实用医学杂志

ABSTRACT

Objective To discuss the diagnostic value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with left heart failure. Methods Patients with medical history of AECOPD, or are diagnosed as AECOPD from March 2014 to February 2015 were involved in the study. Based on echocardiography and clinic characteristics , the patients were divided into left heart failure group (group A) and non-left heart failure group (group B). Related factors of elevated NT-proBNP in AECOPD and the diagnostic value of NT-proBNP for patients with AECOPD complicated with left heart failure were analyzed , and exclusive and diagnostic cutoff were worked out. Results In this study , 109 AECOPD patients were collected , including 21 patients in group A and 88 patients in group B. Multivariate linear regression analysis indicated NT-proBNP was positively associated with PCT (β=0.180,P = 0.011) and PAP(β = 0.333,P = 0.000), and negatively with LVEF(β = -0.511,P = 0.000)and the area under the ROC curve(AUC) was 0.959 (95% confidence interval0.915-1.002,P = 0.000). The exclusive cutoff was 794.6 pg/mL(sensitivity90.5%,specificity92%), and the diagnostic cutoff 1 618 pg/mL(sensitivity85.7%,specificity 97.7%). Conclusions NT-proBNP can help to diagnose whether AECPOD patients are complicated with left heart failure. Besides left heart dysfunction and the state of systemic inflammation , pulmonary hypertension may be the reasons for the elevated NT-proBNP in AECOPD patients.