Abstract Background: This study evaluated the rote of echocardiography and BNP in patients with interstitial lung disease (ILD), to identify those with PH and RV dysfunction. The aims of this study were: 1-to evaluate the accuracy of an algorithm including BNP, DLCO and echocardiographic measurements to identify PH and RV dysfunction; 2- to evaluate BNP and Echo values concordance in relation to right catheterization measurement. Methods: We analyzed 113 patients with diagnosis of ILD. Echo examination included: Pulmonary systolic, diastolic and mean Arterial Pressure (PAPs, PAPd, PAP mean), End-Diastolic and End-Systolic right ventricle diameters, Inferior Caval Vein diameter, and Tricuspid Annular Plane Systolic Excursion (TAPSE). Patients revealing increased PAPs at echocardiography underwent to catheterization. Results: Patients with PAPs > 40 mm Hg (37 patients), PAPmean >= 25 mm Hg (23 patients) and PAPd >= 20 mm Hg showed BNP increased (157 +/- 96 vs 16 +/- 14 pg/ml p = 0.004; 201 +/- 120 vs 28 +/- 17 pg/mL; 124 +/- 88 vs 23 +/- 18 pg/ml p <0.001) as patients with TAPSE <= 16 mm (25 patients) (145 +/- 104 vs 26 +/- 21 pg/ml p <0.001). In catheterized patients (37 patients) BNP was increased in patients with invasive PAPs > 40 mm Hg (165 +/- 112 vs 29 +/- 14 pg/ml p <0.02), as well as in patients with Wedge pressure > 14 mm Hg (199 + 153 vs 54 + 39 pg/mL; p = 0.01). ROC Curve analysis showed that elevated values of BNP, PAPs, PAP mean are able to assess PH. On the other hand, lower values of DLCO (<40%) and TAPSE (<= 16 mm) detect PH. Logistic regression analysis of the previous parameters, confirmed their diagnostic role in PH detection. Conclusions: In patients with ILD, an algorithm including BNP, DLCO and echocardiography could be useful for non invasive screening of PH.

Ruocco, G.M., Cekorja, B., Rottoli, P., Refini, R.M., Pellegrini, M., DI TOMMASO, C., et al. (2015). Role of BNP and echo measurement for pulmonary hypertension recognition in patients with interstitial lung disease: An algorithm application model. RESPIRATORY MEDICINE, 109(3), 406-415 [10.1016/j.rmed.2014.12.011].

Role of BNP and echo measurement for pulmonary hypertension recognition in patients with interstitial lung disease: An algorithm application model

RUOCCO, GAETANO MARIA;ROTTOLI, PAOLA;REFINI, ROSA METELLA;PELLEGRINI, MARCO;DI TOMMASO, CRISTINA;NUTI, RANUCCIO;PALAZZUOLI, ALBERTO
2015-01-01

Abstract

Abstract Background: This study evaluated the rote of echocardiography and BNP in patients with interstitial lung disease (ILD), to identify those with PH and RV dysfunction. The aims of this study were: 1-to evaluate the accuracy of an algorithm including BNP, DLCO and echocardiographic measurements to identify PH and RV dysfunction; 2- to evaluate BNP and Echo values concordance in relation to right catheterization measurement. Methods: We analyzed 113 patients with diagnosis of ILD. Echo examination included: Pulmonary systolic, diastolic and mean Arterial Pressure (PAPs, PAPd, PAP mean), End-Diastolic and End-Systolic right ventricle diameters, Inferior Caval Vein diameter, and Tricuspid Annular Plane Systolic Excursion (TAPSE). Patients revealing increased PAPs at echocardiography underwent to catheterization. Results: Patients with PAPs > 40 mm Hg (37 patients), PAPmean >= 25 mm Hg (23 patients) and PAPd >= 20 mm Hg showed BNP increased (157 +/- 96 vs 16 +/- 14 pg/ml p = 0.004; 201 +/- 120 vs 28 +/- 17 pg/mL; 124 +/- 88 vs 23 +/- 18 pg/ml p <0.001) as patients with TAPSE <= 16 mm (25 patients) (145 +/- 104 vs 26 +/- 21 pg/ml p <0.001). In catheterized patients (37 patients) BNP was increased in patients with invasive PAPs > 40 mm Hg (165 +/- 112 vs 29 +/- 14 pg/ml p <0.02), as well as in patients with Wedge pressure > 14 mm Hg (199 + 153 vs 54 + 39 pg/mL; p = 0.01). ROC Curve analysis showed that elevated values of BNP, PAPs, PAP mean are able to assess PH. On the other hand, lower values of DLCO (<40%) and TAPSE (<= 16 mm) detect PH. Logistic regression analysis of the previous parameters, confirmed their diagnostic role in PH detection. Conclusions: In patients with ILD, an algorithm including BNP, DLCO and echocardiography could be useful for non invasive screening of PH.
2015
Ruocco, G.M., Cekorja, B., Rottoli, P., Refini, R.M., Pellegrini, M., DI TOMMASO, C., et al. (2015). Role of BNP and echo measurement for pulmonary hypertension recognition in patients with interstitial lung disease: An algorithm application model. RESPIRATORY MEDICINE, 109(3), 406-415 [10.1016/j.rmed.2014.12.011].
File in questo prodotto:
File Dimensione Formato  
2015 respiratory medicine.pdf

non disponibili

Descrizione: Free full-text sul sito dell'editore
Tipologia: PDF editoriale
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 648.78 kB
Formato Adobe PDF
648.78 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
REFINI-Role of BNP and Echo-Post--Print.pdf

accesso aperto

Descrizione: Accepted Manuscript
Tipologia: Post-print
Licenza: Creative commons
Dimensione 1.5 MB
Formato Adobe PDF
1.5 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/984378