Can Brain Natriuretic Peptide (BNP) be a Predictor for Pulmonary Arterial Hypertension?

Objective: Brain Natriuretic Peptide (BNP), which is a neuropeptide, is produced and released from the ventricles in response to increased wall stretch and tension. The level of BNP is high in patients with congestive heart failure and even in asymptomathic patients with left ventricle disfunction. There is no adequate literature about the value of BNP in chronic lung diseases such as interstitial lung disease (ILD), chronic pulmonary embolism (PE), chronic obstructive pulmonary disease (COPD) and chronic respiratory failure due to COPD. Material and Method: We investigated the value of BNP in chronic lung diseases, and BNP as a predictor for pulmonary arterial pressure (PAP) levels and right heart failure. A total of 104 patients, who were regularly followed in the outpatient clinic, were included in this study. Twenty-six of them had COPD (FEV1<50%), 21 had chronic PE, 33 had respiratory failure due to COPD and 24 had ILD. Spirometry, DLCO, arterial blood gas analysis, six minute walking test, echocardiography and plasma BNP level measurements were performed in all of the patients. Pearson’s correlation test, linear regression analysis and t test were used for statistical analysis. Results: There were 67 male and 37 female patients and the mean age was 57.6 years. BNP showed a negative correlation with 6-min walk distance (r=-0.204, p=0.045), and positive correlation with PAP (r=0.351, p<0.001).Conclusion: In the subgroup analysis, a significant relationship was found between BNP and pulmonary arterial pressure in chronic PE and ILD groups.