Plazma B - natriüretik peptid (BNP) düzeyi kronik akciğer hastalıklarında pulmoner hipertansiyon için gösterge olabilir mi?
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Dosyalar
Tarih
2011
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: BNP kardiyak volüm ve basınç artışına cevap olarak ventriküllerden salınan bir nöropeptiddir. Bu nedenle konjestif kalp yetmezliğinde, hatta asemptomatik sol ventrikül sistolik disfonksiyonunda BNP normal değerlerin üzerinde saptanır. İntertisyel akciğer hastalığı (İAH), kronik pulmoner emboli (PE), ağır KOAH ve kronik solunum yetersizliği (SY) gibi kronik akciğer hastalıklarında BNP’nin değeri net olarak ortaya konulmamıştır. Gereç ve Yöntem: Plazma BNP düzeyinin kronik akciğer hastalıklarındaki yerini araştırmak ve bu olgularda BNP`nin pulmoner arter basıncı (PAB) ve sağ kalp yetmezliği için bir belirteç olup olmadığını değerlendirmek. Çalışmaya kronik akciğer hastalığı nedeniyle poliklinikten takip edilen stabil 104 olgu (26 ağır KOAH, 21 kronik pulmoner emboli, 24 intertisyel akciğer hastalığı ve 33 KOAH’a bağlı kronik solunum yetersizliği) alındı. Tüm olgulara solunum fonksiyon testi, difüzyon testi, arter kan gazı analizi, altı dakika yürüme testi, ekokardiyografi ve plazma BNP ölçümü yapıldı. İstatistiksel analiz için Pearson korelasyon testi, lineer regresyon analizi ve t test kullanıldı. Bulgular: Olguların 37’si kadın, 67’si erkek ve yaş ortalaması 57.6 yıl idi. BNP düzeyi ile yürüme mesafesi arasında negatif (r=-204, p=0.045), PAB ile pozitif korelasyon (r=0.351, p<0.001) bulundu. Alt grup analizlerine bakıldığında ise yalnızca PE ve İAH gruplarında, PAB ile BNP arasında (p<0.01; p<0.03) anlamlı ilişki saptandı. Sonuç: Çalışmamızda plazma BNP düzeyi, perfüzyon defektleri devam eden kronik PE ve İAH olgularında PAB düzeyi ile ilişkili olarak saptanırken; ağır KOAH ve SY olgularında bu ilişki saptanmadı.
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.
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.
Açıklama
Anahtar Kelimeler
Beyin Natriüretik Peptid, Pulmoner Hipertansiyon, Kronik Pulmoner Tromboemboli, İntertisyel Akciğer Hastalığı, Kronik Obstruktif Akciğer Hastalığı, Brain Natriuretic Peptide, Pulmonary Hypertension, Chronic Thrombemboli, Intertitial Lung Diseases, Chronic Obstructive Pulmonary Diseases
Kaynak
Türk Toraks Dergisi
Turkish Thoracic Journal
Turkish Thoracic Journal
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
12
Sayı
4
