FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2005306722> ?p ?o ?g. }

• W2005306722 endingPage "36" @default.
• W2005306722 startingPage "34" @default.
• W2005306722 abstract "Natriuretic peptides (B-type natriuretic peptide [BNP] and NT pro-BNP) are proposed biomarkers to differentiate between cardiac and pulmonary causes of acute dyspnea [[1]Maisel A.S. Krishnaswamy P. Nowak R.M. McCord J. Hollander J.E. Duc P. Omland T. Storrow A.B. Abraham W.T. Wu A.H. Clopton P. Steg P.G. Westheim A. Knudsen C.W. Perez A. Kazanegra R. Herrmann H.C. McCullough P.A. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. Breathing Not Properly Multinational Study Investigators.N. Engl. J. Med. 2002; 347: 161-167Crossref PubMed Scopus (2823) Google Scholar]. Some emerging data proposed the use in respiratory disease and particularly in patients with acute pulmonary embolism and pulmonary hypertension (PH) [[2]Pruszczyk P. N-terminal pro-brain natriuretic peptide as an indicator of right ventricular dysfunction.J. Card. Fail. 2005; 11: 65-69Abstract Full Text Full Text PDF Scopus (42) Google Scholar]. Prevalence of pulmonary hypertension (PH) in interstitial lung diseases (ILD) is higher in patients with severe fibrosis but it may develop at any stage of the disease [3Behr J. Ryu J.H. Pulmonary hypertension in interstitial lung disease.Eur. Respir. J. 2008; 31: 1357-1367Crossref PubMed Scopus (207) Google Scholar, 4Kimura M. Taniguchi H. Kondoh Y. Kimura T. Kataoka K. Nishiyama O. Aso H. Sakamoto K. Hasegawa Y. Pulmonary hypertension as a prognostic indicator at the initial evaluation in idiopathic pulmonary fibrosis.Respiration. 2013; 85: 456-463Crossref PubMed Scopus (147) Google Scholar]. Early recognition is frequently delayed from symptoms onset and diagnosis. For all these reasons the detection of pulmonary arterial pressure (PAP) in patients affected to ILD is critical for diagnosis and clinical assessment [[5]Humbert M. Gerry Coghlan J. Khanna D. Early detection and management of pulmonary arterial hypertension.Eur. Respir. Rev. 2012; 21: 306-312Crossref PubMed Scopus (85) Google Scholar]. The current gold standard for PH assessment is invasive right heart catheterization, however this procedure is prone to increased risk of complications and it should be carried out in patients with evidence of PH previously identified by non-invasive investigation [[6]Lettieri C.J. Nathan S.D. Barnett S.D. Ahmad S. Shorr A.F. Prevalence and outcome of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis.Chest. 2006; 129: 746-752Crossref PubMed Scopus (657) Google Scholar]. Currently, the optimal tool to measure PH remains unclear. The most appropriate, recognized method to detect PAP noninvasively is trans-thoracic echocardiography, which demonstrated a good correlation with invasive measurement [[7]Bossone E. Bodini B.D. Mazza A. Allegra L. Pulmonary arterial hypertension: the key role of echocardiography.Chest. 2005; 127: 1836-1843Crossref PubMed Scopus (169) Google Scholar]. We hypothesized that the combination of echocardiography and BNP measurement may provide a better detection of PH in patients with ILD. Thus the aims of this study were: 1—to determine the accuracy of echo measurement and BNP assay in the detecting PH through building an algorithm model and 2—to compare BNP and echo values with invasive measurement to establish the exact correlation with PAP. Study design: Patients were eligible if they were admitted with a clinical and radiological diagnosis of interstitial lung disease. All patients underwent to: echocardiography and BNP. We included in this study 120 consecutive patients affected by interstitial lung disease. Patients revealing PAPs > 40 mm Hg (43 patients) were then submitted to RC invasive measurement to calculate PAPs, PAP mean and pulmonary vascular resistance (PVR). Written consent was provided by each patient. Patients were recruited from ARTEMIS-HP trial (www.clinicaltrials.gov: ID number NCT00879229). Laboratory analysis: Within 24 h from enrolment we measured, in all patients, BNP levels. Plasma BNP was measured with Triage BNP Test (Biosite Inc., San Diego, CA, USA); this test is an immunoassay in a single-use plastic cartridge fluorescently labeled monoclonal antibody against BNP labeled with a fluorescent dye and BNP. The level of BNP in 12 healthy subjects was not higher than 80 pg/mL. Echocardiography: Right ventricular (RV) dimension and pulmonary pressure (PAPs and PAP mean) were estimated following the American Society of Echocardiography criteria [[8]Rudski L.G. Lai W.W. Afilalo J. Hua L. Handschumacher M.D. Chandrasekaran K. Solomon S.D. Louie E.K. Schiller N.B. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography.J. Am. Soc. Echocardiogr. 2010; 23: 685-713Abstract Full Text Full Text PDF PubMed Scopus (5005) Google Scholar]. Invasive measurement: For a subgroup of patients with echocardiographic evidence of PH, hemodynamic results of right heart catheterization were obtained, measuring pulmonary artery pressures, pulmonary artery WEDGE pressures and vascular resistance [[9]Swan H.J. Ganz W. Forrester J. Marcus H. Diamond G. Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter.N. Engl. J. Med. 1970; 283: 447-451Crossref PubMed Scopus (1519) Google Scholar]. Endpoints: 1 — To establish correlations among BNP and echocardiographic measurements in the detecting PH, 2 — to calculate the sensibility and accuracy power of the echocardiographic and BNP assessments in recognizing pulmonary hypertension, and 3 — to compare BNP and echo values with invasive measurement to establish the exact correlation with PH, defined as PAP mean > 25 mm Hg. Patients' characteristics: 109 patients (age 62 + 11; 46 males) fulfilled the inclusion criteria. ILD diagnoses included: idiopathic pulmonary fibrosis (IPF; n = 72), sarcoidosis (n = 15), systemic sclerosis (n = 4), extrinsic allergic alveolitis (EAA; n = 2), smoking-related interstitial lung disease or drug-related interstitial fibrosis (n = 15) and Langerhans' cell histiocytosis (n = 1). Among these patients there were 43 subjects with PAPs ≥ 40 mm Hg. All patients with PAPs > 40 mm Hg underwent RC to measure invasive parameters PAPs, PAP mean, WEDGE pressure and PVR. Of 43 catheterized patients, 34 showed PH, defined as PAP mean > 25 mm Hg. BNP mean in all population was of 63 pg/mL [CI: 32–96] (Table 1).Table 1Baseline characteristics of all patients with ILD included in our study. Abbreviations: BNP: B-type natriuretic peptide; FE: Ejection fraction; ILD: Interstitial lung disease; PAPd: End-diastolic pulmonary arterial pressure; PAPs: Pulmonary systolic arterial pressure; PAPm: Pulmonary arterial pressure mean; PVR: Pulmonary vascular resistance; TAPSE: Tricuspid annular plane systolic excursion.Number of the patients109Age (year)63 ± 11Weight (Kg)77 ± 14Height (cm)168 ± 11Gender (n) Male57 Female52Risk factors and comorbidity (%) Hypertension26% Diabetes49% Dyslipidemia32% Osteoporosis76%Interstitial lung disease (n) Pulmonary idiopathic fibrosis72 Sarcoidosis15 Extrinsic allergic alveolitis4 Systemic sclerosis2 Langherans cell hystiocytosis1 Other15Lung diseases' treatment (%) Corticosteroids therapy94 Immunosuppressive therapy17Echocardiographic parameters FE (%)55 ± 3 End-diastolic ventricular diameter (mm)36 ± 7 Right atrium area (cm2)20 ± 3 Caliber inferior cave vein (mm)17 ± 5 PAPs (mm Hg)37 ± 12 PAPs ≥ 40 mm Hg (n)43 PAP mean (mm Hg)18 ± 7 PAP mean ≥ 20 mm Hg (n)29 TAPSE (mm)22 ± 3 TAPSE ≤ 20 mm (n)31Invasive Measurements (43 patients) PAPs (mm Hg)45 ± 14 PAP m (mm Hg)25 ± 10 WEDGE pressure (mm Hg)12 ± 5 PVR (hru)3,21 ± 2.20Pulmonary hypertension defined as invasive PAP mean ≥ 25 mm Hg (n)34BNP (pg/mL)63 [32–96] Open table in a new tab In patients with PAPs > 40 mm Hg BNP levels were significantly increased compared to patients without pulmonary hypertension (162 ± 96 vs 18 ± 7 pg/ml p = 0,004), PAPd > 20 mm Hg (205 ± 118 vs 38 ± 19 pg/mL p = 0,001) and PAP mean < 25 mm Hg (128 ± 84 vs 33 ± 12 pg/ml p < 0.001). BNP was also significantly increased in patients with right ventricular dysfunction (TAPSE < 16 mm) (153 ± 104 vs 21 ± 13 pg/ml p < 0.001) and dilatation of RV (end-diastolic diameter ≥ 38 mm) (179 ± 115 vs 36 ± 24 pg/ml p < 0.001). In patients with invasive PAPs > 40 mm Hg and with invasive PAP mean >25 mm Hg, (n. 34) BNP levels were significantly increased respect patients with invasive PAPs < 40 mm Hg (169 ± 110 vs 39 ± 17 pg/ml p < 0,02) and with invasive PAP mean < 25 mm Hg (206 ± 127 vs 25 ± 18 pg/ml p < 0.005). In patients with WEDGE pressure ≥ 14 mm Hg, BNP levels were significantly higher than patients with WEDGE pressure < 14 mm Hg (207 ± 151 vs 43 ± 31 pg/mL; p = 0.01) (Table 2).Table 2T-test evaluating BNP value changes relation to echocardiographic and invasive parameters. Abbreviations: BNP: B-type natriuretic peptide; PAPd: End-diastolic pulmonary arterial pressure; PAPs: Pulmonary systolic arterial pressure; PAPm: Pulmonary arterial pressure mean; TAPSE: Tricuspid annular plane systolic excursion.All patients (109)Echocardiographic parametersBNP mean (pg/mL)Echocardiographic parametersBNP mean (pg/mL)p-ValuesPAPs < 40 mm Hg18 ± 7PAPs ≥ 40 mm Hg162 ± 960.004PAPd < 20 mm Hg39 ± 19PAPd ≥ 20 mm Hg205 ± 1180.001PAP mean < 25 mm Hg33 ± 12PAP mean ≥ 25 mm Hg128 ± 840.001End diastolic diameter < 38 mm36 ± 24End diastolic diameter ≥ 38 mm179 ± 1150.001TAPSE > 16 mm21 ± 13TAPSE ≤ 16 mm153 ± 1040.001Catheterized patients (43)Invasive measurementBNP mean (pg/mL)Invasive measurementBNP mean (pg/mL)p-ValuesPAPs < 40 mm Hg39 ± 17PAP ≥ 40 mm Hg169 ± 1100.02PAP mean <25 mm Hg25 ± 18PAP mean ≥ 25 mm Hg206 ± 1270.005WEDGE pressure < 14 mm Hg43 ± 31WEDGE pressure ≥ 14 mm Hg207 ± 1510.01 Open table in a new tab Diagnostic prediction for PH: The Roc curve analysis showed that BNP (AUC 0.87; [CI: 0.77–0.98]; p = 0.001), PAP mean (AUC 0.89; [CI: 0.80–0.98]; p = 0.001) and PAPs (AUC 0.81; [CI: 0.76–0.98]; p = 0.001) were all able to detect PH. A cut-off BNP value ≥ 50 pg/ml, recognized patients with PH, with good sensitivity (77%) and good specificity (81%) (Fig. 1). Regression analysis of the above parameters confirmed that echocardiographic measurements (PAPs, PAP mean and TAPSE) and BNP values were significantly related (Table 3).Table 3Logistic regression analysis evaluating ability of echocardiographic parameters (PAPs, PAPm and TAPSE) and BNP to detect PH. Abbreviations: BNP: B-type natriuretic peptide; CI: Confidence interval; OR: Odds ratio; PAPs: Pulmonary systolic arterial pressure; PAPm: Pulmonary arterial pressure mean; PH: Pulmonary hypertension; TAPSE: Tricuspid annular plane systolic excursion.OR [CI]p-ValueBNP > 50 pg/mL11.53 [3.61–24.87]0.001PAPs ≥ 40 mm Hg22.13 [4.47–42.17]0.003PAP mean ≥ 25 mm Hg10.07 [1.17–28.24]0.04TAPSE ≤ 16 mm6.71 [1.72–18.15]0.006 Open table in a new tab Early detection of PH in patients with ILD is determinative to better establish prognostic impact of lung disease and to begin a specific treatment. The current European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines recommend annual echocardiographic screening in symptomatic patients [[10]Galiè N. Hoeper M.M. Humbert M. Torbicki A. Vachiery J.L. Barbera J.A. Beghetti M. Corris P. Gaine S. Gibbs J.S. Gomez-Sanchez M.A. Jondeau G. Klepetko W. Opitz C. Peacock A. Rubin L. Zellweger M. Simonneau G. ESC Committee for Practice Guidelines (CPG). Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT).Eur. Heart J. 2009; 30: 2493-2537Crossref PubMed Scopus (2864) Google Scholar]. Our study is the first attempt to evaluate the diagnostic role of echocardiography and BNP levels in patients with ILD and associated PH. Our findings showed that BNP is significantly correlated to echo-Doppler measurement, particularly those patients with signs of PH or RV dysfunction evidenced higher BNP values when compared with patients who experienced normal pressure and RV function. The logistic regression analysis demonstrated that a cutoff of 50 pg/ml for BNP had a good sensibility and specificity to recognize subjects with PH. The current non-invasive data have been validated in the subgroup submitted to right heart catheterization (n = 43) after echocardiographic screening. In these patients we demonstrated a good correlation between non-invasive and invasive pressure assessments confirming the role of BNP in the detection of moderate PAP increase. All together our findings summarized previous reports showing that BNP is a good diagnostic indicator for PH in ILD. Echocardiography when used in patients with a good acoustic window is a reliable tool to measure PAP and early recognize PH. Recently a good correlation between hemodynamic and echocardiographic measurements has been evidenced in the current setting [[11]Rivera-Lebron B.N. Forfia P.R. Kreider M. Lee J.C. Holmes J.H. Kawut S.M. Echocardiographic and hemodynamic predictors of mortality in idiopathic pulmonary fibrosis.Chest. 2013; 144: 564-570Crossref PubMed Scopus (86) Google Scholar] confirming our results. Therefore an algorithm considering laboratory and echo measurement could help in the identification of those patients with ILD affected with moderate PH. BNP has also demonstrated a prognostic impact in patients with ILD in more recent studies: in an oriental population Song et al. [[12]Song J.W. Song J.K. Kim D.S. Echocardiography and brain natriuretic peptide as prognostic indicators in idiopathic pulmonary fibrosis.Respir. Med. 2009; 103: 180-186Abstract Full Text Full Text PDF PubMed Scopus (77) Google Scholar] showed that a combination of BNP level and PAPs measured by echocardiography may provide a better prediction of mortality than either parameter alone. In another study Corte et al. [[13]Corte T.J. Wort S.J. Gatzoulis M.A. Engel R. Giannakoulas G. Macdonald P.M. Wells A.U. Elevated brain natriuretic peptide predicts mortality in interstitial lung disease.Eur. Respir. J. 2010; 36: 819-825Crossref PubMed Scopus (56) Google Scholar] demonstrated the prognostic value of BNP and echocardiography over the ILD population as a whole, independently of the underlying disease severity. Elevated BNP concentration and pulmonary vascular resistance levels were linked to increased mortality across ILD patients. Our data suggest that BNP levels and echocardiography are clinically useful and easily repeatable tools for mild PH detection in patients with ILD. If our preliminary results will be confirmed in a larger population, an algorithm including echocardiographic measurements associated with a BNP cutoff > 50 pg/ml should be applied in clinical practice as a preliminary screening for invasive hemodynamic study selection. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology." @default.
• W2005306722 created "2016-06-24" @default.
• W2005306722 creator A5013534702 @default.
• W2005306722 creator A5039153112 @default.
• W2005306722 creator A5044332030 @default.
• W2005306722 creator A5045885776 @default.
• W2005306722 creator A5052436866 @default.
• W2005306722 creator A5074510661 @default.
• W2005306722 date "2015-01-01" @default.
• W2005306722 modified "2023-10-16" @default.
• W2005306722 title "Combined BNP and Echocardiographic assessment in interstitial lung disease for pulmonary hypertension detection" @default.
• W2005306722 cites W1988816170 @default.
• W2005306722 cites W1989980464 @default.
• W2005306722 cites W2008423420 @default.
• W2005306722 cites W2016259549 @default.
• W2005306722 cites W2062386272 @default.
• W2005306722 cites W2103641446 @default.
• W2005306722 cites W2118645906 @default.
• W2005306722 cites W2123137799 @default.
• W2005306722 cites W2124625095 @default.
• W2005306722 cites W2126965678 @default.
• W2005306722 cites W2127994875 @default.
• W2005306722 cites W2187630416 @default.
• W2005306722 cites W2321299297 @default.
• W2005306722 doi "https://doi.org/10.1016/j.ijcard.2014.10.120" @default.
• W2005306722 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/25464214" @default.
• W2005306722 hasPublicationYear "2015" @default.
• W2005306722 type Work @default.
• W2005306722 sameAs 2005306722 @default.
• W2005306722 citedByCount "3" @default.
• W2005306722 countsByYear W20053067222015 @default.
• W2005306722 countsByYear W20053067222016 @default.
• W2005306722 countsByYear W20053067222020 @default.
• W2005306722 crossrefType "journal-article" @default.
• W2005306722 hasAuthorship W2005306722A5013534702 @default.
• W2005306722 hasAuthorship W2005306722A5039153112 @default.
• W2005306722 hasAuthorship W2005306722A5044332030 @default.
• W2005306722 hasAuthorship W2005306722A5045885776 @default.
• W2005306722 hasAuthorship W2005306722A5052436866 @default.
• W2005306722 hasAuthorship W2005306722A5074510661 @default.
• W2005306722 hasBestOaLocation W20053067221 @default.
• W2005306722 hasConcept C126322002 @default.
• W2005306722 hasConcept C164705383 @default.
• W2005306722 hasConcept C2777543607 @default.
• W2005306722 hasConcept C2777714996 @default.
• W2005306722 hasConcept C2780930700 @default.
• W2005306722 hasConcept C71924100 @default.
• W2005306722 hasConceptScore W2005306722C126322002 @default.
• W2005306722 hasConceptScore W2005306722C164705383 @default.
• W2005306722 hasConceptScore W2005306722C2777543607 @default.
• W2005306722 hasConceptScore W2005306722C2777714996 @default.
• W2005306722 hasConceptScore W2005306722C2780930700 @default.
• W2005306722 hasConceptScore W2005306722C71924100 @default.
• W2005306722 hasLocation W20053067221 @default.
• W2005306722 hasLocation W20053067222 @default.
• W2005306722 hasLocation W20053067223 @default.
• W2005306722 hasOpenAccess W2005306722 @default.
• W2005306722 hasPrimaryLocation W20053067221 @default.
• W2005306722 hasRelatedWork W1963625111 @default.
• W2005306722 hasRelatedWork W1992085939 @default.
• W2005306722 hasRelatedWork W2128857095 @default.
• W2005306722 hasRelatedWork W2418474481 @default.
• W2005306722 hasRelatedWork W2919762546 @default.
• W2005306722 hasRelatedWork W3022228408 @default.
• W2005306722 hasRelatedWork W3181150091 @default.
• W2005306722 hasRelatedWork W4207000926 @default.
• W2005306722 hasRelatedWork W4235000392 @default.
• W2005306722 hasRelatedWork W4311772452 @default.
• W2005306722 hasVolume "178" @default.
• W2005306722 isParatext "false" @default.
• W2005306722 isRetracted "false" @default.
• W2005306722 magId "2005306722" @default.
• W2005306722 workType "article" @default.