The role of plasma N-terminal brain natriuretic pro-peptide in diagnosing elderly patients with acute exacerbation of COPD concurrent with left heart failure
Authors Guo X, Nie H, Chen Q, Chen S, Deng N, Li R, Ding X, Hu S, Wang A
Received 5 February 2018
Accepted for publication 17 July 2018
Published 21 September 2018 Volume 2018:13 Pages 2931—2940
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Andrew Yee
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Chunxue Bai
Xuxue Guo,1,* Hanxiang Nie,1,* Qianhui Chen,1 Shuo Chen,1 Nishan Deng,1 Ruiyun Li,1 Xuhong Ding,1 Suping Hu,1 Ailing Wang2
1Department of Respiratory Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China; 2Nursing Department, Wuhan University School of Health Sciences, Wuhan 430071, Hubei Province, China
*These authors contributed equally to this work
Introduction: Acute exacerbation of COPD (AECOPD) and left heart failure (LHF) commonly exist together in clinical practice. However, the identification of AECOPD concurrent with LHF is currently challenging. Our study aimed to investigate the role of plasma N-terminal brain natriuretic pro-peptide (NT-proBNP) in diagnosing elderly patients with AECOPD associated with LHF.
Methods and results: LHF was diagnosed in patients with AECOPD according to echocardiographic criteria, and the levels of NT-proBNP in plasma were measured by quantitative electrochemiluminescence assay. Among the 655 patients with AECOPD, 158 (24.1%) had comorbid LHF, whether systolic (n=108, 68.4%) or diastolic (n=50, 31.6%). The plasma concentrations of NT-proBNP in elderly patients with AECOPD associated with LHF were markedly elevated, compared with those with only AECOPD (4,542.5 and 763.0 ng/L, respectively, P<0.01). The receiver operating characteristic curve indicated a diagnostic cutoff value of 1,677.5 ng/L of NT-proBNP in plasma for ascertaining the presence of LHF in AECOPD, with a sensitivity of 87.9%, a specificity of 88.5%, and an accuracy of 88.4%.
Conclusion: The plasma level of NT-proBNP may be a useful indicator in diagnosing AECOPD associated with LHF.
Keywords: COPD, exacerbation, left heart failure, NT-proBNP
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