Biomaterial Database

N-terminal pro-brain natriuretic peptide as an indicator of right ventricular dysfunction. 2005

Piotr Pruszczyk

Department of Internal Medicine, Hypertension, and Angiology, Medical University of Warsaw, Poland.

BACKGROUND Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and brain natriuretic peptide (BNP) are elevated in most patients with acute pulmonary embolism (APE) that results in right ventricular overload. Therefore, APE should be considered in the differential diagnosis of patients with acute dyspnea and abnormal levels of BNPs. Moreover, plasma BNPs have been proved to predict outcome in APE. RESULTS Low NT-proBNP or BNP levels characterize an uneventful hospital course, and NT-proBNP levels of <500 pg/mL identify patients who could potentially be candidates for care on a complete outpatient basis. Moreover, plasma NT-proBNP and BNP reflect the degree of right ventricular overload in APE. Plasma BNPs can also be elevated in chronic precapillary pulmonary hypertension and are strongly related to total pulmonary resistance. Elevated plasma levels of BNP/NT-proBNP and especially their further increase during follow-up are a potent predictor of poor survival. CONCLUSIONS Because levels of brain natriuretic peptides are elevated significantly not only in pathologic conditions that affect the left ventricle but also in clinical conditions that lead to isolated acute or chronic right ventricular overload, it could be proposed that these peptides should not be regarded as biomarkers of congestive heart failure, but as indicators of cardiovascular dyspnea.

UI	MeSH Term	Description	Entries
D006973	Hypertension	Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.	Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D010446	Peptide Fragments	Partial proteins formed by partial hydrolysis of complete proteins or generated through PROTEIN ENGINEERING techniques.	Peptide Fragment,Fragment, Peptide,Fragments, Peptide
D011237	Predictive Value of Tests	In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.	Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011655	Pulmonary Embolism	Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.	Pulmonary Thromboembolism,Thromboembolism, Pulmonary,Embolism, Pulmonary,Embolisms, Pulmonary,Pulmonary Embolisms,Pulmonary Thromboembolisms,Thromboembolisms, Pulmonary
D003937	Diagnosis, Differential	Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.	Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004417	Dyspnea	Difficult or labored breathing.	Orthopnea,Platypnea,Recumbent Dyspnea,Rest Dyspnea,Trepopnea,Breathlessness,Shortness of Breath,Breath Shortness,Dyspnea, Recumbent,Dyspnea, Rest,Dyspneas, Rest
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208	Acute Disease	Disease having a short and relatively severe course.	Acute Diseases,Disease, Acute,Diseases, Acute
D018497	Ventricular Dysfunction, Right	A condition in which the RIGHT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE or MYOCARDIAL INFARCTION, and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the right ventricular wall.	Right Ventricular Dysfunction,Dysfunction, Right Ventricular,Dysfunctions, Right Ventricular,Right Ventricular Dysfunctions,Ventricular Dysfunctions, Right