TY - JOUR
T1 - B-type natriuretic peptide levels in patients with pericardial effusion undergoing pericardiocentesis
AU - Lauri, Gianfranco
AU - Rossi, Chiara
AU - Rubino, Mara
AU - Cosentino, Nicola
AU - Milazzo, Valentina
AU - Marana, Ivana
AU - Cabiati, Angelo
AU - Moltrasio, Marco
AU - De Metrio, Monica
AU - Grazi, Marco
AU - Campodonico, Jeness
AU - Assanelli, Emilio
AU - Riggio, Daniela
AU - Sandri, Maria Teresa
AU - Bonomi, Alice
AU - Veglia, Fabrizio
AU - Marenzi, Giancarlo
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Objectives Pericardial effusion is characterized by progressive accumulation of fluid within the pericardial space, resulting in increased intra-pericardial pressure and compression of the heart. As B-type natriuretic peptide (BNP) is secreted by the ventricles in response to increased myocardial stretch, we hypothesized that pericardial effusion, as well as its resolution, might influence BNP plasma levels. Methods We prospectively measured, in 146 consecutive patients with pericardial effusion, BNP plasma levels at baseline, soon after, and 24 h after pericardiocentesis. A scoring system based on 7 clinical and echocardiographic parameters was developed, and patients were classified according to the number of variables as having low (0-2), intermediate (3-4), or high (5-7) severity score. Results Out of the 146 patients, 42 (29%) had normal values (<100 pg/ml), whereas 104 (71%) had high BNP values at baseline. In the whole population, baseline BNP levels significantly decreased as the severity score increased (r = - 0.21; P = 0.01). 24 h after pericardiocentesis, a significant increase in BNP was observed in patients with intermediate (P = 0.004) score and with high (P <0.001) severity score; no increase occurred in low score patients (P = 0.56). The higher was the severity score, the steeper was the increase in BNP through the three time-points considered (P = 0.04). Conclusions The results of the present study show that BNP plasma levels are suppressed in the presence of severe pericardial effusion, and that they rise after pericardiocentesis. Future studies should investigate the role of BNP in assisting clinicians in the decision-making process of pericardial fluid drainage.
AB - Objectives Pericardial effusion is characterized by progressive accumulation of fluid within the pericardial space, resulting in increased intra-pericardial pressure and compression of the heart. As B-type natriuretic peptide (BNP) is secreted by the ventricles in response to increased myocardial stretch, we hypothesized that pericardial effusion, as well as its resolution, might influence BNP plasma levels. Methods We prospectively measured, in 146 consecutive patients with pericardial effusion, BNP plasma levels at baseline, soon after, and 24 h after pericardiocentesis. A scoring system based on 7 clinical and echocardiographic parameters was developed, and patients were classified according to the number of variables as having low (0-2), intermediate (3-4), or high (5-7) severity score. Results Out of the 146 patients, 42 (29%) had normal values (<100 pg/ml), whereas 104 (71%) had high BNP values at baseline. In the whole population, baseline BNP levels significantly decreased as the severity score increased (r = - 0.21; P = 0.01). 24 h after pericardiocentesis, a significant increase in BNP was observed in patients with intermediate (P = 0.004) score and with high (P <0.001) severity score; no increase occurred in low score patients (P = 0.56). The higher was the severity score, the steeper was the increase in BNP through the three time-points considered (P = 0.04). Conclusions The results of the present study show that BNP plasma levels are suppressed in the presence of severe pericardial effusion, and that they rise after pericardiocentesis. Future studies should investigate the role of BNP in assisting clinicians in the decision-making process of pericardial fluid drainage.
KW - B-type natriuretic peptide
KW - Pericardial effusion
KW - Pericardiocentesis
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U2 - 10.1016/j.ijcard.2016.03.075
DO - 10.1016/j.ijcard.2016.03.075
M3 - Article
AN - SCOPUS:84964070454
VL - 212
SP - 318
EP - 323
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -