B-type natriuretic peptide levels in patients with pericardial effusion undergoing pericardiocentesis

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)318-323
Number of pages6
JournalInternational Journal of Cardiology
Volume212
DOIs
Publication statusPublished - Jun 1 2016

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Pericardiocentesis
Pericardial Effusion
Brain Natriuretic Peptide
Pericardium
Drainage
Decision Making
Reference Values
Pressure

Keywords

  • B-type natriuretic peptide
  • Pericardial effusion
  • Pericardiocentesis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{e89bcffd4b464af1a96ceb4b5813cdd9,
title = "B-type natriuretic peptide levels in patients with pericardial effusion undergoing pericardiocentesis",
abstract = "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.",
keywords = "B-type natriuretic peptide, Pericardial effusion, Pericardiocentesis",
author = "Gianfranco Lauri and Chiara Rossi and Mara Rubino and Nicola Cosentino and Valentina Milazzo and Ivana Marana and Angelo Cabiati and Marco Moltrasio and {De Metrio}, Monica and M. Grazi and Jeness Campodonico and Assanelli, {Emilio Maria} and Daniela Riggio and Sandri, {Maria Teresa} and Alice Bonomi and Fabrizio Veglia and Marenzi, {Giancarlo Silvio}",
year = "2016",
month = "6",
day = "1",
doi = "10.1016/j.ijcard.2016.03.075",
language = "English",
volume = "212",
pages = "318--323",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

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, M.

AU - Campodonico, Jeness

AU - Assanelli, Emilio Maria

AU - Riggio, Daniela

AU - Sandri, Maria Teresa

AU - Bonomi, Alice

AU - Veglia, Fabrizio

AU - Marenzi, Giancarlo Silvio

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

VL - 212

SP - 318

EP - 323

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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