Natriuretic peptide B plasma concentration increases in the first 12 h of pulmonary edema recovery

Research output: Contribution to journalArticle

Abstract

Background: According to guidelines, single determination of B-type Natriuretic peptide (BNP) should be used for distinguishing between cardiac and non-cardiac acute dyspnea at the emergency room. BNP measurement is also recommended before hospital discharge in patients hospitalized for heart failure to assess prognosis and to evaluate treatment efficacy. In acute cardiogenic pulmonary edema, BNP is measured using a single BNP determination, but the temporal behavior of BNP during pulmonary edema recovery is unknown. Methods: Fifty chronic low ejection fraction (<40%) heart failure patients (age 77 ± 9 years, 17 M-33F) admitted for acute pulmonary edema were studied. Patients were grouped according to 50% dyspnea recovery time into 3 groups: ≤30 min (n = 14), 30 to 60 min (n = 19), and > 60 min (n = 17). BNP was measured at arrival and 4, 8, 12 and 24 h afterwards. Results: At arrival, BNP was elevated in all patients without significant difference among groups. In the entire population, BNP median and interquartile range value were 791 (528–1327) pg/ml, 785(559–1299) pg/ml, 1014(761–1573) pg/ml, 1049(784–1412) pg/ml, 805(497–1271) pg/ml at arrival and 4, 8, 12 and 24 h afterwards, respectively, showing higher values at 8 and 12 h. This peculiar temporal behavior of BNP was shared by all study groups. Patients with the longest edema resolution showed the highest BNP level 8 and 12 h after admission. Conclusions: In acute pulmonary edema, BNP increased up to 12 h after emergency admission regardless of dyspnea recovery time, making BNP quantitative meaning in the acute phase of pulmonary edema uncertain.

Original languageEnglish
Pages (from-to)52-56
Number of pages5
JournalEuropean Journal of Internal Medicine
Volume53
DOIs
Publication statusPublished - Jul 1 2018

Fingerprint

Natriuretic Peptides
Brain Natriuretic Peptide
Pulmonary Edema
Dyspnea
peptide B
Patient Discharge
Hospital Emergency Service
Edema
Emergencies
Heart Failure

Keywords

  • Acute dyspnea
  • Acute pulmonary edema
  • Brain natriuretic peptide

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{caf5896e74854dca8898f29c0e7e36a8,
title = "Natriuretic peptide B plasma concentration increases in the first 12 h of pulmonary edema recovery",
abstract = "Background: According to guidelines, single determination of B-type Natriuretic peptide (BNP) should be used for distinguishing between cardiac and non-cardiac acute dyspnea at the emergency room. BNP measurement is also recommended before hospital discharge in patients hospitalized for heart failure to assess prognosis and to evaluate treatment efficacy. In acute cardiogenic pulmonary edema, BNP is measured using a single BNP determination, but the temporal behavior of BNP during pulmonary edema recovery is unknown. Methods: Fifty chronic low ejection fraction (<40{\%}) heart failure patients (age 77 ± 9 years, 17 M-33F) admitted for acute pulmonary edema were studied. Patients were grouped according to 50{\%} dyspnea recovery time into 3 groups: ≤30 min (n = 14), 30 to 60 min (n = 19), and > 60 min (n = 17). BNP was measured at arrival and 4, 8, 12 and 24 h afterwards. Results: At arrival, BNP was elevated in all patients without significant difference among groups. In the entire population, BNP median and interquartile range value were 791 (528–1327) pg/ml, 785(559–1299) pg/ml, 1014(761–1573) pg/ml, 1049(784–1412) pg/ml, 805(497–1271) pg/ml at arrival and 4, 8, 12 and 24 h afterwards, respectively, showing higher values at 8 and 12 h. This peculiar temporal behavior of BNP was shared by all study groups. Patients with the longest edema resolution showed the highest BNP level 8 and 12 h after admission. Conclusions: In acute pulmonary edema, BNP increased up to 12 h after emergency admission regardless of dyspnea recovery time, making BNP quantitative meaning in the acute phase of pulmonary edema uncertain.",
keywords = "Acute dyspnea, Acute pulmonary edema, Brain natriuretic peptide",
author = "Francesca Susini and Emilio Assanelli and Elisabetta Doria and Marco Morpurgo and Denise Brusoni and Alice Bonomi and Simone Barbieri and Angelo Cabiati and Laura Salvini and Roberta Chiodelli and Monica Loguercio and Alessandro Galli and Piergiuseppe Agostoni",
year = "2018",
month = "7",
day = "1",
doi = "10.1016/j.ejim.2018.03.007",
language = "English",
volume = "53",
pages = "52--56",
journal = "European Journal of Internal Medicine",
issn = "0953-6205",
publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Natriuretic peptide B plasma concentration increases in the first 12 h of pulmonary edema recovery

AU - Susini, Francesca

AU - Assanelli, Emilio

AU - Doria, Elisabetta

AU - Morpurgo, Marco

AU - Brusoni, Denise

AU - Bonomi, Alice

AU - Barbieri, Simone

AU - Cabiati, Angelo

AU - Salvini, Laura

AU - Chiodelli, Roberta

AU - Loguercio, Monica

AU - Galli, Alessandro

AU - Agostoni, Piergiuseppe

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: According to guidelines, single determination of B-type Natriuretic peptide (BNP) should be used for distinguishing between cardiac and non-cardiac acute dyspnea at the emergency room. BNP measurement is also recommended before hospital discharge in patients hospitalized for heart failure to assess prognosis and to evaluate treatment efficacy. In acute cardiogenic pulmonary edema, BNP is measured using a single BNP determination, but the temporal behavior of BNP during pulmonary edema recovery is unknown. Methods: Fifty chronic low ejection fraction (<40%) heart failure patients (age 77 ± 9 years, 17 M-33F) admitted for acute pulmonary edema were studied. Patients were grouped according to 50% dyspnea recovery time into 3 groups: ≤30 min (n = 14), 30 to 60 min (n = 19), and > 60 min (n = 17). BNP was measured at arrival and 4, 8, 12 and 24 h afterwards. Results: At arrival, BNP was elevated in all patients without significant difference among groups. In the entire population, BNP median and interquartile range value were 791 (528–1327) pg/ml, 785(559–1299) pg/ml, 1014(761–1573) pg/ml, 1049(784–1412) pg/ml, 805(497–1271) pg/ml at arrival and 4, 8, 12 and 24 h afterwards, respectively, showing higher values at 8 and 12 h. This peculiar temporal behavior of BNP was shared by all study groups. Patients with the longest edema resolution showed the highest BNP level 8 and 12 h after admission. Conclusions: In acute pulmonary edema, BNP increased up to 12 h after emergency admission regardless of dyspnea recovery time, making BNP quantitative meaning in the acute phase of pulmonary edema uncertain.

AB - Background: According to guidelines, single determination of B-type Natriuretic peptide (BNP) should be used for distinguishing between cardiac and non-cardiac acute dyspnea at the emergency room. BNP measurement is also recommended before hospital discharge in patients hospitalized for heart failure to assess prognosis and to evaluate treatment efficacy. In acute cardiogenic pulmonary edema, BNP is measured using a single BNP determination, but the temporal behavior of BNP during pulmonary edema recovery is unknown. Methods: Fifty chronic low ejection fraction (<40%) heart failure patients (age 77 ± 9 years, 17 M-33F) admitted for acute pulmonary edema were studied. Patients were grouped according to 50% dyspnea recovery time into 3 groups: ≤30 min (n = 14), 30 to 60 min (n = 19), and > 60 min (n = 17). BNP was measured at arrival and 4, 8, 12 and 24 h afterwards. Results: At arrival, BNP was elevated in all patients without significant difference among groups. In the entire population, BNP median and interquartile range value were 791 (528–1327) pg/ml, 785(559–1299) pg/ml, 1014(761–1573) pg/ml, 1049(784–1412) pg/ml, 805(497–1271) pg/ml at arrival and 4, 8, 12 and 24 h afterwards, respectively, showing higher values at 8 and 12 h. This peculiar temporal behavior of BNP was shared by all study groups. Patients with the longest edema resolution showed the highest BNP level 8 and 12 h after admission. Conclusions: In acute pulmonary edema, BNP increased up to 12 h after emergency admission regardless of dyspnea recovery time, making BNP quantitative meaning in the acute phase of pulmonary edema uncertain.

KW - Acute dyspnea

KW - Acute pulmonary edema

KW - Brain natriuretic peptide

UR - http://www.scopus.com/inward/record.url?scp=85043975469&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85043975469&partnerID=8YFLogxK

U2 - 10.1016/j.ejim.2018.03.007

DO - 10.1016/j.ejim.2018.03.007

M3 - Article

C2 - 29559199

AN - SCOPUS:85043975469

VL - 53

SP - 52

EP - 56

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -