Nidhi Gupta, Jignesh Vanane, Gajendra Dubey, Ravi Varmore, Pankaj Garg
BACKGROUND It has long been known that pulmonary hypertension (PH) leads to rise in brain natriuretic peptide (BNP) in patients with Chronic Obstructive Pulmonary Disease (COPD). However, data on BNP level in COPD patients without PH is limited. This study was carried out to evaluate the change in BNP level in COPD patients without PH or cor-pulmonale during exacerbation and after remission. MATERIALS AND METHODS The study involved 90 subjects; 60 patients with COPD and 30 age matched healthy subjects without COPD (15-smokers and 15-non-smokers). In all the patients, history and clinical exam, pulmonary function test, BNP level measurement, electrocardiography and echocardiography were performed. In COPD patients, BNP level was measured during exacerbation and after remission and at only once in healthy subjects. RESULTS Levels of BNP were significantly higher in COPD patients (37.54 ± 15.1 pg/mL) compared to control (19.12 ± 4.61 pg/mL) and increased further during exacerbation (67.59 ± 38.4 pg/mL). BNP levels during exacerbation were significantly higher in patients with COPD grade III-IV (88.76 ± 37.54 pg/mL) compared to grade II (55.88 ± 7.6 pg/mL) and grade I (37.66 ± 8.76 pg/mL). It was a significantly inversely related to post FEV1%. Moreover, Comparing the baseline PO2 and PCO2 in COPD patients, PO2 decreased and PCO2 increased significantly as the severity of COPD class increased. CONCLUSION Plasma BNP can be used as a useful diagnostic and prognostic biomarker of COPD and a good predictor of exacerbation.
