Erdal İN, Talat KILIÇ, Yüksel AKSOY, Süleyman Savaş HACIEVLİYAGİL, Özkan YETKİN, Mukadder KARAHAN, Hasan TURHAN, Hakan GÜNEN

Akciğer ve kalp hastalıklarında plazma BNP düzeyinin prognostik değeri

BNP 32 aminoasitli bir peptiddir, vazorelaksan ve natriüretik etkileri vardır, insanlarda daha çok ventriküllerdan salınır. Çalışmamızda, sol ve sağ kalp yetmezliğine neden olan hastalıklarda plazma BNP değerini karşılaştırmayı amaçladık. Çalışmamıza 35 sol kalp yetmezliği, 49 kronik obstrüktif akciğer hastalığı (KOAH)’na sekonder kor pulmonale, 26 KOAH ve 20 pulmoner tromboemboli olgusu ile kontrol grubu olarak 25 sağlıklı bireyden oluşan toplam 155 olgu dahil edildi. Çalışmamızda plazma BNP değeri sol kalp yetmezliği grubunda KOAH-kor pulmonale ve kontrol grubuna göre anlamlı yüksek saptandı (sırasıyla 1167 ± 746, 434 ± 55, 32 ± 12 pg/mL) (p< 0.001). Yine kor pulmonaleli grupta kor pulmonalesi olmayan KOAH grubuna ve kontrol grubuna göre anlamlı düzeyde yüksek olarak ölçüldü (434 ± 55, 32 ± 36 ve 32 ± 12 pg/mL) (p< 0.001). Pulmoner emboli grubunda plazma BNP düzeyinin kontrol grubuna göre anlamlı düzeyde yüksek olduğu (357 ± 391, 32 ± 12 pg/mL) (p< 0.001) ve masif embolisi olan olguların masif olmayanlara göre daha yüksek plazma BNP değerine sahip oldukları gözlendi (699 ± 394 vs. 166 ± 213 pg/mL) (p< 0.001). Sonuç olarak; ventriküllerde yetmezliğin artışına paralel olarak plazma BNP değerinin arttığı, ejeksiyon fraksiyonu ile BNP’nin ters korele olduğu, pulmoner arter basıncı ile korele olduğu izlendi. Pulmoner embolili hastalarda yüksek BNP düzeylerinin artan pulmoner basınç nedeniyle sağ ventrikülde ortaya çıkan fonksiyon bozukluğuna bağlı olduğu düşünüldü.

Value of plasma BNP levels as a prognostic marker in lung and heart disorders

In this study we included 155 subject, 35 patients with left heart failure, 49 chronic obstructive pulmonary disease (COPD)-cor pulmonale, 26 COPD, 20 pulmonary embolism and 25 healty subject. Plasma BNP levels in patient with left heart failure was significantly higher than COPD-cor pulmanale, COPD and control subject in respect 1167 ± 746, 434 ± 55, 32 ± 36 and 32 ± 12 pg/mL. Plasma BNP in group of cor pulmone was higher than COPD and control subject 434 ± 55 vs. 32 ± 12 pg/mL. There were no differance between COPD and control subject 32 ± 36 vs. 32 ± 12 pg/mL. In pulmonary embolism BNP was higher than controls 357 ± 391 vs. 32 ± 12 pg/mL and BNP levels of massive pulmonary embolism was higher non-massive embolism 699 ± 394 vs 166 ± 213 pg/mL. In this study BNP levels negative correlated with EF and positive correlated with pulmonary artery pressure. We suggest that increased BNP levels are correlated with ventricular failure and BNP is diagnostic and prognostic marker of heart failure and increased right ventricular pressure contributes to elevated BNP in patients with PE.

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