Comparison of pleural fluid N-terminal pro-brain natriuretic peptide and brain natriuretic-32 peptide levels.
Chest. 2010 Feb 5;
Authors: Long AC, O'Neal HR, Peng S, Lane KB, Light RW
BACKGROUND: Current evidence indicates that measurement of pleural fluid N-terminal pro-brain natriuretic peptide (NT-proBNP) levels can aid in distinguishing pleural effusions of cardiac origin from those of noncardiac origin. To date only one study has described simultaneous measurement of pleural fluid brain natriuretic-32 peptide (BNP) and NT-proBNP. The purpose of the present study was to determine pleural fluid BNP and NT-proBNP levels and analyze the relationship between these two measurements. We hypothesized that there would be a positive correlation between pleural fluid NT-proBNP and BNP while NT-proBNP levels would be higher than BNP levels. METHODS: Levels of pleural fluid NT-proBNP and BNP were measured by enzyme immunoassay (EIA) in a total of 80 patients: 20 with congestive heart failure (CHF), 20 status post coronary artery bypass graft (CABG), 20 with carcinoma, and 20 with pneumonia. RESULTS: Comparison of NT-proBNP and BNP concentrations using Spearman s method of statistical analysis revealed a correlation coefficient of 0.572, p < 0.001. Evaluation of the diagnostic accuracy of BNP and NT-proBNP in patients with pleural effusions of cardiac origin demonstrated an area under the receiver operating characteristic curve (AUC) of 0.700 (95% confidence interval [CI], 0.569 to 0.831) and 0.835 (95% CI, 0.721 to 0.949), respectively. CONCLUSIONS: Though levels of pleural fluid BNP have a statistically significant correlation with those of NT-proBNP, this relationship only explains 32% of the variancein NT-proBNP levels. Furthermore, when compared to BNP, NT-proBNP is a more accurate diagnostic aid in the evaluation of pleural effusions of cardiac origin.
PMID: 20139229 [PubMed - as supplied by publisher]