Increased brain natriuretic peptide as a marker for right ventricular dysfunction in acute pulmonary embolism

Right ventricular (RV) function is of major prognostic significance in pati ents with acute pulmonary embolism (PE). The aim of the present study was t o evaluate the role of neurohormone plasma brain natriuretic peptide (BNP) in assessing RV function in patients with acute PE. BNP levels were measured in 16 consecutive patients with acute PE as diagno sed by high probability lung scintigraphy or pulmonary angiography. Twelve healthy age-matched volunteers served as controls. All 16 patients underwen t standard echocardiography and blood tests during the first hour of presen tation. In the patient group, survival was studied for a period of 30 days. Plasma BNP levels in patients with acute PE were higher than in controls ( 7.2 [95% Cl 0.4 to 144.6] versus 1.4[95% CI 0.4 to 4.6] pmol/L, p = 0.0008) . Plasma BNP was significantly higher in 5 patients with RV dysfunction com pared to I I patients with normal RV function (40.2 [95% CI 7.5 to 214.9] v ersus 3.3 [95% Cl 0.4 to 24.9] pmol/L, p = 0.0003). RV systolic pressure wa s not significantly correlated with BNP (r = 0.42, p = ns), In conclusion, plasma BNP neurohormone levels might be of clinical importan ce as a supplementary tool for assessment of RV function in patients with a cute PE.