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Hiperkapnik Solunum Yetmezliği Gelişen KOAH'lı Hastalarda Non-İnvaziv Ventilasyonun Plazma Brain Natriüretik Peptid (BNP) ve Troponin Üzerine Etkisi

The Effect of Noninvasive Ventilation on Plasma Brain Natriuretic Peptide (BNP) and Troponin in COPD Patients With Hypercapneic Respiratory Failure

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2011

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
It was reported that there is relationship between high brain natriuretic peptide (BNP) levels and mortality in chronic obstructive pulmonary disease (COPD). In this study, we investigated effect of NIV to the BNP and troponin. Fifty eight cases with COPD were enrolled to this study. The patients were divided into two groups as cases receiving NIV (n:41) and cases not receiving NIV (n:17). In both groups pretreatment and posttreatment pro BNP and troponin levels were measured. Initially, in NIV group both pro-BNP (2013.95 pg/ml) and troponin (0.17 ng/ml) levels were significantly higher than those of control group (328.9 pg/ml and 0.02 ng/ml, respectively) (p<0.001). During treatment, while there was significant decrease in pro-BNP values (783.15 pg/ml) (p<0.01), no significant difference was present in troponin values (p>0.05). In conclusion, in severe COPD acute exacerbations that develop respiratory failure, both pro-BNP and troponin levels increase significantly. This increase suggests that in COPD exacerbations, depending on severity of exacerbation right ventricle load and pulmonary hypertension may be more prominent and myocardial injury may accompany this. In COPD exacerbations, NIV treatment could safely decrease the increased pro-BNP levels without increasing the myocardial injury.
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Abstract (Original Language): 
Kronik obstrüktif akciğer hastalığında (KOAH) yüksek BNP değerleri ile mortalite arasında ilişki olduğu bildirilmiştir. Bu çalışmada non-invaziv ventilasyonun (NIV) pro-BNP ve troponine etkisi araştırılmıştır. Bu çalışmaya KOAH'lı 58 hasta alınmıştır. Hastalar NIV uygulananlar (n:41) ve uygulanmayanlar (n:17) olarak iki gruba ayrıldı. Kontrol grubunda ve NIV uygulananlarda tedavi öncesi ve sonrası pro-BNP ve troponin değerleri ölçüldü. Başlangıçta NIV grubunda hem pro-BNP (2013.95 pg/ml) hem de troponin (0.17 ng/ml) seviyeleri kontrol grubundan (sırasıyla 328.9 pg/ml, 0.02 ng/ml) anlamlı olarak belirgin yüksekti (p<0.001). NIV grubunda tedavi sonrasında pro-BNP değerlerinde (783.15 pg/ml) anlamlı azalma varken (p<0.01), troponin değerlerinde anlamlı değişiklik yoktu (p>0.05). Solunum yetmezliği gelişen şiddetli KOAH akut alevlenmelerinde pro-BNP ve troponin seviyeleri belirgin artmaktadır. Bu artış KOAH alevlenmelerinde alevlenmenin şiddetine bağlı olarak sağ ventrikül yüklenmesinin ve pulmoner hipertansiyonun daha fazla olabileceğini ve buna miyokard hasarının da eklenebileceğini düşündürmektedir. NIV tedavisi hiperkapnik solunum yetmezliğinin geliştiği KOAH akut alevlenmelerinde artmış pro-BNP seviyelerini miyokard hasarını arttırmadan güvenli bir şekilde düşürmektedir.
FULL TEXT (PDF): 
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  • 3
142-145
  • Turkish

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