Use of plasma NT-proBNP level to predict persistent pulmonary arterial hypertension in patients with secundum atrial septal defect after transcatheter closure
Keywords:
secundum ASD, ASDII, transcatheter closure, pulmonary arterial hypertension, NT-proBNPAbstract
Background: Persistent pulmonary arterial hypertension (PPAH) after transcatheter ASD closure (TCA) in patients with secundum atrial septal defect (ASDII) is associated with high morbidity and mortality. There were few reports of biomarkers as predictors of pulmonary arterial hypertension (PAH) after TCA.Objective: To determine whether plasma
NT-proBNP level can predict PPAH in ASDII patients after TCA. Method: A prospective cohort study was conducted among ASDII patients who underwent TCA in Central Chest Institute of Thailand between January 2016 and June 2016.
Demographic data, body mass index, underlying diseases and echocardiographic data were assessed. The outcome in this study was the proportion of PPAH after TCA for six months in those with normal and high NT-proBNP levels.
The outcome between two groups were compared with unpaired t-tests. Receiver operator characteristic (ROC) curve were used to illustrate the capacity of NT-proBNP prognostic predictor of PPAH in ASDII patients after TCA. Result:
A total of thirty patients were prospectively recruited. Of these, twenty patients had normal baseline NT-proBNP,and ten patients had high baseline NT-proBNP. The patients with high baseline NT-proBNP had more decreased NTproBNP than those with normal baseline NT-proBNP with statistical significance (p-value = 0.01). The proportion of patients with high baseline NT-proBNP had more PPAH than those with normal baseline NT-proBNP with statistical
significance (p-value = 0.008). The ROC curve showed that baseline NT-proBNP ≥ 240 picograms/milliliter (pg/ml)
had a sensitivity of 100%, a specificity of 88.5%, a positive predictive value of 57% and a negative predictive value of 100%). Conclusion: ASDII patients with high baseline NT-proBNP had significant PPAH after TCA compared with
those with normal baseline NT-proBNP. Baseline NT-proBNP level ≥ 240 pg/ml may be used for predicting PPAH in these patients. The further larger studies will be needed for confirmation of these findings.
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