The N-terminal pro-B-type natriuretic peptide as a predictor of disease progression in patients with pericardial effusion

BackgroundThe purpose of this study was to evaluate the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a predictor of disease progression in patients with pericardial effusions (PE).MethodWe retrospectively studied consecutive patients that had moderate or large PEs. Patients with pericardial events, such as reaccumulation of PE, persistent drainage through a catheter longer than one week, or newly developed constrictive pericarditis were defined as the progression group (Group A), and patients without these findings were defined as the group with no progression (Group B). The NT-proBNP assay was performed when PE was detected.ResultsCompared to Group B (27 patients), Group A (15 patients) exhibited lower systolic and diastolic blood pressures (106 ± 13 vs. 118 ± 19 mmHg, p = 0.028; 69 ± 9 vs. 75 ± 11 mmHg, p = 0.047), higher NT-proBNP levels (1063 ± 756 vs. 578 ± 1090 ng/L, p = 0.002), larger inferior vena cava (21 ± 6 vs. 17 ± 5 mm, p = 0.039) and higher estimated right ventricular systolic pressure (37 ± 5 vs. 32 ± 6 mmHg, p = 0.024). NT-proBNP was the only independent predictor of disease progression (p = 0.034) by multivariate regression analysis. The receiver-operating characteristic curve analysis showed that NT-proBNP values ≥ 548 ng/L demonstrated a sensitivity of 80% and a specificity of 78% for identifying disease progression (p = 0.001).ConclusionsThe NT-proBNP value may predict disease progression in patients with PE. However, additional prospective studies with more patients are needed.