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KMID : 0876920040080010017
Kwandong Medical Journal
2004 Volume.8 No. 1 p.17 ~ p.24
The Usefulness of N-Terminal Pro-Brain Natriuretic Peptide Test in Critically Ill Elderly Patients with Acute Dyspnea
Choi Jeong-Eun

Abstract
Background: N-terminal pro-Brain type natriuretic peptide (NT-proBNP) originates mainly from the ventricle and has been shown to be of diagnostic value in congestive heart failure, predictive of sudden cardiac death and prognostic for death in acute coronary syndrome. And recent studies suggested NT-proBNP can be increased in various disease such as pulmonary embolism, primary pulmonary hypertension and essential hypertension. Sometimes it is difficult to differentiate a cause of dyspnea in aged patients with variable underlying diseases. In this study, the NT-proBNP were measured from aged dyspneic patients in intensive care unit to evaluate the usefulness of NT-proBNP in differentiating the cause dyspnea and in predicting prognosis of that patients.

Methods: 42 aged patients with dyspnea in ICU, who were hospitalized from April to October 2003 were enrolled in this study. Elecsys proBNP with electrochemiluminescence method was used for measurement of serum NT-proBNP. The acute physiology and chronic health evaluation (APACHE) II score and mortality were recorded.

Results: The mean age was 76.2±6.3 years old. There were 14 males and 28 females. The mean NT-proBNP level was 8186.4±1742.2 pg/ml, which showed marked elevation compared to normal values. There were significant differences in NT-proBNP levels among the variable diseases (p=0.017). The mean APACHE Ⅱ score was 13.4±0.8 and predicted mortality was 16.9±1.8%. The correlation between the NT-proBNP and APACHE Ⅱ score, between the NT-proBNP and mortality were significant (r=0.355, p=0.021 & r=0.346, p=0.025)

Conclusion: The measurement of serum NT-proBNP is helpful and noninvasive tool for differentiating of various cause of dyspnea and also useful for predicting prognosis in aged patients with dyspnea.
KEYWORD
N-Terminal pro-Brain Natriuretic Peptide, APACHE Ⅱ score, Acute dyspnea, Critically ill, Aged patient
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