Bratisl Lek Listy. 2024;125(10):652-656. doi: 10.4149/BLL_2024_100.
The objective of this study was to investigate whether there are differences between brain natriuretic peptide (BNP) levels and computed tomography pulmonary angiography (CTPA) parameters, in patients with acute PE, with respect of sex.
Acute pulmonary embolism (PE) may provoke sudden right ventricle overload and stretching of their thin walls, causing significant raise of BNP blood levels, which correlates to acute PE severity. The properties of RV are different between sexes.
This retrospective analysis was gained from the data of 1612 PE patients from the regional PE register. The patients have had CTPA verification of PE, with described localization of thrombus masses, as well as the ratio between RV and left ventricle (RV/LV), and BNP as biomarker, measured during the first 24 hours upon admission.
Out of 96 male patients with detected central thrombus, 75.0% patients had an increase in BNP level compared to 25.0% patients with normal BNP value (p<0.001). Of the 94 female patients with central thrombus, 85.1% patients had an elevated BNP level, compared to 14.9% patients, with BNP normal values (p<0.001). Of the 135 male patients with RV/LV˃1, 79.3% of them, had elevated BNP, compared to 20.7% patients whose BNP level was normal (p<0.001). Out of 123 female patients with RV/LV˃1, 91.1% patients had elevated BNP compared to 8.9%, whose BNP was normal (p<0.001).
Elevated BNP blood level correlates with CTPA parameters, such as the presence of central thrombus and the ratio between right and left ventricles greater than 1, in patients with acute PE, regardless of sex (Tab. 2, Fig. 2, Ref. 23). Text in PDF www.elis.sk Keywords: acute pulmonary embolism, computed tomography pulmonary angiography, brain natriuretic peptide, right ventricle.
本研究旨在探讨急性肺动脉栓塞(PE)患者的脑钠肽(BNP)水平与 CT 肺动脉造影(CTPA)参数是否存在性别差异。
急性 PE 可引起右心室(RV)突然负荷过重和其薄壁拉伸,导致 BNP 血水平显著升高,与急性 PE 严重程度相关。RV 的特性在性别之间存在差异。
本回顾性分析来自区域 PE 登记处的 1612 例 PE 患者的数据。患者接受 CTPA 验证 PE,并描述血栓块的定位,以及 RV 与左心室(RV/LV)的比值,以及入院后 24 小时内测量的生物标志物 BNP。
在 96 例检测到中央血栓的男性患者中,75.0%的患者 BNP 水平升高,而 25.0%的患者 BNP 值正常(p<0.001)。在 94 例有中央血栓的女性患者中,85.1%的患者 BNP 水平升高,而 14.9%的患者 BNP 值正常(p<0.001)。在 135 例 RV/LV>1 的男性患者中,79.3%的患者 BNP 升高,而 20.7%的患者 BNP 水平正常(p<0.001)。在 123 例 RV/LV>1 的女性患者中,91.1%的患者 BNP 升高,而 8.9%的患者 BNP 正常(p<0.001)。
无论性别如何,急性 PE 患者的 BNP 血水平升高与 CTPA 参数相关,如中央血栓存在和 RV/LV 比值大于 1(表 2,图 2,参考文献 23)。