Association of Left-Heart Dysfunction with Severe Exacerbation of Chronic Obstructive Pulmonary Disease

• DOI: 10.1164/rccm.200603-380oc
• Publication Date: 2006-07-14T04:53:27Z
• Authors: Fekri Abroug; Lamia Ouanes-Besbes; Noureddine Nciri; Noura Sellami; Faouzi Addad; Khaldoun Ben Hamda; Adel Ben Amor; Mohamed F. Najjar; Jalel Knani
• Keywords: Male; Likelihood Functions; Middle Aged; Peptide Fragments; 3. Good health; Pulmonary Disease, Chronic Obstructive; Ventricular Dysfunction, Left; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Troponin T; Multivariate Analysis; Natriuretic Peptide, Brain; Humans; Female; Prospective Studies; Protein Precursors; Biomarkers; Aged

Cardiac biomarkers are used to distinguish acute dyspnea due left-heart dysfunction from that of pulmonary origin. However, they have not been assessed in the specific setting exacerbation chronic obstructive disease (AECOPD), where might be released without impairment.To assess accuracy troponin T and amino-terminal pro-brain natriuretic peptide (NT-proBNP) diagnosis AECOPD associated with left ventricular (LV) dysfunction.Both were measured 148 consecutive patients on intensive care unit admission for AECOPD. A panel physicians adjudicated blindly cause unlikely, possibly associated, or definitely LV dysfunction.The final was 31.1%, 13.5%, probably 55.4%. Both NT-proBNP levels significantly different among three groups. The area under receiver operating characteristic curve greater (0.95 vs. 0.67). cutoff 1,000 pg/ml accurate rule out involvement (sensitivity, 94%; negative predictive value, likelihood ratio, 0.08). 2,500 had best characteristics (positive 5.16). Left-heart only variable independently increased secretion (odds 74; 95% confidence interval, 15-375; p = 0.0001).NT-proBNP useful excluding dysfunction. more two.