SFEBES2013 Poster Presentations Clinical biochemistry (22 abstracts)
High pulmonary artery pressure is associated with BNP and NT-proBNP in lowlanders acclimatising to high altitude
A Mellor 1, , N E Hill 1 , C Boos 3 , D Holdsworth 3 , J Begley 4 , M Stacey 1 , D Hall 7 , A Lumley 7 , A Hawkins 4 , S Foxen 1 , J O’ Hara 5 , C Smith 1 , S Ball 6 & D Woods 1,
1Defence Medical Services, UK; 2Academic Department of Emergency Medicine, James Cook University Hospital, Middlesborough, UK; 3Department of Cardiology, Poole Hospital NHS Foundation Trust, Dorset, UK; 4Department of Biochemistry, Poole Hospital NHS Foundation Trust, Dorset, UK; 5Carnegie Institute, Leeds Metropolitan University, Leeds, UK; 6University of Newcastle, Newcastle upon Tyne, UK; 7Ministry of Defence Hospital, Northallerton, UK.
Background: We have previously demonstrated that the natriuretic peptides BNP and NT-proBNP rise with ascent to high altitude (HA). Both peptides are classically markers of congestive cardiac failure but have also recently been found to be associated with pulmonary hypertension at sea-level (SL). As pulmonary hypertension is central to the risk of high altitude pulmonary oedema we aimed to establish if there was any association between high pulmonary artery systolic pressure (PASP) and BNP/NT-proBNP at HA.
Methods: 20 subjects from an expedition to Nepal (study 1) and 48 subjects from an expedition to Bolivia (study 2) were recruited and had BNP and NT-proBNP assayed and non-invasive assessment of PASP performed with ascent to 5150 m.
Results: BNP and NT-proBNP generally increased at altitude compared to baseline. PASP increased progressively with ascent. Generally, a PASP ≥40 mmHg (vs <40 mmHg) at various altitudes was associated with a higher BNP and NT-proBNP. For example, in study one at 5150 m those with a PASP ≥40 mmHg (n=8) vs those <40 mmHg had BNP of 54.5±36 vs 13.4±17 pg/ml (P=0.012). In study two those with a high PASP at 3600 m at rest (n=6) had higher BNP (37.5±38 vs 10±6.7, P=0.003) and NT-proBNP (370±413 vs 101±72, P=0.003).
Conclusion: BNP and NT-proBNP may serve as markers for elevated PASP, a central feature of high altitude pulmonary oedema, at HA. In this respect they offer the potential to facilitate early diagnosis and management, particularly with the availability of point-of-care testing.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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