Abstract:
BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) have increased cardiovascular risk. Natriuretic peptides (NP) in other populations are useful in identifying cardiovascular disease, stratifying risk, and guiding therapy. METHODS:We performed a systematic literature review to examine NP in COPD, utilising Medline, EMBASE, and the Cochrane Library. RESULTS:Fifty one studies were identified. NP levels were lower in stable compared to exacerbation of COPD, and significantly increased with concomitant left ventricular systolic dysfunction or cor pulmonale. Elevation occurred in 16 to 60% of exacerbations and persisted in approximately one half of patients at discharge. Cardiovascular comorbidities were associated with increased levels. Levels consistently correlated with pulmonary artery pressure and left ventricular ejection fraction, but not pulmonary function or oxygen saturation. NP demonstrated high negative predictive values (0.80 to 0.98) to exclude left ventricular dysfunction in both stable and exacerbation of COPD, but relatively low positive predictive values. NP elevation predicted early adverse outcomes, but the association with long term mortality was inconsistent. CONCLUSION:NP reflect diverse aspects of the cardiopulmonary continuum which limits utility when applied in isolation. Strategies integrating NP with additional variables, biomarkers and imaging require further investigation.
journal_name
BMC Pulm Medjournal_title
BMC pulmonary medicineauthors
Hawkins NM,Khosla A,Virani SA,McMurray JJ,FitzGerald JMdoi
10.1186/s12890-016-0345-7subject
Has Abstractpub_date
2017-01-10 00:00:00pages
11issue
1issn
1471-2466pii
10.1186/s12890-016-0345-7journal_volume
17pub_type
杂志文章,评审abstract:BACKGROUND:Exposure to perinatal anxiety affects disease susceptibility in offspring but studies on the association between perinatal anxiety and gene polymorphisms are lacking. This study aimed to elucidate the interaction between perinatal anxiety and polymorphisms in antioxidant defense and innate immunity genes on ...
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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