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| Predictive Value of Right Ventricular Myocardial Perfomance Index Combined with NT-proBNP in COPD Associated Pulmonary Arterial Hypertension |
| YANG Menghong, XIN Ahuan |
| The Third Department of Recuperation, Lintong Rehabilitation Center, Xi'an Shaanxi 710600 |
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Abstract 【Objective】To explore the predictive value of right ventricular myocardial performance index (RVMPI) combined with N-terminal pro-brain natriuretic peptide (NT-proBNP) for chronic obstructive pulmonary disease (COPD)-associated pulmonary arterial hypertension (PH).【Methods】NT-proBNP, RVMPI, and pulmonary artery systolic pressure (PASP) levels were measured in 144 COPD patients within 24 hours of admission and PASP levels were reassessed after one month of treatment. Patients were divided into a PH group and a normal pulmonary artery group based on their PASP levels. Logistic multivariate regression was used to identify factors associated with secondary PH, and receiver operating characteristic (ROC) curves were used to assess the predictive value of RVMPI and NT-proBNP for secondary PH.【Results】 Of the 144 patients, 49 had PH (34.03%) and 95 had normal pulmonary artery pressure (65.97%). The PH group had a higher proportion of smoking history, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores, NT-proBNP level, and RVMPI level compared to the normal group, while their 6-minute walk distance(6MWD) distance and FEV1/FVC levels were lower (P<0.05). Multivariate regression analysis showed that smoking history, lower 6MWD distance, higher APACHE Ⅱ scores, elevated NT-proBNP level, and increased RVMPI were associated with secondary PH in COPD patients (P<0.05). ROC analysis indicated that the area under the curve (AUC) for predicting secondary PH using NT-proBNP, RVMPI, and their combination were 0.764, 0.746, and 0.854, respectively, with the combined prediction being superior to either alone (P<0.05).【Conclusion】 COPD patients with secondary PH have elevated NT-proBNP and RVMPI levels, and both markers provide high predictive efficacy for PH.
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Received: 20 December 2023
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2024, Vol. 41 
