EXPRESS PUBLICATION
The Efficacy of Brain Natriuretic Peptide Levels in Differentiating Constrictive Pericarditis From Restrictive Cardiomyopathy
Ferdinand S. Leya, MD*,*,
Dinesh Arab, MD*,
Dominique Joyal, MD*,
Krystyna M. Shioura, PhD ,
Bruce E. Lewis, MD*,
Lowell H. Steen, MD* and
Leslie Cho, MD*
* Division of Cardiology, Section of Interventional Cardiology, Loyola University Medical Center, Maywood, Illinois.
Division of Cardiology, Section of Heart Transplant, Loyola University Medical Center, Maywood, Illinois.
Manuscript received January 6, 2005;
revised manuscript received March 17, 2005,
accepted March 29, 2005.
* Reprint requests and correspondence: Dr. Ferdinand S. Leya, Department of Medicine, Division of Cardiology, Loyola University Medical Center, 2160 S. First Avenue, Maywood, Illinois 60153. (Email: fleya{at}lumc.edu).
OBJECTIVES: We sought to determine the usefulness of brain natriuretic peptide (BNP) measurements to differentiate constrictive pericarditis (CP) from restrictive cardiomyopathy (RCMP).
BACKGROUND: The differentiation of CP from RCMP may be clinically difficult and often requires hemodynamic assessment. No laboratory marker has been shown to differentiate the two conditions.
METHODS: We measured BNP levels in 11 patients suspected of having either CP or RCMP. All patients had hemodynamic assessment the day of BNP measurements.
RESULTS: Six patients had CP and five patients had RCMP based on established hemodynamic criteria. Both CP and RCMP patients had similar elevation in intracardiac pressures. Despite similar pressures, the mean plasma BNP levels were significantly higher in RCMP compared to CP (825.8 ± 172.2 pg/ml vs. 128.0 ± 52.7 pg/ml, p < 0.001, respectively).
CONCLUSIONS: The BNP levels are significantly elevated in RCMP compared to CP patients; BNP may prove to be a useful noninvasive marker for the differentiation of the two conditions.
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Abbreviations and Acronyms
| | BNP = brain natriuretic peptide | | CP = constrictive pericarditis | | LAP = left atrial pressure | | LVEDP = left ventricular end-diastolic pressure | | PAP = pulmonary artery pressure | | PCWP = pulmonary capillary wedge pressure | | RAP = right atrial pressure | | RCMP = restrictive cardiomyopathy |
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