NT-proBNP and BNP Testing in Pulmonary Arterial Hypertension: Point-of-Care and Remote Monitoring.

IF 6.6 2区医学 Q1 RESPIRATORY SYSTEM

Respirology Pub Date : 2025-07-03 DOI:10.1111/resp.70087

Charlotte Durrington, Christian Battersby, Laura Holt, Alexandra Fairman, Scarlett Strickland, Thomas Salisbury, Helena A Turton, Lisa Watson, Ian Smith, Stefan Roman, Jenna Ablott, Felicity Hitchcock, Chloe Roddis, Eleanor Oakes, Heather Wilshaw, Iain Woodrow, Iain Armstrong, Athanasios Charalampopoulos, Charlie A Elliot, Abdul Hameed, Neil Hamilton, Judith A Hurdman, Allan Lawrie, Jennifer T Middleton, Hamza Zafar, Alex M K Rothman, Robin Condliffe, Robert A Lewis, David G Kiely, A A Roger Thompson

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引用次数: 0

Abstract

Background and objectives: Brain natriuretic peptide (BNP) and N-terminal prohormone of BNP (NT-proBNP) are important biomarkers in pulmonary arterial hypertension (PAH). However, results are rarely available at the time of clinical assessment. The reliability of NT-proBNP/BNP point-of-care tests (POCT) in PAH patients and the stability of NT-proBNP in posted blood samples, to simulate remote monitoring, was investigated.

Methods: Group 1 PAH patients were prospectively recruited. A sample of 40 was required to demonstrate an intraclass correlation coefficient (ICC) of 0.94 with a 95% confidence interval width of < 0.1 for agreement between POCT and the laboratory standard. Blood samples were taken at two time-points for laboratory and POCT NT-proBNP/BNP. Separate samples were returned to the laboratory by post and some samples were assessed pre- and post-exercise assessing the impact of exercise.

Results: Forty-one patients were enrolled with 56 study visits. NT-proBNP laboratory and POCT (n = 50) provided equivalent test results (Passing-Bablok slope = 1.08, CI = 0.97-1.19, intercept = 18.22, CI = -41.6 to 4.5) and ICC = 0.97. However, laboratory and POCT BNP (n = 49), showed non-equivalence (Passing-Bablok slope = 1.24, CI 1.11-1.31, intercept = -5.11, CI = -9.4 to -0.46), ICC = 0.96. POCT NT-proBNP/BNP correctly classified 92% and 86% of cases, respectively against COMPERA 2.0 4-risk-strata thresholds. NT-proBNP postal laboratory samples and immediately processed NT-proBNP laboratory samples showed good agreement and exercise had no clinically significant effect on NT-proBNP/BNP results. Laboratory BNP identified fewer patients as high risk compared to NT-proBNP. BNP and NT-proBNP risk status agreed at only 57% of visits (p < 0.0009).

Conclusions: These data support the use of POCT NT-proBNP as a rapidly accessible and reliable alternative in clinical settings and highlight the potential of NT-proBNP for remote monitoring via posted samples.

Trial registration: ClinicalTrials.gov registration: NCT05421949.

查看原文本刊更多论文

肺动脉高压的NT-proBNP和BNP检测：护理点和远程监测。

背景与目的：脑钠肽（BNP）和BNP n端原激素（NT-proBNP）是肺动脉高压（PAH）的重要生物标志物。然而，在临床评估时，结果很少可用。研究了PAH患者NT-proBNP/BNP点护理试验（POCT）的可靠性以及NT-proBNP在邮寄血液样本中的稳定性，以模拟远程监测。方法：前瞻性招募1组PAH患者。需要40个样本来证明类内相关系数（ICC）为0.94,95%置信区间宽度为结果：41名患者入组，进行了56次研究访问。NT-proBNP实验室和POCT （n = 50）提供了相同的测试结果（Passing-Bablok斜率= 1.08,CI = 0.97-1.19，截距= 18.22,CI = -41.6至4.5），ICC = 0.97。然而，实验室和POCT BNP （n = 49）显示不等效（Passing-Bablok斜率= 1.24,CI = 1.11-1.31，截距= -5.11,CI = -9.4至-0.46），ICC = 0.96。POCT NT-proBNP/BNP分别对COMPERA 2.0 4个风险层阈值正确分类了92%和86%的病例。邮政NT-proBNP实验室样品和立即处理的NT-proBNP实验室样品显示出良好的一致性，运动对NT-proBNP/BNP结果没有临床显著影响。与NT-proBNP相比，实验室BNP鉴定出的高风险患者较少。结论：这些数据支持POCT NT-proBNP作为临床环境中快速可及和可靠的替代方案的使用，并强调了NT-proBNP通过张贴样本进行远程监测的潜力。试验注册：ClinicalTrials.gov注册：NCT05421949。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respirology 医学-呼吸系统

CiteScore

10.60

自引率

5.80%

发文量

225

审稿时长

1 months

期刊介绍： Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and clinically-relevant experimental respiratory biology and disease. Fields of research include immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology, physiology, paediatric respiratory medicine, clinical trials, interventional pulmonology and thoracic surgery. The Journal aims to encourage the international exchange of results and publishes papers in the following categories: Original Articles, Editorials, Reviews, and Correspondences. Respirology is the preferred journal of the Thoracic Society of Australia and New Zealand, has been adopted as the preferred English journal of the Japanese Respiratory Society and the Taiwan Society of Pulmonary and Critical Care Medicine and is an official journal of the World Association for Bronchology and Interventional Pulmonology.