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
{"title":"肺动脉高压的NT-proBNP和BNP检测：护理点和远程监测。","authors":"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","doi":"10.1111/resp.70087","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registration: NCT05421949.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"NT-proBNP and BNP Testing in Pulmonary Arterial Hypertension: Point-of-Care and Remote Monitoring.\",\"authors\":\"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\",\"doi\":\"10.1111/resp.70087\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registration: NCT05421949.</p>\",\"PeriodicalId\":21129,\"journal\":{\"name\":\"Respirology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.6000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respirology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/resp.70087\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respirology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/resp.70087","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
NT-proBNP and BNP Testing in Pulmonary Arterial Hypertension: Point-of-Care and Remote Monitoring.
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.
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.
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