Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 9:23:100359.
doi: 10.1016/j.ijcha.2019.100359. eCollection 2019 Jun.

Serum BNP levels are associated with malignant pericardial effusion

Shemy Carasso  1   2 , Liza Grosman-Rimon  1   2 , Ali Nassar  1 , Fabio Kusniec  1   2 , Diab Ghanim  1   2 , Gabby Elbaz-Greener  1   2 , Wadi Kinany  1   2 , Doron Sudarsky  1 , Evgeni Hazanov  1 , Offer Amir  1   2
Affiliations

Serum BNP levels are associated with malignant pericardial effusion

Shemy Carasso et al. Int J Cardiol Heart Vasc. .

Abstract

Introduction: The development of malignant pericardial effusion indicates a poor prognosis and is the leading cause of cardiac tamponade. The objectives of the study were to examine the levels of BNP in traumatic, malignant and non-malignant pericardial effusion etiologies, and to assess the value of serum and pericardial fluid BNP levels in the prognosis of malignant pericardial effusion.

Methods: A of 56 patients with clinical and echocardiographic diagnosis of pre-tamponade or tamponade who required pericardiocentesis were included in the study. BNP levels were assessed in the serum and within the pericardial fluid. The diagnostic value of BNP levels in discriminating between malignant and non- malignant etiology of pericardial effusion was examined using a receiver-operating characteristic (ROC).

Results: Pericardial fluid BNP levels were similar across all etiology groups. In patients with malignant etiology, the amount of pericardial fluid was high and their serum BNP levels were relatively low. BNP levels were strong predictors of malignant pericardial effusion, and the cut-off point of BNP ≤ 250 pg/ml demonstrated the highest sensitivity (90.0%) for malignant etiology.

Conclusions: Low serum BNP levels were significantly associated with malignancy in patients undergoing pericardiocentesis for pericardial effusions. Serum BNP levels <250 pg/ml may trigger more extensive diagnostic testing for malignant pericardial effusion in patients with small pericardial effusion who are not considered for pericardiocentesis due to small effusion, in whom the etiology is unclear.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Panel a. Serum BNP levels in traumatic, malignant and non-malignant etiology groups; Panel b. Pericardial fluid BNP levels in traumatic, malignant and non-malignant etiology groups. Panel c. Pericardial fluid amount in traumatic, malignant and non-malignant etiology groups. Box plots showing median levels of BNP measured in the three groups of patients. The top and bottom borders of the box mark the 75th and 25th percentiles, respectively; whiskers mark the 90th and 10th percentiles. A circle represents extreme outliers beyond the 90th and 10th percentiles; horizontal line indicates the median.
Fig. 2
Fig. 2
ROC curves for BNP, differentiating between Malignant and Non-Malignant pericardial effusion.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fejka M., Dixon S.R., Safian R.D., O'Neill W.W., Grines C.L., Finta B., Marcovitz P.A., Kahn J.K. Diagnosis, management, and clinical outcome of cardiac tamponade complicating percutaneous coronary intervention. Am. J. Cardiol. 2002;90:1183–1186. - PubMed
    1. Lange R., Bleiziffer S., Piazza N., Mazzitelli D., Hutter A., Tassani-Prell P., Laborde J.C., Bauernschmitt R. Incidence and treatment of procedural cardiovascular complications associated with trans-arterial and trans-apical interventional aortic valve implantation in 412 consecutive patients. Eur. J. Cardiothorac. Surg. 2011;40:1105–1113. - PubMed
    1. Imazio M., Adler Y. Management of pericardial effusion. Eur. Heart J. 2013;34:1186–1197. - PubMed
    1. Wiyeh A.B., Ochodo E.A., Wiysonge C.S., Kakia A., Awotedu A.A., Ristic A., Mayosi B.M. A systematic review of the efficacy and safety of intrapericardial fibrinolysis in patients with pericardial effusion. Int. J. Cardiol. 2018;250:223–228. - PubMed
    1. Krupicka J., Janota T., Kasalova Z., Hradec J. Natriuretic peptides - physiology, pathophysiology and clinical use in heart failure. Physiol. Res. 2009;58:171–177. - PubMed

LinkOut - more resources