CHEST Guidelines-Untangling-BNP-and-BMI

Untangling-BNP-and-BMI_chest

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In a recent issue of CHEST, Drs. Sarah K. Medrek and Lana Melendres-Groves highlighted concerns over the study by Frantz et al., which assessed brain natriuretic peptide (BNP) as a prognostic marker for pulmonary arterial hypertension (PAH) using data from the REVEAL registry. They pointed out that the study found a negative correlation between body mass index (BMI) and BNP levels but did not consider factors like weight, age, and renal function that can affect BNP. Citing other studies, they emphasized that obesity might limit BNP's predictive value in PAH, particularly for stratifying risk in patients with higher BMIs. <br /><br />In response, the study authors acknowledged these concerns by providing additional analysis. They confirmed a weak correlation between BMI and BNP levels (correlation coefficient of -0.11) and noted that higher BMI was surprisingly associated with a slightly higher survival rate, pointing out the intricacies of obesity affecting BNP levels and patient outcomes. They also performed further subgroup analysis on patients with higher BMI to delve deeper into this complexity.<br /><br />Dr. Medrek and Dr. Melendres-Groves raised an important question considering the rise in obesity rates, prompting a more nuanced exploration of how BMI might influence BNP's utility in managing PAH. By conducting further analysis, the original study's authors have contributed additional insights, although the relationship between obesity, BNP levels, and PAH outcomes requires further investigation to ensure accurate patient risk stratification.

Keywords

CHEST journal

BNP levels

pulmonary arterial hypertension

REVEAL registry

body mass index

obesity

risk stratification

patient outcomes

prognostic marker

subgroup analysis