Brain Natriuretic Peptide and NT-proBNP Levels Reflect Pulmonary Artery Systolic Pressure in Trekkers at High Altitude

Abstract

Our objective was to evaluate the utility of the natriuretic peptides BNP (brain natriuretic peptide) and NT-proBNP as markers of pulmonary artery systolic pressure (PASP) in trekkers ascending to high altitude (HA). 20 participants had BNP and NT-proBNP assayed and simultaneous echocardiographic assessment of PASP performed during a trek to 5150 m. PASP increased significantly (p=0.006) with ascent from 24±4 to 39±11 mm Hg at 5150 m. At 5150 m those with a PASP≥40 mm Hg (n=8) (versus those with PASP<40 mm Hg) had higher post-exercise BNP (pg/ml): 54.5±36 vs. 13.4±17 (p=0.012). Their resting BNP at 5150 m was also higher: 57.3±43.4 vs. 12.6±13 (p=0.017). In those with a pathological (≥400 pg/ml) rise in NT-proBNP at 5150 m (n=4) PASP was significantly higher: 45.9±7.5 vs. 32.2±6.2 mm Hg (p=0.015). BNP and NT-proBNP may reflect elevated PASP, a central feature of high altitude pulmonary oedema, at HA.