Background: Brain natriuretic peptide (BNP) is associated
with increased myocardial stretching. This study aims
to assess the effect of mild diuretics on plasma BNP
levels in patients with an acute exacerbation of chronic
obstructive pulmonary disease (COPD) who have high
plasma concentrations of BNP.
Methods: Thirty consecutive patients with an acute
exacerbation of COPD without any clinical evidence
of cor pulmonale who had elevated plasma BNP
concentrations (group 1) and 15 patients with stable
COPD as controls (group 2) participated in this study.
A mild diuretic treatment in addition to the standard
treatment for an acute attack of COPD was randomised to 15 patients in group 1 (group 1A). The remaining patients in group 1 only took standard treatment for acute COPD exacerbation (group 1B). Plasma BNP concentrations were measured on admission and repeated on the 5th and 10th days.
Results: There was a significant decrease in plasma
BNP concentrations, more striking in group 1A than
1B. Both in group 1A and 1B, the fall in plasma BNP
concentrations was independent of either presence
or absence of right ventricular dysfunction on echo
Conclusion: Adding mild diuretics to the standard treatment for an acute attack of COPD may rapidly reduce plasma BNP levels in COPD patients with acute exacerbations who have high plasma BNP levels without any clinical evidence of cor pulmonale.