Myocardial damage in a 4-year old who ingested bisoprolol and hydrochlorothiazide - Incidental CK-BB highlighted other tissue toxicity.

N-Terminal Pro-B-Type Natriuretic Peptide as an Indicator of Disease Severity in a Heterogeneous Group of Patients With Chronic Precapillary Pulmonary Hypertension

Low-Level Environmental Metals Exposures, Biomarkers of Myocardial Injury and Hemodynamic Stress, and Mortality Risk

Acute carbon monoxide (CO) poisoning may cause cardiotoxicity. The natriuretic peptides, including atrial natriuretic peptide, brain natriuretic peptide (BNP), N-BNP, and NT-proBNP (N-terminal pro brain natriuretic peptide), are endogenous cardiac hormones that may be secreted upon myocardial stress. The aim of this study was to assess the plasma NT-proBNP level in acute CO poisoning and to compare it with healthy control. After approval by the ethical committee, 15 healthy controls and 15 patients admitted to the Gaziantep University Hospital (Gaziantep, Turkey) between January 2005 and July 2005 with the diagnosis of carbon monoxide poisoning were studied. Echocardiography was performed to all patients. Serum NT-proBNP, creatine kinase (CK), creatine kinase-MB (CK-MB), and troponin-T were also analyzed, along with the carboxyhemoglobin (COHb) level. The correlation between serum NT-proBNP and COHb level was investigated. Electrocardiography (ECG) was performed to all patients and healthy controls, and the results were compared. Differences in troponin, CK, and CK-MB levels were not statistically significant between groups (p > 0.05). The level of NT-proBNP and COHb were found to be increased in the study group. There was a positive correlation between the COHb and the NT-proBNP (r = 0.829, p < 0.01), and between the COHb and the CK (r = 0.394, p < 0.01). There was no difference between groups in other parameters, all of which were within normal range. Thus, in this sudy we showed that the plasma NT-proBNP level may contribute to the early diagnosis of cardiotoxicity in patients with carbon monoxide poisoning.

High-sensitivity troponin T (hsTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) strongly predict heart failure (HF) in the general population. However, the interpretation of levels of these biomarkers as predictors of HF is uncertain among patients with CKD. Here, we investigated whether hsTnT and NT-proBNP are associated with incident HF among patients with CKD. In a prospective cohort analysis, we studied 3483 people with CKD in the Chronic Renal Insufficiency Cohort (CRIC) Study recruited from June of 2003 to August of 2008 who were free of HF at baseline. We used Cox regression to examine the association of baseline levels of hsTnT and NT-proBNP with incident HF after adjustment for demographic factors, traditional cardiovascular risk factors, markers of kidney disease, pertinent medication use, and mineral metabolism markers. At baseline, hsTnT levels ranged from ≤5.0 to 738.7 pg/ml, and NT-proBNP levels ranged from ≤5 to 35,000 pg/ml. Compared with those who had undetectable hsTnT, participants in the highest quartile (>26.5 pg/ml) had a significantly higher rate of HF (hazard ratio, 4.77; 95% confidence interval, 2.49 to 9.14). Similarly, compared with those in the lowest NT-proBNP quintile (<47.6 pg/ml), participants in the highest quintile (>433.0 pg/ml) experienced a substantially higher rate of HF (hazard ratio, 9.57; 95% confidence interval, 4.40 to 20.83) [corrected]. In conclusion, hsTnT and NT-proBNP were strongly associated with incident HF among a diverse cohort of individuals with mild to severe CKD. Elevations in these biomarkers may indicate subclinical changes in volume and myocardial stress that subsequently contribute to clinical HF.

Background: Hospitalized Coronavirus disease 2019 (COVID-19) patients continue to experience high mortality, and while either high-sensitive troponin I (HsTnI) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) alone can stratify mortality risk, it is uncertain whether a combined approach retains prognostic power across evolving pandemic waves. We established two registries that enrolled consecutive COVID-19 patients admitted between July 2020 and September 2021 (Cohort-1, 917 patients) and between October 2021 and October 2022 (Cohort-2, 1,102 patients). Hypothesis: Combining HsTnI and NT-proBNP at prespecified low and high cutoff values predicts all-cause death more accurately than either biomarker alone, irrespective of pandemic waves. Aims: We sought to assess the performance of the dual-biomarker risk model using prespecified cutoff values in an initial cohort (Cohort-1) and in a second cohort (Cohort-2). Method: Additional measurements using blood serum banks were performed on blood tests at admission, and both HsTnI and NT-proBNP were available in 921 patients. (Cohort-1: 530 patients, and Cohort-2: 391 patients). Within each cohort, we divided patients into four groups using low-cutoff values of HsTnI at 5 ng/L and NT-proBNP at 125 pg/mL or high-cutoff values at the 99th upper reference limit (URL) for HsTnI and 900 pg/mL for NT-proBNP. The primary outcome measure was all-cause death during follow-up. Results: The median follow-up period was 29 days. In low-cutoff strata, the double-positive stratum (LS3: HsTnI ≥5 ng/L and NT-proBNP &gt;125 pg/mL) showed the highest incidence of mortality relative to the other groups. In the high-cutoff strata, the double-negative stratum (HS0: HsTnI &lt;99th URL and NT-proBNP ≤900 pg/mL) exhibited the lowest mortality compared with the other groups. After adjustment, cardiac biomarkers alone were not independent predictors of prognosis; however, the double-negative stratum remained independently associated with lower risk in both cohorts (Cohort-1: hazard ratio 0.41, 95% confidence interval 0.22-0.74, P=0.003; Cohort-2: hazard ratio 0.13, 95% confidence interval 0.03-0.55, P=0.005). Conclusions: Using a dual-biomarker strategy that combines HsTnI and NT-proBNP, a double-negative result at prespecified cutoff values reliably identifies low-risk hospitalized COVID-19 patients across different pandemic waves. These findings may help guide early triage and management decisions on patients with COVID-19.

BACKGROUND : Cardiac failure is one of the most serious and life threatening condition which needs an early diagnosis and prompt management to avoid mortality. 2 D echo serves as a very important tool in confirming the diagnosis of cardiac failure. Many centers in our country still don't have the facility of the same and hence we studied the role of NT pro-BNP as a substitute for 2 D echo. AIM: The aim of this study was to compare the level of serum NT pro-BNP with the 2 D echo findings in patients with acute onset dyspnea. METHODS: We studied 100 patients with acute onset dyspnea. Through history and examination was done. 2 d echo was done in all the patients. We measured the baseline level of serum NT Pro BNP in all the patients and a cut off level of 1800pg/ml was kept to compensate for the caveats in the measurement of NT ProBNP. The personnel who did echo were blinded to the result of NT pro- BNP . We compared the 2 D echo findings of the patients with the levels of NT pro-BNP. RESULTS : The ejection fraction, regional wall motion abnormality and diastolic dysfunction had significant correlation with a positive NT-ProBNP level, where as ventricular hypertrophy and pulmonary artery systolic pressure had no correlation with the same . CONCLUSIONS: NT pro- BNP level can be used to confirm the diagnosis of cardiac failure state in absence of 2 D echo facilities.

Background Patients with atrial fibrillation (AF) have progressive cardiac structural changes that may be manifest by biomarkers of myocardial injury and hemodynamic stress. Baseline values of hsTnT (high-sensitivity troponin T), and NT-proBNP (N-terminal pro-brain natriuretic peptide) are associated with stroke risk and GDF-15 (growth differentiation factor-15) is associated with bleeding risk in patients with AF. However, the variability of these biomarkers over time and their associations with stroke or systemic embolism events (S/SEE) and bleeding in patients with AF remain unclear. Purpose We examined whether patients with AF demonstrate detectable changes in these biomarkers over 12 months and whether such changes from baseline to 12 months are associated with the subsequent risk of S/SEE (hsTnT, NT-proBNP) and bleeding (GDF-15). Methods ENGAGE AF-TIMI 48 was a multinational randomized trial of the oral factor Xa inhibitor edoxaban in patients with atrial fibrillation and a CHADS2 score ≥2. We performed a nested prospective biomarker study in 6062 patients, analyzing hsTnT, NT-proBNP, and GDF-15 at baseline and 12 months. Event rates were estimated and displayed with annualized event rates after 12 months. Results Of 6062 patients, hsTnT was dynamic in 46.9% (≥2 ng/L change), NT-proBNP in 51.9% (≥200 pg/L change), GDF-15 in 45.6% (≥300 pg/L change) between baseline and 12 months. In addition, 7.7% in hsTnT shifted from low-&amp;gt;high categories, 9.4% in NT-proBNP from low-&amp;gt;high, 10.6% in GDF-15 from low-&amp;gt;high over 12 months (Figure). Elevated hsTnT (≥14 ng/L) and NT-proBNP (≥900 pg/L) either at baseline or at 12 months were independently associated with higher rates of subsequent S/SEE, and elevated GDF-15 (≥1800 pg/L) either at baseline or at 12 months were independently associated with higher rates of subsequent bleeding (P&amp;lt;0.001 for each). In a Cox regression model, the absolute changes in log2-transformed hsTnT and NT-proBNP were associated with increased risk of S/SEE (adj-HR, 1.75; 95% CI, 1.38–2.23; p&amp;lt;0.001, and adj-HR, 1.31; 95% CI, 1.11–1.55; p=0.002, respectively) and log2-transformed GDF-15 with bleeding (adj-HR, 1.42; 95% CI, 1.04–1.92; p=0.025). Analyzed in a categorical manner (Figure), patients who increased hsTnT or NT-proBNP between baseline and 12 months or had high hsTnT or NT-proBNP at both timepoints were at higher risk for S/SEE (adj-HR 1.87 and 1.50 for hsTnT; adj-HR 1.80 and 2.59 for NT-proBNP, respectively). Patients with persistently elevated GDF-15 appeared to be at higher risk for bleeding (adj-HR,1.35) (Figure). Conclusions Serial assessment of hsTnT, NT-proBNP, and GDF-15 revealed a substantial proportion of patients with AF had dynamic values. Patients with either persistently elevated or dynamic values were at higher risk of adverse clinical outcomes. Those biomarkers may play a role in personalizing preventive strategies in patients with AF based on risk. Change in biomarkers and event rate Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Daiichi Sankyo Pharma Development

Introduction: Troponin-defined myocardial injury or N-terminal pro-B-type natriuretic peptide (NT-proBNP) elevation frequently coincides with coronavirus disease 2019 (COVID-19). Our prior study (COVID-MI Registry Cohort-1) confirmed that high-sensitive troponin I (HsTnI) and NT-proBNP effectively stratified mortality risk. However, variants of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) change rapidly, and it remains unclear whether these biomarkers are consistently effective in predicting prognosis of COVID-19 patients irrespective of epidemic periods. Research Questions: Can HsTnI or NT-proBNP stratify mortality risk in recent COVID-19 cohorts? Aims: To assess the potential of HsTnI and NT-proBNP levels for risk stratification in the recent COVID-19 waves. Methods: In the COVID-MI Registry Cohort-2, we enrolled 1115 consecutive COVID-19 patients admitted between October 2021 and October 2022, during the Omicron variant endemic. We collected data of HsTnI or NT-proBNP levels from hospital charts or using the samples in our hospital's serum/plasma bank if the data were not available. The primary outcome measure was all-cause mortality. Results: On admission, more than one-third of patients were classified as having severe COVID-19. HsTnI and NT-proBNP levels were available for 427 and 414 patients, respectively. The median HsTnI and NT-proBNP levels were 16 (interquartile range [IQR]: 5-57) ng/L and 524 (IQR: 140-2056) pg/mL, respectively. We stratified the patients into three groups by HsTnI level: &lt;5.0 ng/L (95 patients), 5.0 ng/L to 99%ile URL (151 patients), and ≥99%ile URL (181 patients). For NT-proBNP, patients were grouped as follows: &lt;125 pg/mL (95 patients), 125-900 pg/mL (161 patients), and ≥900 pg/mL (158 patients). The median follow-up duration was 25 days. Regarding cumulative 30-day incidence of mortality, higher HsTnI as well as higher NT-proBNP levels were associated with a higher risk. (HsTnI: &lt; 5.0 ng/L group, 1.1%; 5.0 ng/L to 99%ile URL group, 3.0%; and ≥ 99%ile URL group, 21.7%; P &lt;0.001. NT-proBNP: &lt; 125 pg/mL group, 0%; 125-900 pg/mL group, 4.7%; and ≥ 900 pg/mL group, 17.1%; P &lt;0.001). Conclusions: HsTnI and NT-proBNP levels on admission can stratify mortality risk in recent COVID-19 cohorts, which is consistent with previous studies on different SARS-CoV-2 variants.

We investigated the dynamics, associations with patient characteristics, other biomarkers, and clinical outcomes of pentraxin 3 in acute coronary syndrome. In multivariate analyses, pentraxin 3 measured in 5154 patients randomised in the Platelet Inhibition and Patients Outcomes (PLATO) trial (NCT00391872) was compared with leukocytes, high-sensitivity C-reactive protein, interleukin-6, cystatin C, N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15 concerning prediction of clinical outcome. Pentraxin 3 peaked earlier than high-sensitivity C-reactive protein and was more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein. The frequency of cardiovascular death, spontaneous myocardial infarction or stroke by quartiles of pentraxin 3 at admission was 6.1%, 7.3%, 9.7% and 10.7%, respectively (p<0.0001). The hazard ratio per 50% increase of pentraxin 3 was 1.13 (95% confidence interval: 1.07-1.19), p<0.0001. This association remained significant after stepwise adjustments for leukocytes/high-sensitivity C-reactive protein (1.09 (1.02-1.15)), p=0.009, interleukin-6 (1.07 (1.01-1.14)), p=0.026, and cystatin C (1.07 (1.00-1.13)), p=0.044, but not after adjustment for N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15. Admission pentraxin 3 was also associated with several of the individual endpoint components (cardiovascular death/spontaneous myocardial infarction; p=0.008, cardiovascular death; p=0.026, and spontaneous myocardial infarction; p=0.017), but not with stroke. Pentraxin 3 measured in the chronic phase (i.e. at one month) was still predictive of the composite endpoint in univariate analysis (1.12 (1.04-1.20) per 50% increase) p=0.0024, but not after adjustment for the other biomarkers. Admission level of pentraxin 3 is a modestly stronger predictor than high-sensitivity C-reactive protein and interleukin-6, but not than N-terminal prohormone brain natriuretic peptide or high-sensitivity troponin T, concerning cardiovascular outcome in acute coronary syndrome. Pentraxin 3 is more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein.

BackgroundPatients with rheumatoid arthritis (RA) have a 1.5–2.0 fold higher risk of developing congestive heart failure than the general population. Small increases in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels predict...

Aim. To assess the state of the glomerular and tubulointerstitial apparatus depending on the level of the N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertension (HTN).Material and methods. The study included 119 patients with stage I-II HTN (target organ damage classification). We determined the cystatin C level, glomerular filtration rate (GFF) using the CKD-EPI equation, neutrophil gelatinase‐associated lipocalin (NGAL) and NT-proBNP levels; echocardiography and sphygmoplethysmography was performed. In the first analysis, patients were divided into two groups depending on the NT-proBNP level. Group 1 (n=32) consisted of patients with NTproBNP level &gt;125 pg/ml, group 2 (n=87) — with NT-proBNP level &lt;125 pg/ml. Empirically, the NT-proBNP cutoff point (75 pg/ml) was found to assess the role of cystatin C. The first group included 41 patients with NT-proBNP level &gt;75 pg/ml, the second group — 78 patients with NT-proBNP level &lt;75 pg/ml.Results. In the group 1 (NT-proBNP &gt;125 pg/ml) the NGAL concentration was significantly higher than in the group 2: 2,50 [1,90;2,85] vs 1,30 [0,9;2,0] ng/ml, respectively (p=0,022). Patients in the groups did not significantly differ in the cystatin C levels and GFR (p=0,099 and p=0,090, respectively). When dividing patients according to the NT-proBNP cutoff point (75 pg/ml), the following data were obtained. The concentration of cystatin C in the first group with NT-proBNP &gt;75 pg/ml was 1041,50 [995,00;1185,00] vs 964,30 [801,00;1090,00] ng/ml in the second group (p=0,034). Patients in the groups significantly differed in GFR (p=0,027). A correlation analysis revealed a moderate, direct relationship of NT-proBNP with cystatin C (r=0,32; p&lt;0,005) and NGAL levels (r=0,36; p&lt;0,05), as well as a moderate, inverse relationship with GFR (r=-0,35; p&lt;0,005).Conclusion. NT-proBNP determination can be used as an integrative risk stratification tool for glomerular and tubulointerstitial injury in HTN patients.

Background The importance of left ventricle diastolic dysfunction (LVDD) has been recognized widely, as it is well established that heart failure with preserved ejection fraction has a poor prognosis. Furthermore, N-terminal pro–B-type natriuretic peptide (NT-ProBNP) is used as a marker of heart failure. However, the association between LVDD and NT-proBNP is unclear. Purpose The aim of this study was to clarify the association between LVDD and NT-ProBNP. Methods In this study, an index based on gated myocardial perfusion SPECT using CardioREPO software for the diagnosis of LVDD was used. Out of the 171 patients who underwent myocardial perfusion imaging (MPI) between January 2015 and December 2018, 163 individuals (116 men and 47 women) completed MPI and NT-ProBNP. Patients were classified into 4 groups: NT-ProBNP levels below 125 pg/ml (n = 52), NT-ProBNP levels 125 to 400 pg/ml (n = 33), NT-ProBNP levels 400 to 900 pg/ml (n = 23), and NT-ProBNP levels over 900 pg/ml (n = 37). CardioREPO parameters (peak filling rate (PFR), 1/3 mean filling rate (MFR), and time to peak filling rate/R-R (TTPFR)) were compared between the 4 NT-ProBNP groups. Results Of the 163 patients, 55 had LVDD. The PFR and 1/3MFR were associated with LVDD. There was a statistically significant difference in PFR and 1/3 MFR between the NT-ProBNP levels below 125 pg/ml group and the NT-ProBNP levels 400 to 900 pg/ml group (PFR = 2.51+/-1.11 vs. 1.80+/-0.65, p = 0.001; 1/3 MFR = 1.41+/-0.55 vs. 1.06+/-0.47, p = 0.006, Table). Conclusions The MPI indices obtained by CardioREPO software were useful in the diagnosis of LVDD. The evaluation of LVDD by MPI correlated with NT-Pro BNP level is thought to have a clinical utility in the diagnosis and management of LVDD. Variable: NT-ProBNP 0-125 (n = 52) 125-400 (n = 33) 400-900 (n = 23) 900- (n = 37) p Age 66 ± 11 72 ± 11 68 ± 17 70 ± 12 0.133 Male 40 (77%) 22 (12%) 18 (78%) 23 (62%) 0.36 Left ventricular diastolic dysfunction 8 (15%) 4 (12%) 10 (43%) 27 (73%) &amp;lt;0.001 E/A 0.9 ± 0.3 0.8 ± 0.2 1.1 ± 0.7 1.4 ± 0.9 (35) &amp;lt;0.001 E/e" 10.27 ± 3.69 (20) 8.83 ± 3.56 (10) 12.46 ± 3.75 (12) 20.25 ± 8.30 (25) &amp;lt;0.001 rest-PFR /s 2.51 ± 1.11 2.06 ± 0.58 2.16 ± 0.65 1.80 ± 0.65 0.001 rest-1/3 MFR /s 1.41 ± 0.55 1.19 ± 0.41 1.16 ± 0.50 1.06 ±0.47 0.008 rest-TTPFR ms 177 ± 53 181 ± 69 198 ± 80 166 ± 85 0.38 rest-TTPFR / R-R 0.19 ± 0.06 0.20 ± 0.11 0.21 ±0.09 0.21 ± 0.15 0.92

Increased concentrations of B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (HsTnI) in COVID-19 patients have already been reported. The aim of this study is to evaluate which of these common markers of cardiac disease is the most useful predictor of fatal outcome in COVID-19 patients. One hundred and seventy-four patients affected with COVID-19 were recruited, and markers of cardiac disease and the clinical history of the patients were collected at admission in the infectious disease unit or intensive care unit. NT-proBNP, BNP and HsTnI values were higher in in-hospital non-surviving patients. Receiver operating characteristic (ROC) curve analysis of NT-proBNP, BNP and HsTnI was performed, with NT-proBNP (AUC = 0.951) and HsTnI (AUC = 0.947) being better performers (p = 0.01) than BNP (AUC = 0.777). Logistic regression was performed assessing the relation of HsTnI and NT-proBNP to fatal outcome adjusting for age and gender, with only NT-proBNP being significant. The population was then divided into two groups, one with higher NT-proBNP values at admission than the cut-off resulted from the ROC curve (511 ng/L) and a second one with lower values. The Kaplan–Meier analysis showed an absence of fatal outcome in the group of patients with NT-proBNP values lower than the cut-off (p < 0.001). NT-proBNP proved to be the best prognostic tool for fatal outcome among markers of cardiac disease in COVID-19 patients.

BackgroundSubclinical myocardial injury, as measured by high‐sensitivity cardiac troponin T (hsTnT), and myocardial stress, as measured by N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), are related to glycemic control in patients with type 2 diabetes mellitus, and are strong predictors of adverse cardiovascular outcomes. We sought to determine whether antihyperglycemic therapy improves measures of myocardial injury and myocardial stress in patients with type 2 diabetes mellitus.Methods and ResultsWe randomized, in a 2×2 factorial fashion, 438 patients with type 2 diabetes mellitus to insulin glargine, metformin, the combination, or placebo and measured changes in NT‐proBNP and hsTnT after 12 weeks of therapy. At baseline, the median (Q1–Q3) plasma concentration was 35.4 (15.7–86.3) ng/L for NT‐proBNP and 6.7 (4.6–10.1) ng/L for hsTnT. The adjusted (95% confidence interval) change in NT‐proBNP concentration was 20.7% (7.9–35.0) in the insulin arm compared with 0.13% (−10.8 to 12.5) in the no‐insulin arm (P=0.03 for comparison). These changes were not related to changes in fasting or postprandial glucose, glycated hemoglobin, weight, blood pressure, or inflammation. In the metformin arm, the adjusted change in NT‐proBNP was 7.8% (−3.7 to 20.7) compared with 13.0% (0.72–26.8) in the no‐metformin arm (P=0.58). No significant changes in hsTnT concentrations were observed for any of the treatment arms.ConclusionsInsulin glargine was associated with a significant 20.7% increase in NT‐proBNP, a marker of myocardial stress, after 12 weeks of therapy. No change in hsTnT, a marker of myocardial injury, was observed. The changes were independent of substantial improvements in glucose control.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00366301.

Objective To explore the clinical significance and correlation of serum amino terminal pro brain natriuretic peptide (NT Pro BNP),C-reaction protein (CRP) and the D-Dimer levels in patients of the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with pulmonary hypertension(PH).Methods One hundred and twenty six patients with AECOPD were measured pulmonary artery systolic pressure (PASP) by echocardiography.They were divided into 3 groups according to PASP:control group (＜40 mmHg) 45 cases,mild PH group (40～60 mmHg) 47 cases and mederate-severe PH group (＞60 mmHg) 34 cases.Serum NT Pro BNP,CRP,D-Dimer levels and arterial blood gas analysis were detected from all the selected patients.Results Serum NT Pro BNP,PCO2,CRP and D-Dimer in AECOPD with mederate-severe PH group [NT-Pro BNP:(1 711.15 ± 437.05) ng/L;PCO2:(47.24±8.60) mmHg;CRP:(25.53±1.73) mg/L;D-Dimer:(648.88±618.37) μg/L]were significantly higher than the control ones [NT-Pro BNP:(221.78±63.62) ng/L;PCO2:(40.04±6.83) mmHg;CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L](t =-4.005,-3.880,-3.094,-4.073; P ＜0.05) ;while PO2 [arterial partial pressure of oxygen:(59.43 ± 16.49) mmHg]were significantly lower than the control ones (71.28±15.16) mmHg (t =3.276; P ＜0.05).Serum NT-Pro BNP,PCO2 in AECOPD with mederate-severe PH group [NTPro BNP:(1 711.15 ±437.05) ng/L; PCO2:(47.24 ± 8.60) mmHg] ; were significantly higher than the mild PH ones [NT Pro BNP:(583.77±213.98) ng/L;PCO2:(40.85±8.96) mmHg](t =-3.069,-3.442; P ＜0.05) ;while PO2 (59.43 ± 16.49)] mmHg were significantly lower than the mild PH group ones (66.81 ±16.22) mmHg (t =2.061; P ＜0.05).Serum CRP and the D-Dimer levels in mild PH group [CRP:(17.55 ±4.17) mg/L;D-Dimer:(501.61±218.71) μg/L] were significantly higher than the control ones [CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L](t =-1.452,-2.551; P ＜ 0.05).NT-Pro BNP was observered a significant positive linear relationship between PASP (r =0.346,t =4.11,P ＜0.01) and PCO2(r =0.336,t =3.97,P ＜0.01)).We also found that PCO2,CRP,D-Dimer levels have a significant positive linear relationship between PASP(r =0.389,t =4.70; r 0.245,t =2.81; r =0.349,t=4.15; P＜0.05),whilePO2 was negatively correlated withPASP (r=-0.262,t=3.02,P ＜ 0.05).Conclusions Serum NT-Pro BNP,CRP and D-Dimer levels are closely related to the PASP,and can be used as indicators to judge the severity of PH in of AECOPD patients. Key words: Chronic obstructive pulmonary disease; Pulmonary hypertension; N-terminal pro-brain natriuretic peptide ; C-reaction protein ; D-Dimer