ICMR domestically. Plasma BNP is a non-invasive biomarker to

ICMR STS PROJECT FORMAT

 

1. REFERENCE ID: 2018-01743

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2. TITLE:

A CORRELATION BETWEEN
PLASMA BRAIN NATRIURETIC PEPTIDE LEVELS AND CARDIOVASCULAR MORBIDITY IN
PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

 

3. INTRODUCTION:

 

Chronic Obstructive
Pulmonary Disease (COPD) is among the top five leading causes of death worldwide
1. COPD makes up 42% of the annual mortalities due to non-communicable
diseases, only behind cardiovascular conditions in that regard. COPD is a broad
term used to describe progressive lung diseases such as emphysema, chronic
bronchitis and non-reversible asthma.

COPD is characterized by
persistent airflow limitation that is typically progressive and associated with
an enhanced chronic inflammatory reaction in the airways and lung tissue in
response to harmful particles or gases 2. The chronic airflow limitation in
COPD is caused by the combination of parenchymal destruction (emphysema) and
small airways disease (obstructive bronchiolitis), of which the relative
presence varies from person to person 2.

Due to the size and varied
nature of the Indian population, the frequency of COPD in India has not been
well studied. A few studies carried out by Murthy & Sastry3 and Jindal4
approximate that the prevalence may average around 5% in adults, with higher
frequencies in males, smokers, varying with living conditions (rural/urban) and
type of fuel used domestically.

Plasma BNP is a non-invasive
biomarker to diagnose and monitor cardiac diseases as well as heart failure 5,
6. It is known that plasma BNP levels are elevated in cor pulmonale patients,
due to right atrial stretch in reply to increased right ventricular afterload
5. Although increased BNP level was reported as a risk factor for death
independent of chronic lung disease 7, few studies have assessed the
prognostic value of BNP for identifying the possibility of progression to
secondary pulmonary hypertension and for determining COPD severity.

After collection of the
required data (plasma BNP values of patients, Spirometry readings, pulmonary
artery systolic pressure PASP from 2D echocardiogram), the research will
compare the measured plasma BNP levels with the PASP values obtained from the
2D-Echocardiogram, as well as with the COPD severity of the patient- according
to the FEV1% values obtained from Spirometry (as per the GOLD
staging system).

Therefore, the aim of the
present study is to investigate the use of plasma BNP levels as a prognostic
marker for COPD progression to cardiovascular conditions, and use it to stage
COPD severity in COPD patients.

 

4. OBJECTIVES OF THE STUDY:

1.     To measure the plasma BNP levels in COPD patients

2.     To
find a correlation between determining
COPD severity and identifying the possibility of progression to secondary
pulmonary hypertension.

3.     To examine the value of plasma BNP levels in COPD patients
to predict severity and staging of COPD (according to the Global Initiative for Chronic
Obstructive Lung Disease classification)

 

5. METHODOLOGY:

v Study
design:  Case control study

v Study
period: 

1.     Period needed for collecting data: 2 months

2.     Period required for analyzing data: 1 month

v Inclusion criteria:

1.    
Patients with stable COPD were
enrolled with a history of smoking, and an FEV1