Objective To investigate the predictive value of B-type natriuretic peptide (BNP) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by right heart failure (RHF).

Methods This study selected AECOPD patients admitted to Jiangyin Hospital Affiliated to Nantong University and Nanjing Chest Hospital from January 2022 to January 2024 as objects. According to the inclusion and exclusion criteria, 122 patients were ultimately enrolled. The patients were divided into observation group (AECOPD with RHF, n=72) and control group (AECOPD without RHF, n=50) based on whether they had RHF. Differences in various indicators between the two groups were compared, and the predictive value of BNP for AECOPD patients with RHF was assessed through Logistic regression analysis and receiver operating characteristic (ROC) curves. The cut-off value of BNP was determined using the ROC curve.

Results Statistically significant differences were observed between the two groups in terms of gender, body temperature, albumin, blood glucose, chloride ions, pulmonary artery pressure (PAP), and BNP levels(P < 0.05). Logistic regression analysis showed that BNP was an independent predictor for AECOPD patients with RHF (OR=1.03; 95%CI, 1.01 to 1.04; P < 0.05). The ROC curve results indicated that when the BNP cut-off value was 83.5 pg/mL, the sensitivity was 0.820, the specificity was 0.972, and the Youden index was 0.792. The area under the curve for BNP was 0.875 (95%CI, 0.800 to 0.949, P < 0.001). When the BNP level in AECOPD patients exceeded 83.5 pg/mL, the incidence of RHF significantly increased.

Conclusion Patients with AECOPD complicated by RHF have higher plasma BNP levels than those without RHF, and BNP has significant predictive value for determining whether AECOPD patients have RHF.