Contents lists available at ScienceDirect Am J Otolaryngol journal homepage: www.elsevier.com/locate/amjoto NT-pro BNP as a new marker in the investigation of nasal septum deviation impacts on cardiopulmonary functions Bülent Ulusoy a, ⁎ , Abdullah Tunçez b , Osman Gül a , Hüseyin Tezcan b , Ömer Erdur a , Hüsamettin Vatansev c , Esra Paydaş Hataysal c , Muslu Kazım Körez d , Bahar Çolpan a a Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Selçuk University, Konya, Turkey b Department of Cardiology, Faculty of Medicine, Selçuk University, Konya, Turkey c Department of Biochemistry, Faculty of Medicine, Selçuk University, Konya, Turkey d Department of Statistics, Faculty of Science, Selçuk University, Konya, Turkey ARTICLE INFO Keywords: Nasal obstruction Nasal septum Nasal surgery Cardiac failure B-type natriuretic Peptide Pulmonary hypertension 1. Introduction The B-type natriuretic peptide (BNP) is a hormone that is synthe- sized in the cardiac ventricles in response to stretching and/or over- pressure loading of myositis. BNP is an active hormone and the N- terminal part (NT-proBNP) of BNP is the inactive form [1,2]. Both are equally found in plasma and have been reported to provide valuable information about many cardiovascular diseases such as congestive heart failure and acute coronary syndrome [2]. In addition, NT-proBNP has been shown to have a prognostic value in chronic heart failure [1]. In addition to its vasodilator effect, BNP also reduces the proliferation of fibroblast and smooth muscle cells, sympathetic nerve activity, salt and water retention, release of antidiuretic hormones, aldosterone synthesis and release [1,2]. It has been reported that BNP can be a useful marker in determining cardiovascular risk even in people who do not have clinical evidence of cardiovascular disease [2]. Septoplasty is the most common Otorhinolaryngology operation performed in adults with nasal obstruction as its main indication [3,4]. Septal deviation can lead along with chronic upper respiratory ob- struction to chronic alveolar hypoventilation, pulmonary hypertension, and cor pulmonale [4–6]. We aimed to investigate the utility of NT-pro BNP in demonstrating the probable negative effects of markedly septum deviation on cardiac functions. 2. Materials–methods Forty patients with a nasal obstruction for at least 1 year due to markedly nasal septal deviation between the ages of 18–65 were in- cluded in this study as the patient group. The diagnosis of nasal septal deviation was made by anterior rhinoscopy and diagnostic nasal en- doscopy. In addition, paranasal sinus computed tomography (PNCT) imaging was performed to rule out additional pathologies such as chronic sinusitis. Exclusion criteria were determined as; patients aged under 18 and over 65, individuals with a history of rhinological surgery (such as turbinate surgery, and septoplasty), presence of chronic sinu- sitis, other causes of nasal obstruction (such as a nasal polyp, allergic rhinitis, adenoid hypertrophy, and turbinate hypertrophy), presence of sleep apnea symptoms or findings, additional systemic diseases (such as cardiac diseases, acute pulmonary embolism, chronic obstructive pul- monary disease, and hyperthyroidism), and drug use (ACE inhibitors, angiotensin II receptor blockers. and beta-blockers). Forty individuals, similar in terms of age, gender, and body mass index but without nasal obstruction complaints have included as the control group. Approval was obtained from the ethics committee of our hospital. Additionally, informed consent was obtained from all participants. https://doi.org/10.1016/j.amjoto.2020.102671 Received 30 June 2020 ⁎ Correspondence author at: Selçuk University, Faculty of Medicine, Department of Otorhinolaryngology, Konya 42075, Turkey. E-mail address: bulentulusoy@selcuk.edu.tr (B. Ulusoy). Am J Otolaryngol 41 (2020) 102671 0196-0709/ © 2020 Elsevier Inc. All rights reserved. T