Urinary NT-proBNP Level: Relationship With Ventricular Function Parameters in Heart Failure (original) (raw)
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NT-proBNP and echocardiographic parameters in patients with acute heart failure
Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové, 2007
The aim of this study was to analyse the relation between clinical, haemodynamic and X-ray parameters and plasma NT-proBNP level in pts with symptoms of left ventricular dysfunction. The plasma NT-proBNP levels, chest x-ray, transthoracic 2-d and Doppler echocardiography were performed at the time of admission in a group of 96 consecutive patients (mean age 68 +/- 11 years) with symptoms of acute heart failure. NT-proBNP levels were assessed with the use of commercial tests (Roche Diagnostics). All patients have significant increase in NT-proBNP (8000 +/- 9000 pg/mL vs. controls 90 +/- 80 pg/mL, p < 0.001). The group of all patients has shown a significant increase in cardiothoracic ratio (CTR, 0.6 +/- 0.1, vs. 0.4 +/- 0.1, p < 0.001), left atrium diameter (LAD, 4.4 +/- 0.8 cm, vs.3.5 +/- 0.4 cm, p < 0.01). Left ventricular ejection fraction (LVEF) was decreased (37 +/- 15%, vs. 64 +/- 5%, p < 0.001). In patients with acute heart failure, NT-proBNP significantly correlat...
Heart, 2007
Objectives: To examine N-terminal pro-brain natriuretic peptide (NT-proBNP) variability in plasma and urine samples of patients with stable heart failure (HF) during a 24-month follow-up. Design: Prospective study. Setting: Teaching hospital based study. Patients: 74 clinically and functionally stable patients (NYHA class 2¡0.5) out of 114 patients diagnosed with HF were followed up, and NT-proBNP plasma and urine levels were measured at baseline, 12 and 24 months. Results: Significant differences in mean urinary levels (p,0.01) were found during follow-up, but no changes were found in plasma. Bland-Altman plots showed few variations in plasma percentages in the three intervals (stage I-basal; stage II-stage I; stage II-basal) with a coefficient of reproducibility (CR) of 22%, 21% and 25%, respectively. Changes in NT-proBNP urinary levels had a CR of 7.1%, 6.8% and 9.4% at the three intervals, respectively. A good correlation was found between plasma and urinary levels of NT-proBNP (p,0.001) and between the different NT-proBNP plasma (p,0.001) and urine measurements (p,0.001). Conclusions: NT-proBNP plasma and urine levels show good stability in a 24-month follow-up of patients with stable heart failure. Thus, assessment of urinary and plasma NT-proBNP concentrations may be a useful tool for monitoring patients with HF during follow-up. The results suggest that variations in peptide concentrations exceeding 22% in plasma and 7% in urine in a 12-month follow-up and 25% and 9% in a 24month follow-up may indicate pathophysiological changes.
Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia, 2006
We investigated the performance of brain natriuretic peptides (BNP and NT-proBNP) in detecting various degrees of left ventricular systolic dysfunction. The NT-proBNP assay (Roche) and the BNP assay (Bayer Shionoria) were performed in 46 patients (mean age 50 years; range 20-79 years) with various types of heart disease (chronic heart failure due to coronary artery disease, cardiomyopathy, acquired valve disease, congenital heart diseases) and different impairment of left ventricular systolic dysfunction was assessed by echocardiography. Patients were divided into four groups according to the left ventricular ejection fraction (LVEF) correlated with clinical severity. Significant differences in medians of NT-proBNP and BNP values between all groups were determined (P= 0.0161 for NT-proBNP and P=0.0180 for BNP). For identifying patients with severe systolic dysfunction (LVEF<40%), receiver operating characteristic (ROC) analysis for both BNP and NT-proBNP was performed. The diagno...
Heart, 2007
Objectives: To examine N-terminal pro-brain natriuretic peptide (NT-proBNP) variability in plasma and urine samples of patients with stable heart failure (HF) during a 24-month follow-up. Design: Prospective study. Setting: Teaching hospital based study. Patients: 74 clinically and functionally stable patients (NYHA class 2¡0.5) out of 114 patients diagnosed with HF were followed up, and NT-proBNP plasma and urine levels were measured at baseline, 12 and 24 months. Results: Significant differences in mean urinary levels (p,0.01) were found during follow-up, but no changes were found in plasma. Bland-Altman plots showed few variations in plasma percentages in the three intervals (stage I-basal; stage II-stage I; stage II-basal) with a coefficient of reproducibility (CR) of 22%, 21% and 25%, respectively. Changes in NT-proBNP urinary levels had a CR of 7.1%, 6.8% and 9.4% at the three intervals, respectively. A good correlation was found between plasma and urinary levels of NT-proBNP (p,0.001) and between the different NT-proBNP plasma (p,0.001) and urine measurements (p,0.001). Conclusions: NT-proBNP plasma and urine levels show good stability in a 24-month follow-up of patients with stable heart failure. Thus, assessment of urinary and plasma NT-proBNP concentrations may be a useful tool for monitoring patients with HF during follow-up. The results suggest that variations in peptide concentrations exceeding 22% in plasma and 7% in urine in a 12-month follow-up and 25% and 9% in a 24month follow-up may indicate pathophysiological changes.
Dialysis & Transplantation, 2007
OBJECTIVETo determine the association of plasma amino terminal pro-brain natriuretic peptide (NT-proBNP) level with left ventricle hypertrophy (LVH) among hemodialysis (HD) patients.To determine the association of plasma amino terminal pro-brain natriuretic peptide (NT-proBNP) level with left ventricle hypertrophy (LVH) among hemodialysis (HD) patients.METHODSWe evaluated 65 patients on maintenance HD (28 women, 37 men) treated thrice weekly by low-flux hollow-fiber dialyzers for at least 6 months. Patients were divided into 2 groups according to whether they had LVH. NT-proBNP concentration of the patients was measured before and after the HD session. Cardiac parameters were detected by echocardiography after the day of HD after the session.We evaluated 65 patients on maintenance HD (28 women, 37 men) treated thrice weekly by low-flux hollow-fiber dialyzers for at least 6 months. Patients were divided into 2 groups according to whether they had LVH. NT-proBNP concentration of the patients was measured before and after the HD session. Cardiac parameters were detected by echocardiography after the day of HD after the session.RESULTSIn group 1 were the 34 patients who were LVH(−) (19 women and 15 men) and in group 2 were the 31 patients who were LVH(+) (9 women and 22 men). Mean left ventricular posterior wall diameter (LVPWd) was 0.87 ± 0.16 cm in group 1 and 1.28 ± 0.16 cm in group 2 (p < .001). Men were predominant in group 2 (p = .029). The patients in group 2 were older than those in group 1 (p = .033). There were no significant differences between the groups in pre-HD and post-HD NT-proBNP levels (p = .163 and p = .327, respectively). We did not find any significant relationship between mean concentration of pre-HD NT-proBNP and LVPWd (r = 0.064, p = 0.612). A positive correlation was found between mean concentration of pre-HD NT-proBNP with age (r = 0.281, p = 0.023), MAP (r = 0.469, p < 0.001), and left atrial diameter (r = 0.322, p = 0.009).In group 1 were the 34 patients who were LVH(−) (19 women and 15 men) and in group 2 were the 31 patients who were LVH(+) (9 women and 22 men). Mean left ventricular posterior wall diameter (LVPWd) was 0.87 ± 0.16 cm in group 1 and 1.28 ± 0.16 cm in group 2 (p < .001). Men were predominant in group 2 (p = .029). The patients in group 2 were older than those in group 1 (p = .033). There were no significant differences between the groups in pre-HD and post-HD NT-proBNP levels (p = .163 and p = .327, respectively). We did not find any significant relationship between mean concentration of pre-HD NT-proBNP and LVPWd (r = 0.064, p = 0.612). A positive correlation was found between mean concentration of pre-HD NT-proBNP with age (r = 0.281, p = 0.023), MAP (r = 0.469, p < 0.001), and left atrial diameter (r = 0.322, p = 0.009).CONCLUSIONAlthough increased serum levels of NT-proBNP in HD patients was found to be related to LAd, an indicator of hypervolemia, there was no association between NT-proBNP and LVH. Elevation of NT-proBNP is affected by multiple factors such as age, sex, arterial blood pressure, and dialyzer membrane.Although increased serum levels of NT-proBNP in HD patients was found to be related to LAd, an indicator of hypervolemia, there was no association between NT-proBNP and LVH. Elevation of NT-proBNP is affected by multiple factors such as age, sex, arterial blood pressure, and dialyzer membrane.
European Journal of Heart Failure, 2004
Background: Measurement of brain natriuretic peptide (BNP) has become a potent diagnostic aid as a means of identifying patients with systolic or diastolic dysfunction. Due to better stability in circulating blood, we reasoned that measurement of Nterminal proBNP (NT-proBNP) may be a more discerning marker for the detection and evaluation of chronic heart failure. Methods: The relationships between plasma concentrations of NT-proBNP and BNP, and aetiology, New York Heart Association (NYHA) classification, and left ventricular ejection fraction (LVEF) were analyzed in 105 patients with chronic heart failure. Sixty-seven healthy volunteers were studied as the controls. Results: Both NT-proBNP and BNP showed progressive increases (P-0.001) in proportion to the NYHA classification; the increment of NT-proBNP was larger than that of BNP. Elevated NT-proBNP significantly correlated with BNP (rs0.737, P-0.001). Receiver operating characteristics analysis to detect LVEF-40% showed similar values (area under the curve, AUC: NT-proBNP 0.754 vs. BNP 0.770), however, AUC to detect LVEF-50% tended to be greater for NT-proBNP than that for BNP (NT-proBNP 0.820 vs. BNP 0.794). Conclusion: NT-proBNP may be a more discerning marker for the detection and evaluation of heart failure than BNP.
Diagnostic Values of Plasma, Fresh and Frozen Urine NT-proBNP in Heart Failure Patients
Journal of cardiovascular and thoracic research, 2014
The plasma N-terminal probrain natriuretic peptide (NT-proBNP) level is an important diagnostic and prognostic marker of heart failure. Recent studies have suggested urinary NT-proBNP as a new and simple test for diagnosis of heart failure. We aim to compare diagnostic value of plasma, fresh and frozen urine levels of N-terminal probrain natriuretic peptide (NT-proBNP) for detecting heart failure. Between January 2010 and January 2012, we measured urine and plasma levels of NTproBNP in 98 patients with chronic heart failure (CHF) and 29 age- and sex-matched healthy control subjects. There were significant correlations between plasma NT-proBNP and fresh (r=0.45, p<0.001) and frozen (r=0.42, p<0.001) urine NT-proBNP concentrations in CHF patients. Due to receiver operating curve analysis, fresh and frozen urine NT-proBNP could diagnose HF with are aunder curve (AUC) of 0.73±0.04 (p<0.001) and 0.65±0.05 (p=0.01) with sensitivity and specificity of 73.97%, 58.62%, and 65.31%, 6...
2014
Background and aims: N-terminal pro brain natriuretic peptide (NT-proBNP) is known to aid intensive care unit diagnosis of Acutely Heart Failure Syndromes. Our aim was to study the percentage change in Plasma NT-proBNP level following treatment of Acute Heart Failure Syndromes and to establish time basis for measuring the second Plasma NT-proBNP. Methodology: This study was conducted in 36 patients admitted with Acute Heart Failure Syndromes in Dr B R A M Hospital and Pt J N M Medical College. All the patients underwent comprehensive clinical evaluation and necessary investigations. Plasma NT-proBNP analysis was done twice in each patient, initially at the time of admission and later either at 72 hrs if patient had improved or else at the time of discharge. Results: In our study, 22 (61.12%) patients showed more than 50% decrease in NT-proBNP values after treatment. While 5 (13.88%) patients showed 30-50% decrease in NT-proBNP values. Remaining 9(25%) patients showed less than 30% c...