N‐terminal prohormone B‐type natriuretic peptide (NT‐proBNP) is an important biomarker of prognosis in heart failure and single valve disease. There are limited studies of complex valve disease. Patients with complex valve disease adopt a sedentary lifestyle, so symptoms may be difficult to detect. The authors aimed to determine whether NT‐proBNP correlates with the severity of the valve lesion and underlying cardiac function and whether resting NT‐proBNP predicts impaired peak VO2 in patients with complex valve disease. Forty‐five patients with complex moderate to severe stenosis or regurgitation of the heart valves underwent a clinical assessment, echocardiography, resting NT‐proBNP assessment, and formal cardiopulmonary exercise testing. In a multivariate analysis, the log NT‐proBNP (β=−9.3, SE=1.9, P<.0001) and lean body weight (β=0.59, SE=0.22, P=.01) were dominant independent predictors of peak VO2. An NT‐proBNP value of 84 pmol/L had 77% sensitivity and 70% specificity to predict impaired functional capacity, peak VO2 <60% (predicted), area under the curve=0.80. Resting NT‐proBNP was the best predictor of peak VO2 in patients with complex valve disease, while symptoms and ejection fraction are a less reliable guide. Congest Heart Fail. 2010;16:50–54. © 2009 Wiley Periodicals, Inc.
Background: Coronary artery disease (CAD) is the most common cause of sudden cardiac death (SCD) in Australians aged <40 years. The relevance of post-mortem lipid levels in this setting is currently unknown. Aim: We investigated post-mortem lipid levels in consecutive decedents with a spectrum of CAD in whom a coronial inquest was performed to elucidate a cause of death between 2006 and 2009. Methods: Seventy-two decedents aged 39 ± 7 years (range 18-49 years) and 92% males were investigated. Decedents either had obstructive CAD (>70% stenosis, n = 51), non-obstructive CAD (<70% stenosis, n = 15) or normal coronary arteries (n = 6). The post-mortem concluded that CAD was the cause of death in all cases of obstructive CAD, where as CAD was unrelated to the cause of death in non-obstructive cases or where there were normal coronary arteries. Post-mortem blood samples were analysed for total cholesterol, apolipoprotein B (ApoB), high-density lipoprotein (HDL), apolipoprotein AI (ApoAI), lipoprotein(a), cotinine, HbA1c and C-Reactive Protein (CRP). Results: Post-mortem ApoB (1.33 ± 0.5 vs 1.04 ± 0.39 g/L, p = 0.04) and total cholesterol levels (7.98 ± 2.7 vs 5.67 ± 2.39 mmol/L, p = 0.002) were significantly higher in decedents with obstructive CAD compared with non-obstructive CAD. ApoB levels were also significantly elevated when decedents with obstructive CAD were compared to decedents with normal coronary arteries (1.32 ± 0.5 vs 0.87 ± 0.39 g/L, p = 0.04). There were no significant differences in HDL, ApoAI, lipoprotein(a), cotinine, HbA1c and CRP between groups. Conclusions: Post-mortem ApoB and total cholesterol levels may provide insights into mechanisms associated with fatal premature CAD and have implications for screening of first-degree relatives.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.