Role of BNP Levels on the Prognosis of Decompensated Advanced Heart Failure

Pereira-Barretto, Antônio Carlos; Carlo, Carlos Henrique Del; Cardoso, Juliano Novaes; Ochiai, Marcelo Eidi; Lima, Marcelo; Curiati, Milena Cardoso; Scipioni, Airton R.; Ramires, José Antônio Franchini

doi:10.5935/abc.20130066

Cited by 9 publications

(9 citation statements)

References 11 publications

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“…When the study population was divided into two groups on the basis of in-hospital mortality, the lymphocyte count was lower while the WBC count, neutrophil count, and N/L ratio were higher, on admission. In this study, the mortality rate was higher compared to results of the previous similar studies [22,24,29]. Some of the possible explanations for this issue could be increased age of our study population (mean age 63.4 ± 14.9 years old), worst functional status of the patients (all the patients were NYHA Class IV), and ischemic etiology as the underlying pathology in most of the patients (77%).…”

Section: Discussioncontrasting

confidence: 55%

“…Some of the possible explanations for this issue could be increased age of our study population (mean age 63.4 ± 14.9 years old), worst functional status of the patients (all the patients were NYHA Class IV), and ischemic etiology as the underlying pathology in most of the patients (77%). Pereira-Barretto et al recently published their inhospital mortality rate as 16% in a similar study group consisting of patients with advanced heart failure (NYHA Class III/IV, mean LVEF 26%) [29]. After the infusion of levosimendan, a significant increase in the lymphocyte count and significant decreases in the neutrophil count and N/L ratio were observed only in patients who recovered (group 2) after the infusion of levosimendan.…”

Section: Discussionmentioning

confidence: 95%

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Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

Taşal

Ertürk

Uyarel

et al. 2014

Journal of Cardiology

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 95%

Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

Taşal

Ertürk

Uyarel

et al. 2014

Journal of Cardiology

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“…These findings show us that physicians used to treating HF can most often prescribe and achieve the target doses of drugs of proven efficacy in HF 2,9 . It also showed that Chagas disease, probably due to higher cardiac impairment and clinical forms, makes it difficult to achieve the target doses of these drugs 19,20 . The higher degree of involvement and nonprescription / no tolerance to target doses may explain the worse outcomes in patients with this disease when they have HF 19,20 .…”

Section: Resultsmentioning

confidence: 99%

Optimized Treatment and Heart Rate Reduction in Chronic Heart Failure

Moreno¹,

Carlo²,

Pereira-Barretto³

2013

Arquivos Brasileiros De Cardiologia

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BackgroundHeart failure (HF) is a syndrome that leads to poor outcome in advanced forms. The neurohormonal blockade modifies this natural history; however, it is often suboptimal. ObjectiveThe aim of this study is to assess at what percentage cardiologists used to treating HF can prescribe target doses of drugs of proven efficacy. MethodsA total of 104 outpatients with systolic dysfunction were consecutively enrolled, all under stabilized treatment. Demographic and treatment data were evaluated and the doses achieved were verified. The findings are shown as percentages and correlations are made between different variables. ResultsThe mean age of patients was 64.1 ± 14.2 years, with SBP =115.4 ± 15.3, HR = 67.8 ± 9.4 bpm, weight = 76.0 ± 17.0 kg and sinus rhythm (90.4%). As for treatment, 93.3% received a RAS blocker (ACEI 52.9%), all received beta-blockers (BB), the most often prescribed being carvedilol (92.3%). As for the doses: 97.1% of those receiving an ARB were below the optimal dose and of those who received ACEI, 52.7% received an optimized dose. As for the BB, target doses were prescribed to 76.0% of them. In this group of patients, most with BB target dose, it can be seen that 36.5% had HR ≥ 70 bpm in sinus rhythm. ConclusionCardiologists used to treating HF can prescribe target doses of ACEI and BB to most patients. Even though they receive the recommended doses, about one third of patients persists with HR > 70 bpm and should have their treatment optimized.

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“…The BNP dose during hospitalization for prognosis assessment would be significant with a longer follow-up, 28) which was not evaluated in this work. Miyata, et al 29) conducted a prospective multicenter study to confirm the results of thermotherapy using laboratory markers.…”

Section: Discussionmentioning

confidence: 99%

Thermal Vasodilation Using a Portable Infrared Thermal Blanket in Decompensated Heart Failure

et al. 2014

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SummaryAdjunctive and non-pharmacological therapies, such as heat, for the treatment of heart failure patients have been proposed. Positive results have been obtained in clinically stable patients, but no studies of the use of thermal therapy in patients with decompensated heart failure (DHF) have been reported. An open randomized clinical trial was designed in patients with DHF and controls. We studied 38 patients with a mean age of 56.9 years. A total of 86.8% were men, and 71% had nonischemic myocardiopathy. All participants were using dobutamine, and the median brain natriuretic peptide (BNP) level was 1396 pg/mL. An infrared thermal blanket heated the patients, who were divided into 2 groups: group T (thermal therapy) and group C (control). Group T underwent vasodilation using the thermal blanket at 50°C for 40 minutes in addition to drug treatment. The cardiac index increased by 24.1% (P = 0.009), and systemic vascular resistance decreased by 16.0% in group T (P < 0.024) after thermal therapy. Heat as a vasodilator increased the cardiac index and lowered systemic vascular resistance in DHF patients. These data suggest thermal therapy as a therapeutic approach for the adjuvant treatment of DHF patients. (Int Heart J 2014; 55: 433-439)

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Role of BNP Levels on the Prognosis of Decompensated Advanced Heart Failure

Abstract: In advanced HF, high BNP levels identified patients at higher risk of a poorer outcome. Chagasic patients showed higher BNP levels than those with heart diseases of other causes, and have poorer prognosis.

Cited by 9 publications

References 11 publications

Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

Optimized Treatment and Heart Rate Reduction in Chronic Heart Failure

Thermal Vasodilation Using a Portable Infrared Thermal Blanket in Decompensated Heart Failure

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