Aminoterminal pro type B natriuretic peptide as a predictive and prognostic marker in patients with chronic heart failure

Rothenburger, Markus; Wichter, Thomas; Schmid, Çhristof; Stypmann, Jörg; Tjan, T. D. T.; Berendes, Elmar; Etz, Christian D.; Pioux, Aurélien; Löher, Andreas; Wenzelburger, Frauke; Drees, G.; Hoffmeier, A.; Breithardt, G.; Scheld, Hans H.

doi:10.1016/j.healun.2004.07.006

Cited by 65 publications

(41 citation statements)

References 40 publications

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“…In one patient there was a decrease in EF from 48 to 38% and an increase in natriuretic peptides to levels compatible with heart failure NYHA functional class III [39] after 3 months of treatment (serum NT-proBNP increased from 287 to 1,974 pg/mL). Thus as a clinical implication attention might in some cases be paid to the possibility of decreased heart function in the initial phase of treatment.…”

Section: Discussionmentioning

confidence: 96%

Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides

et al. 2010

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Long-term treatment of acromegaly prevents aggravation and reverses associated heart disease. A previous study has shown a temporary increase in serum levels of the N-terminal fraction of pro B-type natriuretic peptide (NT-proBNP) suggesting an initial decline in cardiac function when treatment of acromegaly is initiated. This was a three months prospective study investigating short-term cardiac effects of treatment in acromegalic patients. Cardiac function was evaluated by the gold standard method cardiac magnetic resonance imaging (CMRI) and circulating levels of B-type natriuretic peptides (BNP and NT-proBNP). CMRI was performed at baseline and after 3 months of treatment. Levels of IGF-I, BNP and NT-proBNP were measured after 0, 1, 2 and 3 months. Eight patients (5 males and 3 females, mean age 53 ± 12 years (range 30-70)) and 8 matched healthy control subjects were included. Median IGF-I Z-score decreased from 4.5 (range 2.5-6.4) to 2.3 (-0.1 to 3.3). At baseline the patients had increased left ventricle mass index (LVMI) compared to control subjects (ΔLVMI 35 g/m(2) (95% CI 8-63 g/m(2), P = 0.016). After 3 months of treatment there was an increase in end-diastolic volume index EDVI (ΔEDVI 9 mL/m(2) (95% CI 3-14), P = 0.007) and an increase in levels of BNP (median (ranges) 7 (0.58-286) vs. 20 (1-489) pg/mL, P = 0.033) and of NT-proBNP (63 (20-1004) vs. 80 (20-3391) pg/mL, P = 0.027). Assessed by the highly sensitive and precise CMRI method, 3 months treatment of acromegaly resulted in an increase in EDVI, and increased levels of BNP and NT-proBNP suggesting an initial decrease in cardiac function.

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Section: Discussionmentioning

confidence: 96%

Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides

et al. 2010

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“…22 Nowadays, the levels of BNP or NT-pro-BNP and their reactions to therapy can also be taken into consideration as predictors of a poor prognosis, although large studies are lacking. 23,24 The timing of evaluation is an important aspect of the risk assessment in heart failure patients. It will be clear that the risk score is considerably worse in severely congested patients and can be improved by increasing the medication.…”

Section: Guidelines For Heart Transplantationmentioning

confidence: 99%

Guidelines for heart transplantation

Jonge

Kirkels

Klöpping

et al. 2008

NHJL

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Based on the changes in the field of heart transplantation and the treatment and prognosis of patients with heart failure, these updated guidelines were composed by a committee under the supervision of both the Netherlands Society of Cardiology and the Netherlands Association for Cardiothoracic surgery (NVVC and NVT).THE INDICATION FOR HEART TRANSPLANTATION IS DEFINED AS: 'End-stage heart disease not remediable by more conservative measures'.CONTRAINDICATIONS ARE: irreversible pulmonary hypertension/elevated pulmonary vascular resistance; active systemic infection; active malignancy or history of malignancy with probability of recurrence; inability to comply with complex medical regimen; severe peripheral or cerebrovascular disease and irreversible dysfunction of another organ, including diseases that may limit prognosis after heart transplantation.Considering the difficulties in defining end-stage heart failure, estimating prognosis in the individual patient and the continuing evolution of available therapies, the present criteria are broadly defined. The final acceptance is done by the transplant team which has extensive knowledge of the treatment of patients with advanced heart failure on the one hand and thorough experience with heart transplantation and mechanical circulatory support on the other hand. (Neth Heart J 2008;16:79-87.).

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“…The increase was stopped when the morning resting heart rate was 55 to 60 times per min. The dose was reduced when fluid retention occurred or heart failure worsened [3].…”

Section: Treatment Protocolmentioning

confidence: 99%

“…In support of these hypotheses, poor heart failure outcomes are linked to elevated serum levels of biomarkers of myocardial stress and inflammation, including cardiac hormones and pro-inflammatory mediators [2][3][4][5]. In addition to optimal biomarkers, BNP may be one of biomarkers seen with myocardial stress in patients with HF [6,7].…”

mentioning

confidence: 97%

Clinical implications of normal B-type natriuretic peptide levels in patients with severe chronic heart failure

Gao

Guo

et al. 2014

Asian Biomedicine

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Background: High plasma B-type natriuretic peptide (BNP) levels in patients with severe chronic heart failure (CHF) often indicate poor ventricular function and poor prognosis. However, in some such patients plasma BNP levels are normal. Objective: To investigate the clinical implications of BNP levels in patients with severe CHF. Methods: Fifty-seven patients with severe CHF were divided into group A (13 normal plasma BNP level) and 44 patients (high plasma BNP levels) group B. Diuretics, angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonist, e.g., metoprolol) and digitalis were used as conventional treatment. The clinical characteristics of all patients in two groups were analyzed and compared. Results: At the first admission, left ventricular end diastolic diameter in group B was significantly lower than group A (p < 0.05), and the plasma BNP level in group B was significantly higher than group A (p < 0.05). When metoprolol was used, 6 and 5 patients in group A and B could not tolerate the initial dose. In other cases using metoprolol at average maximum tolerance dose of metoprolol 12.5 6.25 and 24.20 11.22 mg/day in group A and B, respectively, there was a significant difference between them (p < 0.05). There were no significant differences in plasma BNP levels between two groups during stable period. The plasma BNP level in group B during acute worsening stage was significantly higher than in the remission stage (962.73 165.00 ng/L vs 876.24 167.70 ng/L, p < 0.05). However, there was no significant difference between group A (74.03 11.18 ng/L) and group B (71.38 11.68 ng/L) (p > 0.05). The mobility of group A was higher than group B (11/12 vs 6/44, p < 0.05). Logistic regression analysis showed that, the plasma BNP level was the independent risk factor for predicting cardiac death (regression coefficient, 3.817; OR, 45.488; 95% CI, 5.322"388.791). Conclusion: In patients with severe CHF, normal plasma BNP level suggests depletion of BNP secretion and further deterioration of cardiac function, indicating a poor prognosis.

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Aminoterminal pro type B natriuretic peptide as a predictive and prognostic marker in patients with chronic heart failure

Cited by 65 publications

References 40 publications

Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides

Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides

Guidelines for heart transplantation

Clinical implications of normal B-type natriuretic peptide levels in patients with severe chronic heart failure

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