Comparable increase of B-type natriuretic peptide and amino-terminal pro-B-type natriuretic peptide levels in patients with severe sepsis, septic shock, and acute heart failure*

Rudiger, Alain; Gasser, S; Fischler, Manuel; Hornemann, Thorsten; Eckardstein, Arnold von; Maggiorini, Marco

doi:10.1097/01.ccm.0000229144.97624.90

Cited by 186 publications

(127 citation statements)

References 33 publications

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“…We found that mortality rate significantly increased when proBNP levels were above 3736 mg/dL. There are many studies in the literature suggesting a direct correlation between proBNP levels and mortality in patients with sepsis (25)(26)(27)(28)(29). Plasma proBNP levels increase with increasing cardiac load and atrial strain; as it would be expected, proBNP levels increase in cases with an increase in the volume load.…”

Section: Discussionsupporting

confidence: 52%

Level of adrenomedullin in cases with adrenal defficiency and its relation to mortality in patients with sepsis

Balcan

Yıldızeli²,

Akbaş³

et al. 2016

Tuberk Toraks

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Section: Discussionsupporting

confidence: 52%

Level of adrenomedullin in cases with adrenal defficiency and its relation to mortality in patients with sepsis

Balcan

Yıldızeli²,

Akbaş³

et al. 2016

Tuberk Toraks

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“…In our study, the median pro-BNP value was found to be 3726 pg/mL in patients discharged from the ICU, and it was observed that mortality significantly increased in patients with pro-BNP value above 7241 pg/mL. In literature review, in the study conducted by Rudriger et al [5], the median pro-BNP value was detected to be 6526 pg/mL, and pro-BNP increased in patients with sepsis and septic shock. In another prospective study, patients monitored in the ICU because of sepsis and septic shock were evaluated, and the median pro-BNP value was found to be 7386 pg/mL in patients discharged from ICU and 13415 pg/mL in exitus patients.…”

Section: Discussionmentioning

confidence: 92%

Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit

et al. 2015

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OBJECTIVES:Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS:Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS:A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8±17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multidrug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16±3.16, median APACHE-II score was 24.9±7.83, and median duration of hospitalization in the ICU was 8.44±11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION:It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.

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“…In addition, severe systemic syndromes, such as sepsis, can produce elevated BNP levels in the absence of CHF. A recent study (32) demonstrated that in 249 critically ill patients, patients with CHF confirmed by invasive hemodynamic measurements had BNP and NT-proBNP levels comparable with those of patients with sepsis, who did not have invasive hemodynamic evidence of CHF.…”

Section: Bnp Versus Nt-probnpmentioning

confidence: 99%

Combining tissue Doppler echocardiography and B-type natriuretic peptide in the evaluation of left ventricular filling pressures: Review of the literature and clinical recommendations

Dokainish¹

2007

Canadian Journal of Cardiology

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Dyspnea is a common presenting symptom in patients seeking medical attention. However, determining the exact cause of dyspnea in a given patient can prove to be difficult, especially in patients with a noncardiac cause of dyspnea in the setting of known cardiac disease. Although invasively measured left ventricular (LV) filling pressure is the reference standard for establishing that pulmonary venous pressure elevation is contributing to symptoms of dyspnea in a given patient, it is not clinically feasible to subject all patients presenting with dyspnea to cardiac catheterization. Therefore, noninvasive methods of estimating LV filling pressures -B-type natriuretic peptide (BNP) measurement and the tissue Doppler (TD)-derived transmitral early diastolic/annular velocity ratio (E/Ea) -have attracted attention. Both BNP and mitral E/Ea possess important strengths and limitations. Therefore, in certain clinical scenarios, combining these indexes is superior to using either in isolation. However, there has been, to date, no clear consensus on the optimal clinical use of BNP and E/Ea in patients presenting with dyspnea. Therefore, the present paper comprehensively reviews the current literature on BNP and E/Ea, and makes clinical recommendations on the optimal use of these variables in patients with dyspnea and suspected congestive heart failure (CHF). A BRIEF HISTORY OF TD IMAGINGTD imaging of the heart is a Doppler technique that measures the frequency of ultrasound returning from moving myocardium to estimate the velocity of the myocardial wall. In 1989, Isaaz et al (1) were the first to describe clinical applications of TD in cardiac disease, demonstrating that low myocardial velocities at the posterior mitral annulus correlated with abnormal posterior wall motion on LV angiography. Gulati et al (2) demonstrated in 1996 that TD systolic mitral annular velocities correlated with global LV ejection fraction (EF), as assessed by radionuclide ventriculography. It was then shown that TD-derived Ea correlated with the invasively measured LV time constant of relation (Tau), establishing Ea as a relatively load-independent measure of myocardial Consequently, mitral E/Ea can help to establish the presence of clinical congestive heart failure in patients with dyspnea. However, E/Ea has a significant 'gray zone', and is not well validated in nonsinus rhythm and mitral valve disease. B-type natriuretic peptide (BNP) is a protein released by the ventricles in the presence of myocytic stretch, and has been correlated to LV filling pressure and, independently, to other cardiac morphological abnormalities. In addition, BNP is significantly affected by age, sex, renal function and obesity. Given its correlation with multiple cardiac variables, BNP has high sensitivity, but low specificity, for the detection of elevated LV filling pressures. Taking into account the respective strengths and limitations of BNP and mitral E/Ea, algorithms combining them can be used to more accurately estimate LV filling pressures in patients presenti...

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Comparable increase of B-type natriuretic peptide and amino-terminal pro-B-type natriuretic peptide levels in patients with severe sepsis, septic shock, and acute heart failure*

Cited by 186 publications

References 33 publications

Level of adrenomedullin in cases with adrenal defficiency and its relation to mortality in patients with sepsis

Level of adrenomedullin in cases with adrenal defficiency and its relation to mortality in patients with sepsis

Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit

Combining tissue Doppler echocardiography and B-type natriuretic peptide in the evaluation of left ventricular filling pressures: Review of the literature and clinical recommendations

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