Elevated Pro-Brain Natriuretic Peptide, Troponin T and Malnutrition Inflammatory Score in Chronic Hemodialysis Patients with Overt Cardiovascular Disease

Trimarchi, Hernán; Muryan, Alexis; Campolo-Girard, Vicente; Dicugno, Mariana; Barucca, Nanci; Lombi, Fernando; Young, Pablo; Pomeranz, Vanesa; Forrester, Mariano; Alonso, Mirta; Iriarte, Romina; Díaz, Marisa Luisa; Lindholm, Bengt

doi:10.1159/000320195

Cited by 12 publications

(8 citation statements)

References 97 publications

(49 reference statements)

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“…Obesity‐related diseases are associated with pathological cardiac remodeling and myocardial hypertrophy, probably due to hypoadiponectinemia 24–26 . The considerably higher adipocyte mass could decrease Pro‐BNP levels, perpetuating its characteristically low levels 20,21,27 . This phenomenon could also contribute to a low adiponectin secretion.…”

Section: Discussionmentioning

confidence: 99%

In hemodialysis, adiponectin, and pro‐brain natriuretic peptide levels may be subjected to variations in body mass index

Trimarchi

Muryan

Dicugno

et al. 2011

Hemodialysis International

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Adiponectin exerts cardiovascular protective actions, although some studies have shown the opposite. In hemodialysis, obese subjects display lower mortality rates despite hypoadiponectinemia, while higher adiponectin concentrations correlate with an elevated cardiovascular risk in nonobese subjects. The aim of the study is to suggest that adiponectin level variations are associated with differences in the body mass index (BMI). The interplay between adiponectin and pro-brain natriuretic peptide (Pro-BNP) levels may vary according to body fat mass. Fifty-two chronic hemodialysis patients were divided into three groups. Group A, BMI<25 (n=20); Group B, BMI 25 to 30 (n=21), and Group C, BMI>30 (n=11). Diabetics: Group A 10%; Group B 6 29%; Group C 55%, P=0.027. Determinations: Adiponectin, Pro-BNP, insulin, insulin resistance (HOMA), troponin T, nutritional status, ultrafiltration rates, C-reactive protein (CRP), vascular accesses, and echocardiography. Group A: adiponectinemia positively and significantly correlated with Pro-BNP, CRP, and troponin T. As BMI increased, adiponectin, Pro-BNP, and malnutrition significantly decreased, while insulin, HOMA, and ultrafiltration rates significantly increased. Cardiac restriction was significantly higher in obese patients. In all groups, Pro-BNP and troponin T displayed a strong positive correlation. In low-BMI subjects, high Pro-BNP and adiponectin, low myocardial restriction, and worse nutritional status were prevalent. In obesity, hypoadiponectinemia stimulates cardiac remodeling, cardiac hypertrophy, and decreased stretching, rendering Pro-BNP levels low despite high ultrafiltration rates. Thus, adiponectin correlates inversely with BMI, probably playing different cardiovascular roles as BMI changes.

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Section: Discussionmentioning

confidence: 99%

In hemodialysis, adiponectin, and pro‐brain natriuretic peptide levels may be subjected to variations in body mass index

Trimarchi

Muryan

Dicugno

et al. 2011

Hemodialysis International

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“…10 Pro-brain natriuretic peptide, an indicator of volume overload, is correlated with troponin T, homocysteine, and CRP levels and malnutrition inflammation scores in patients undergoing HD. 30 These findings are important, as they indicate an association between hypervolemia and malnutrition. Besides autonomic dysfunction, hypervolemia also contributes to deterioration of the diurnal blood pressure balance.…”

Section: Discussionmentioning

confidence: 94%

Effects of nutritional parameters on nocturnal blood pressure in patients undergoing hemodialysis

et al. 2013

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“…A few studies investigated this relation by the way but none of them used anthropometric parameters except for body mass index. 23,24 However, classic anthropometric parameters are more specific than body mass index or albumin in the evaluation of nutrition, as they estimate the percentage of body fat and body muscle. Inverse correlations of troponin T and anthropometric parameters have not been reported before.…”

Section: Discussionmentioning

confidence: 99%

A comparison of markers of myocardial injury and their relation to nutritional parameters in hemodialysis patients

Stošović¹,

Stanković²,

Stanojević³

et al. 2014

Renal Failure

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Background: Serum cardiac troponin T (cTnT) is a valuable marker of ischemic heart disease (IHD) and left ventricular hypertrophy, as well as a mortality predictor in hemodialysis populations. We compared the value of cTnT, creatinine kinase (CK)-MB mass and myoglobin as mortality predictors in our hemodialysis patients and evaluated their relation to nutritional status. Methods: A total of 118 hemodialysis patients were prospectively studied from January 2004 to April 2013. Clinical and laboratory evaluations during the 12-month baseline period included the history of IHD, signs of left ventricular hypertrophy (LVH), Kt/V and serum cardiac markers together with the percentage of body fat (%fat), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), triceps skinfold (TSF) and BMI. Results: Underweight patients had significantly higher cTnT values (Mann-Whitney, p50.05). Correlation analysis (Spearman) showed an inverse association between cTnT and TSF ( ¼ À0.22, p50.05), as well as between CK-MB mass and TSF ( ¼ À0.26, p50.01). In men cTnT also correlated inversely with %fat ( ¼ À0.27, p50.05) and BMI ( ¼ À0.33, p50.05). In addition, myoglobin was correlated significantly with MAC, MAMC and albumin. Among cardiac markers cTnT was the only independent variable predicting mortality (Multivariate Cox regression, HR ¼ 1.04 CI (1.01-1.07); p50.01; measurement units 0.01 mg/L). Conclusion: Troponin T and CK-MB mass were significantly elevated in the underweight patient group. Troponin T was the only independent cardiac marker predictor of all cause mortality in our hemodialysis patients.

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Elevated Pro-Brain Natriuretic Peptide, Troponin T and Malnutrition Inflammatory Score in Chronic Hemodialysis Patients with Overt Cardiovascular Disease

Cited by 12 publications

References 97 publications

In hemodialysis, adiponectin, and pro‐brain natriuretic peptide levels may be subjected to variations in body mass index

In hemodialysis, adiponectin, and pro‐brain natriuretic peptide levels may be subjected to variations in body mass index

Effects of nutritional parameters on nocturnal blood pressure in patients undergoing hemodialysis

A comparison of markers of myocardial injury and their relation to nutritional parameters in hemodialysis patients

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