2011
DOI: 10.1159/000333841
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N-Terminal Pro-Brain Natriuretic Peptide as a Predictor of Heart Failure with Preserved Ejection Fraction in Hemodialysis Patients without Fluid Overload

Abstract: Background/Aims: The diagnostic value of N-terminal pro-brain natriuretic peptide (NT-pro BNP) for heart failure with preserved ejection fraction (EF; HF-PEF) was evaluated in hemodialysis (HD) patients. Method: In total, 83 patients were analyzed. Left-ventricular (LV) function was assessed using trans-thoracic Doppler echocardiography, and indices of hydration status were assessed using bioelectrical impedance analysis. Plasma NT-pro BNP levels were measured simultaneously. Results: A moderate negative corre… Show more

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Cited by 15 publications
(15 citation statements)
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“…Additionally, strongly elevated NT pro-BNP levels were not associated with HFpEF, but only with HFrEF diagnosis. This result stands in contrast with an analysis by Kamano et al, who used NT pro-BNP levels as a predictive marker for diastolic dysfunction and HFpEF in HD [28]. According to our results, NT pro-BNP should only be applied for the exclusion of HFrEF, but cannot help in distinguishing HFpEF patients from those without HF.…”
Section: Discussioncontrasting
confidence: 99%
“…Additionally, strongly elevated NT pro-BNP levels were not associated with HFpEF, but only with HFrEF diagnosis. This result stands in contrast with an analysis by Kamano et al, who used NT pro-BNP levels as a predictive marker for diastolic dysfunction and HFpEF in HD [28]. According to our results, NT pro-BNP should only be applied for the exclusion of HFrEF, but cannot help in distinguishing HFpEF patients from those without HF.…”
Section: Discussioncontrasting
confidence: 99%
“…Systolic left ventricular function served as a surrogate for cardiac status and still showed a high correlation to the plasma natriuretic peptide concentration. Other cardiac morbidities, such as diastolic function [16], valvular disease or rhythm disturbances, might also contribute to elevations in natriuretic peptide concentration, but were not entered into the model. Again it should be emphasized that association studies cannot prove causality between the studied parameters and elevated plasma natriuretic peptide concentrations and cannot distinguish between cause and consequence.…”
Section: Discussionmentioning
confidence: 99%
“…In patients with end-stage renal disease, largely elevated plasma natriuretic peptide concentrations are difficult to interpret due to possibly reduced renal clearance and accumulation on the one hand and a high prevalence of cardiac disease and heart failure, even in the in the presence of preserved ejection fraction, on the other [16,17]. In addition, plasma natriuretic peptide concentrations are affected by the volume status [18], which varies particularly between the hemodialysis sessions.…”
Section: Introductionmentioning
confidence: 99%
“…This could offer an explanation for the finding of elevated NT-proBNP in patients with PEW. Previous studies have not established if it is possible to use NT-proBNP to distinguish fluid overload from left ventricular dysfunction in dialysis patients [25,36,37,38,39]. …”
Section: Discussionmentioning
confidence: 99%