The role of N-terminal pro-B-type natriuretic peptide in prognostic evaluation of heart failure

Lam, Carolyn S.P.; Li, Yi‐Heng; Bayés‐Genís, Antoni; Ariyachaipanich, Aekarach; Huan, Do Quang; Sato, Naoki; Kahale, Pravin; Cuong, Ta Manh; Dong, Yugang; Li, Xinli; Zhou, Yanli

doi:10.1097/jcma.0000000000000102

Cited by 15 publications

(10 citation statements)

References 46 publications

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“…Few studies have investigated the accuracy of urine NT-proBNP and cGMP as biomarkers to assess the prognosis of HF patients with respect to subsequent ED visits or hospitalization. The accuracy of plasma NT-proBNP concentration for diagnosing acute or chronic HF has been improved [13, 14], with current guidelines suggesting that a plasma NT-proBNP level of 300 pg/mL indicates a diagnosis of HF [2] and 1,000 pg/mL indicates that the patient should start HF treatment [14] and is at increased risk of hospitalization [15]. Our study population had a median plasma NT-proBNP concentration of 511.5 pg/mL, indicating that our patients were receiving therapy in accordance with standard guidelines, including angiotensin receptor neprilysin inhibitor, RAAS inhibitors, mineralocorticoid receptor antagonist, β-blockers, sodium glucose cotransporter 2 inhibitors, and diuretics.…”

Section: Discussionmentioning

confidence: 99%

The Ratio of Urine N-Terminal Pro B-Type Natriuretic Peptide to Cyclic Guanosine Monophosphate Predicts Emergency Department Visits for Heart Failure

2022

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Introduction: Emergency department (ED) visits for decompensated heart failure (HF) are frequent and associated with poor long-term outcomes. Plasma N-terminal pro b-type natriuretic peptide (NT-proBNP) and cyclic guanosine monophosphate (cGMP) are used in diagnosis and prognosis of HF patients, while clinical values of urine NT-proBNP/cGMP ratio has been rarely explored. This study aims to compare the predictive values of urine NT-proBNP/cGMP ratio versus plasma NT-proBNP for ED visits for decompensated HF. Methods: This prospective study included 126 HF patients with reduced left ventricular ejection fraction (LVEF) (< 50%) and without chronic kidney disease. Baseline data included demographics, comorbidities, and co-medications. Medical records were used to determine the incidence of ED visits for decompensated HF during the three months following the last visit. Results: Patients with subsequent ED visits had significantly higher levels of plasma and urine NT-proBNP and urine cGMP in than those without. Multivariate Cox regression analysis disclosed that Lg10urine NT-proBNP/cGMP was an independent risk factor for subsequent ED visits (OR= 3.267; 95% CI, 1.105–9.663; P = 0.032). ROC analysis revealed a Lg10urine NT-proBNP/cGMP ratio optimal cut-off value of 0.1706 (AUC, 0.700; 95% CI, 0.543–0.857; P = 0.036) for predicting subsequent heart-failure–related ED visits. Conclusion: A single measurement of urinary NT-proBNP/cGMP ratio is predictive of subsequent ED visits for decompensated HF. This non-invasive and easy measurement may be a clinically useful tool for identifying a subset of patients at higher risk of ED visits.

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Section: Discussionmentioning

confidence: 99%

The Ratio of Urine N-Terminal Pro B-Type Natriuretic Peptide to Cyclic Guanosine Monophosphate Predicts Emergency Department Visits for Heart Failure

2022

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“…NT-pro-BNP has been widely used to diagnose congestive heart failure in children [ 3 ]. SMII has also been used to describe CHF subjects in adult studies [ 4 ]. This study was intended to monitor cardiac performance before and after fluid resuscitation using both biomarker (NT-pro-BNP) and bedside haemodynamic marker (SMII) in non-CHF subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Serum level of amino-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is found to increase in structural cardiac diseases, as well as cardiac failure [ 3 , 4 ]. Its use has been previously validated for diagnosis and therapeutic guidance, as well as a prognostic value among heart failure subjects [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Serum NT-Pro-BNP versus Noninvasive Bedside Inotropic Index in Paediatric Shock: A Contest of Myocardial Performance in Response to Fluid Loading

Pudjiadi

Rahayu²,

Wijaya

et al. 2021

Critical Care Research and Practice

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Background. Mild elevation of serum amino-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is associated with myocardial dysfunction. A significantly lower Smith–Madigan inotropic index (SMII) has been shown to accurately represent cardiac contractility among heart failure subjects. We aim to monitor the effect of fluid resuscitation on cardiac function among paediatric patients by measuring serum NT-pro-BNP and SMII. Methods. This is an observational study on 70 paediatric shock patients. NT-pro-BNP and noninvasive bedside haemodynamic monitoring were done by using an ultrasonic cardiac output monitor (USCOM, USCOM, Sydney, Australia). The presence of cardiac diseases was excluded. SMII was obtained from the USCOM. An increase in the stroke volume index (SVI) of ≥15% indicates fluid responders. Measurements were taken before and after fluid loading. Results. Preloading NT-pro-BNP and SMII category were significantly different between the fluid responsiveness group, p = 0.001 and p = 0.004 , respectively. Higher median NT-pro-BNP (preloading NT-pro-BNP of 1175.00 (254.50–9965.00) ng/mL vs. 196.00 (65.00–509.00) ng/mL, p = 0.002 ) was associated with fluid nonresponders (subjects >12 months old). Preloading NT-pro-BNP <242.5 ng/mL was associated with fluid responders (AUC: 0.768 (0.615–0.921), p = 0.003 ), 82.1% sensitivity, and 68.7% specificity for subjects >12 years old. Delta NT-pro-BNP in fluid responders (15.00 (−16.00–950.00) ng/mL) did not differ from fluid nonresponders (505.00 (−797.00–1600.00) ng/mL), p = 0.456 . Postloading SMII >1.25 W·m−2 was associated with fluid responders (AUC: 0.683 (0.553–0.813), p = 0.011), 61.9% sensitivity, and 66.7% specificity, but not preloading SMII. Fluid responders had a higher mean postloading SMII compared to nonresponders (1.36 ± 0.38 vs. 1.10 ± 0.34, p = 0.006 ). Conclusion. Higher NT-pro-BNP and lower SMII in the absence of cardiac diseases were associated with poor response to fluid loading. The SMII is affected by low preload conditions.

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“…Worldwide, the incidence of HF is approximately 1−2% of the general population (i.e., >64 million people globally), and this significantly increases to 8−10% in the elderly (those aged over 75 years) [1]. In Asia-Pacific and Europe, the prevalence ranges from 1.26% to 6.70% and from 0.4% to 2.0% of the region's population, respectively [2]. HF has been acknowledged as a leading cause of premature death in patients with cardiovascular diseases (Ponikowski et al, 2016), with a mortality rate ranging from 10% to 60%, dependent on the disease stage [3].…”

Section: Introductionmentioning

confidence: 99%

“…Early diagnosis is vital for optimal treatment outcomes. Consequently, the accurate prediction of HF is likely to result in cost savings, increased treatment efficiency, and improved overall survival rates [2]. Identifying cardiovascular diseases, specifically HF, in their early stages depend on the sensitivity and specificity Since 2002 of the diagnostic tools.…”

Section: Introductionmentioning

confidence: 99%

The Role of Neutrophil Gelatinase-Associated Lipocalin and N-Terminal Pro B-Type Natriuretic Peptide in the Prediction of Heart Failure in Patients with Acute Coronary Syndrome

Tran

Tran²,

Nguyen³

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: Heart failure, where the heart cannot pump blood effectively, significantly affects patient quality of life and impacts national health-care services. Acute coronary syndrome is a common underlying cause of acute heart failure. Neutrophil gelatinase-binding lipocalin (NGAL) and N-terminal pro B-type natriuretic peptide (NT-proBNP) are biomarkers released during myocardial injury. Thus, the measured levels of these chemicals may be associated with heart failure events in patients with acute coronary syndrome. AIM: The present study determined the serum levels and measured increases in NGAL and NT-proBNP, as well as recorded heart failure events in patients with acute coronary syndrome in Vietnam. METHODS: A descriptive cross-sectional method was used to recruit 58 patients with acute coronary syndrome and assess the degree to which the two markers could predict ejection fraction (EF). RESULTS: The median values of NGAL and NT-proBNP concentrations in the group with EF ≥40% (7.14 ng/mL and 952.00 pg/mL) were significantly lower than those with EF <40% (166.10 ng/mL and 27,498.00 pg/mL). NGAL was used to predict heart failure events at a threshold of 94.86 ng/mL with a sensitivity of 83.3%, a specificity of 90.4%, and an area under the curve (AUC) of 0.83. Similarly, NT-proBNP predicted heart failure events at a threshold of 8660.5 pg/mL with a sensitivity of 83.3%, a specificity of 84.6%, and an AUC of 0.79. CONCLUSIONS: Serum NGAL and NT-proBNP levels can be used as reliable biomarkers for predicting heart failure events in patients with acute coronary syndrome.

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The role of N-terminal pro-B-type natriuretic peptide in prognostic evaluation of heart failure

Cited by 15 publications

References 46 publications

The Ratio of Urine N-Terminal Pro B-Type Natriuretic Peptide to Cyclic Guanosine Monophosphate Predicts Emergency Department Visits for Heart Failure

The Ratio of Urine N-Terminal Pro B-Type Natriuretic Peptide to Cyclic Guanosine Monophosphate Predicts Emergency Department Visits for Heart Failure

Serum NT-Pro-BNP versus Noninvasive Bedside Inotropic Index in Paediatric Shock: A Contest of Myocardial Performance in Response to Fluid Loading

The Role of Neutrophil Gelatinase-Associated Lipocalin and N-Terminal Pro B-Type Natriuretic Peptide in the Prediction of Heart Failure in Patients with Acute Coronary Syndrome

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