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Sample records for plasma nt-pro-bnp level

  1. Placental expression of proBNP/NT-proBNP and plasma levels of NT-proBNP in early- and late-onset preeclampsia.

    Science.gov (United States)

    Junus, Katja; Wikström, Anna-Karin; Larsson, Anders; Olovsson, Matts

    2014-09-01

    Levels of plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) are elevated in preeclampsia. In this study, the possibility that the placenta produces and releases proBNP/NT-proBNP was explored. Plasma levels of NT-proBNP in early- and late-onset preeclampsia were also measured. Placental proBNP mRNA in early-onset preeclampsia (n = 7), late-onset preeclampsia (n = 8), and controls of similar gestational age (n = 10) was assessed by quantitative real-time polymerase chain reaction. ProBNP/NT-proBNP protein was studied in placental samples with immunohistochemistry (n = 8) and tissue culture (n = 2). Plasma levels of NT-proBNP were measured in early-onset preeclampsia (n = 18), late-onset preeclampsia (n = 20), and relevant controls (n = 36). Transcripts of proBNP mRNA were found in 20 out of 25 samples, there were no differences in expression between the groups. ProBNP/NT-proBNP protein was observed in maternal spiral arteries and in syncytiotrophoblasts in all placental samples. After placental tissue culture, there were measurable amounts of NT-proBNP in the culture media. Women with both early- (365 [14-9815] pg/ml) and late-onset preeclampsia (176 [33-2547] pg/ml) had higher levels of NT-proBNP than their controls (P preeclampsia than in women with late-onset preeclampsia (P = 0.057). The results indicate possible placental production and release of proBNP/NT-proBNP into the maternal circulation. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. NT pro BNP plasma level and atrial volume are linked to the severity of liver cirrhosis.

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    Anna Licata

    Full Text Available BACKGROUND AND AIMS: Plasma levels of NT-pro-BNP, a natriuretic peptide precursor, are raised in the presence of fluid retention of cardiac origin and can be used as markers of cardiac dysfunction. Recent studies showed high levels of NT pro BNP in patients with cirrhosis. We assessed NT pro-BNP and other parameters of cardiac dysfunction in patients with cirrhosis, with or without ascites, in order to determine whether the behaviour of NT pro BNP is linked to the stage of liver disease or to secondary cardiac dysfunction. METHODS: Fifty eight consecutive hospitalized patients mostly with viral or NAFLD-related cirrhosis were studied. All underwent abdominal ultrasound and upper GI endoscopy. Cardiac morpho-functional changes were evaluated by echocardiography and NT-pro-BNP plasma levels determined upon admission. Twenty-eight hypertensive patients, without evidence of liver disease served as controls. RESULTS: Fifty eight cirrhotic patients (72% men with a median age of 62 years (11% with mild arterial hypertension and 31% with type 2 diabetes had a normal renal function (mean creatinine 0.9 mg/dl, range 0.7-1.06. As compared to controls, cirrhotic patients had higher NT pro-BNP plasma levels (365.2±365.2 vs 70.8±70.6 pg/ml; p<0.001. Left atrial volume (LAV (61.8±26.3 vs 43.5±14.1 ml; p = 0.001, and left ventricular ejection fraction (62.7±6.9 vs. 65.5±4%,; p = 0.05 were also altered in cirrhotic patients that in controls. Patients with F2-F3 oesophageal varices as compared to F0/F1, showed higher e' velocity (0.91±0.23 vs 0.66±0.19 m/s, p<0.001, and accordingly a higher E/A ratio (1.21±0.46 vs 0.89±0.33 m/s., p = 0.006. CONCLUSION: NT-pro-BNP plasma levels are increased proportionally to the stage of chronic liver disease. Advanced cirrhosis and high NT-pro-BNP levels are significantly associated to increased LAV and to signs of cardiac diastolic dysfunction. NT pro-BNP levels could hence be an useful prognostic

  3. Relationship of plasma level of NT- ProBNP with development of AF in CABG patients

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    Tanaray B

    2010-10-01

    Full Text Available "nBackground: Studies of the association between post operative AF and Plasma level of NT- Pro BNP have reported conflicting findings. The aim of the present study was evaluation of the association between post coronary bypass graft- Atrial Fibrillation (AF and Plasma level of NT- ProBNP as an independent risk factor of AF development in patients undergoing coronary artery bypass graft."n "nMethods: In a cohort study, 79 patients with sinus rhythm who admitted in Imam Khomeini Hospital in Tehran, Iran, during February 2009 and February 2010 for CABG are included the study and followed for developing post operative AF rhythm."n "nResults: Post operative AF was found in 17.7% of patients. The peak time from the operation to the first AF episode was in second post op day in ten patients (71.4%. The serum level of ProBNP in patients with AF was significantly higher (1624± 647 versus 221± 238 pg/ml, p< 0/0001. Increased age, Increased LA size and high plasma level of ProBNP were associated with increased risk for post op AF. After adjustment of risk factors, plasma level of ProBNP was the most important risk factor with odds ratio of 15.34 with CI 95% 1.77-132.95 and then LA diameter with odds ratio of 6.11 with CI 95% 0.99-37.42 was independently correlated with post op AF. Correlation between plasma level of ProBNP with age and LA size was seen too (LA size r = 0.0281, p= 0.012. Between age and ProBNP (r= 0.337, p= 0.002. The best cut off point for plasma ProBNP as a predictor of post op AF was 854 pg/ml."n "nConclusion: Increased level of preoperative ProBNP levels could be an independent predictor of post operative Atrial Fibrillation.

  4. NT-ProBNP levels in saliva and its clinical relevance to heart failure.

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    Jared Yong Yang Foo

    Full Text Available BACKGROUND: Current blood based diagnostic assays to detect heart failure (HF have large intra-individual and inter-individual variations which have made it difficult to determine whether the changes in the analyte levels reflect an actual change in disease activity. Human saliva mirrors the body's health and well being and ∼20% of proteins that are present in blood are also found in saliva. Saliva has numerous advantages over blood as a diagnostic fluid which allows for a non-invasive, simple, and safe sample collection. The aim of our study was to develop an immunoassay to detect NT-proBNP in saliva and to determine if there is a correlation with blood levels. METHODS: Saliva samples were collected from healthy volunteers (n = 40 who had no underlying heart conditions and HF patients (n = 45 at rest. Samples were stored at -80°C until analysis. A customised homogeneous sandwich AlphaLISA((R immunoassay was used to quantify NT-proBNP levels in saliva. RESULTS: Our NT-proBNP immunoassay was validated against a commercial Roche assay on plasma samples collected from HF patients (n = 37 and the correlation was r(2 = 0.78 (p<0.01, y = 1.705× +1910.8. The median salivary NT-proBNP levels in the healthy and HF participants were <16 pg/mL and 76.8 pg/mL, respectively. The salivary NT-proBNP immunoassay showed a clinical sensitivity of 82.2% and specificity of 100%, positive predictive value of 100% and negative predictive value of 83.3%, with an overall diagnostic accuracy of 90.6%. CONCLUSION: We have firstly demonstrated that NT-proBNP can be detected in saliva and that the levels were higher in heart failure patients compared with healthy control subjects. Further studies will be needed to demonstrate the clinical relevance of salivary NT-proBNP in unselected, previously undiagnosed populations.

  5. Plasma NT-proBNP and White Matter Hyperintensities in Type 2 Diabetic Patients

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    Reinhard, Henrik; Garde, Ellen; Skimminge, Arnold

    2012-01-01

    Elevated plasma N-terminal (NT)-proBNP from the heart as well as white matter hyperintensities (WMH) in the brain predict cardiovascular (CV) mortality in the general population. The cause of poor prognosis associated with elevated P-NT-proBNP is not known but WMH precede strokes in high risk...... populations. We assessed the association between P-NT-proBNP and WMH or brain atrophy measured with magnetic resonance imaging (MRI) in type 2 diabetic patients, and age-matched controls....

  6. Plasma NT-proBNP and White Matter Hyperintensities in Type 2 Diabetic Patients

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Garde, Ellen; Skimminge, Arnold;

    2012-01-01

    Elevated plasma N-terminal (NT)-proBNP from the heart as well as white matter hyperintensities (WMH) in the brain predict cardiovascular (CV) mortality in the general population. The cause of poor prognosis associated with elevated P-NT-proBNP is not known but WMH precede strokes in high risk pop...... populations. We assessed the association between P-NT-proBNP and WMH or brain atrophy measured with magnetic resonance imaging (MRI) in type 2 diabetic patients, and age-matched controls....

  7. Prognostic threshold levels of NT-proBNP testing in primary care

    DEFF Research Database (Denmark)

    Rosenberg, J.; Schou, M.; Gustafsson, F.;

    2008-01-01

    level of the cardiac peptide, NT-proBNP, could be identified. METHODS AND RESULTS: From 2003-2005, 5875 primary care patients with suspected HF (median age 73 years) had NT-proBNP analysed in the Copenhagen area. Eighteen percent died and 20% had a cardiovascular (CV) hospitalization (median follow......-up time: 1127 and 1038 days, respectively). In Cox proportional hazards regression models regarding NT-proBNP levels, the fourth decile (range: 83-118 pg/mL) was associated with a 90% (95% CI: 30-190, P .../mL) was associated with an 80% (95% CI: 20-190, P = 0.01) increased mortality risk after adjustment for age, sex, previous hospitalization, CV diseases, and chronic diseases. CONCLUSION: We identified prognostic threshold levels for mortality and CV hospitalization for NT-proBNP in primary care patients suspected...

  8. Relationship between the level of NT-proBNP and left ventricular diastolic function in chronic heart failure patients with preserved ejection fraction

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    Zhu Youfeng; Li Kong; Wei Jianrui; Yin Haiyan; Zhang Rui

    2014-01-01

    Objective To investigate the relationship between n-terminal pro-brain natriuretic peptide (NT-proBNP) level and echocardiographic parameter in patients with chronic heart failure with preserved ejection fraction (HFPEF) and evaluate the correlation,specificity and sensitivity on these indices.Methods Sixty-six symptomatic patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction (LVEF) (≥ 50%) and forty-three people with normal left ventricular (LV) function were examined by conventional echocardiography,tissue Doppler imaging (TDI).Plasma NT-proBNP levels were determined simultaneously.Results Compared with control group,NT-proBNP,E/Em,LVMI were significantly higher in HFPEF (P < 0.01); NT-proBNP was significantly correlated with E/Em (correlation coefficient r =0.576).Conclusion NT-proBNP,E/Em,LVMI were significant markers for reflecting left ventricular diastolic function and good tools for diagnosing HFPEF.NT-proBNP had a significant negative predictive value (92.7%) when NT-proBNP < 90 pg/ml.

  9. Clinical Value of Combined Detection of CK-MB, MYO, cTnI and Plasma NT-proBNP in Diagnosis of Acute Myocardial Infarction.

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    Fan, Jiubo; Ma, Ji; Xia, Ning; Sun, Li; Li, Baoan; Liu, Haiju

    2017-03-01

    Acute myocardial infarction (AMI) is a serious life-threatening and common heart disease that is based on coronary atherosclerosis. The aim is to study the changes in the level of kinase isoenzyme (CK-MB), myoglobin (MYO), cardiac troponin I (cTnI), and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction (AMI) and the four indicators of joint detection clinical value for diagnosis of AMI. Plasma NT-proBNP, CK-MB, MYO, and cTnI were detected by CLIA in 208 AMI patients (AMI group) and 115 non-AMI patients (control group). SPSS 19.0 software was used to analyze the data. The concentrations of CK-MB, MYO, cTnI, and NT-proBNP show significant differences between these two groups. In the AMI group, a significantly positive correlation was found between CK-MB and each of MYO and cTnI (r = 0.537, r = 0.226). Meanwhile, the sensitivity of combined detection has been improved up to 92.79%. Therefore, these results suggested that detecting CK-MB, MYO, cTnI, and plasma NT-proBNP levels together can significantly contribute to the early diagnosis of AMI. It can also provide diagnostic evidence to clinic and thus lower the mortality of AMI in acute phase.

  10. Clinical outcomes after utilizing surviving sepsis campaign in children with septic shock and prognostic value of initial plasma NT-proBNP

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    Rujipat Samransamruajkit

    2014-01-01

    Full Text Available Background and Objective: The surviving sepsis campaign treatment guideline (SSC implementation is associated with improved outcome in adults with severe sepsis. The effect on outcome of pediatric sepsis is less clear. Purpose : To determine the clinical outcomes of SSC implementation and to investigate the prognostic value of initial plasma NT-proBNP and procalcitonin in children. Materials and Methods: Infants and children (aged 1month/0-15 years with severe sepsis or septic shock were prospectively enrolled and treated according to the guidelines. Initial blood drawn was saved for NT-pro-BNP, procalcitonin measurements and clinical data were also recorded. Results: A total of 47 subjects were recruited. Since the application of the SSC, our mortality rate had significantly decreased from 42-19% (P = 0.003 as compared to the data in the previous 3 years. Clinical factors that significantly increased the mortality rate were: Initial central venous oxygen saturation < 7 0% after fluid resuscitation [odds ratio (OR = 23.3; 95% confidence interval (CI 3.7-143; P = 0.001], and initial albumin level (≤ 3 g/dl, OR = 6.7; 95% CI 1.2-37.5, P = 0.03. There was asignificant difference between the initial NT-proBNP levels between survivors and non survivors, (6280.3 ± 9597 ng/L, P < 0.001, but not for procalcitonin (12.7 ± 24.8, 29.3 ± 46 μg/L, P = 0.1, respectively. An initial NT-proBNP level of more than 11,200 pg/ml predicted Pediatric Intensive Care Unit (PICU mortality with a sensitivity of 85.7% and a specificity of 90%. Conclusions: A modified SSC for severe sepsis and septic shock significantly reduced the mortality rate in our PICU. High initial NT-ProBNP level was associated with mortality.

  11. Evaluating the Correlation between Serum NT-proBNP Level and Diastolic Dysfunction Severity in Beta-Thalassemia Major Patients

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    Alizadeh, Behzad; Badiee, Zahra; Mahmoudi, Mahmoud; Mohajery, Mahsa

    2016-01-01

    Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) is a sensitive biomarker for the detection of asymptomatic left ventricular (LV) dysfunction. Since β-thalassemia major patients suffer from early diastolic dysfunction due to iron deposition of chronic blood transfusion, we tried to evaluate the correlation between the serum NT-proBNP level and the severity of LV diastolic dysfunction determined by echocardiography in these patients. Methods: Fifty β-thalassemia major patients with normal LV systolic function were studied by tissue Doppler echocardiography, and blood samples were taken at the same time to measure the serum NT-proBNP level. Using flow velocity through the mitral valve on the tissue velocity of the mitral annulus in early ventricular filling (E/E') as an LV diastolic function indicator, the patients were divided into 3 groups: group 1) no diastolic dysfunction (E/E' 15). Other variables assessed included sex, age, method of chelator therapy, and mean hemoglobin and ferritin levels for the past 2 years. Results: According to the echocardiographic findings of all the 50 patients (29 male and 21 female) with an age range of 11-35 years (mean = 17.98 y), 46% were classified in group 1, 54% in group 2, and none in group 3. The NT-proBNP level was 1070 ± 566 ng/mL in group 1 and 974 ± 515 ng/mL in group 2. The t-test showed no significant difference between groups 1 and 2 in the NT-proBNP level (p value = 0.536). Conclusion: Due to specific conditions in thalassemia major patients, the correlation between the serum NT-proBNP level and the severity of diastolic dysfunction seems to be not meaningful. PMID:27928257

  12. Evaluating the Correlation between Serum NT-proBNP Level and Diastolic Dysfunction Severity in Beta-Thalassemia Major Patients

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    Behzad Alizadeh

    2016-10-01

    Full Text Available Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is a sensitive biomarker for the detection of asymptomatic left ventricular (LV dysfunction. Since β-thalassemia major patients suffer from early diastolic dysfunction due to iron deposition of chronic blood transfusion, we tried to evaluate the correlation between the serum NT-proBNP level and the severity of LV diastolic dysfunction determined by echocardiography in these patients. Methods: Fifty β-thalassemia major patients with normal LV systolic function were studied by tissue Doppler echocardiography, and blood samples were taken at the same time to measure the serum NT-proBNP level. Using flow velocity through the mitral valve on the tissue velocity of the mitral annulus in early ventricular filling (E/E' as an LV diastolic function indicator, the patients were divided into 3 groups: group 1 no diastolic dysfunction (E/E' < 8, group 2 suspected diastolic dysfunction (E/E' = 8-15, and group 3 documented diastolic dysfunction (E/E' >15. Other variables assessed included sex, age, method of chelator therapy, and mean hemoglobin and ferritin levels for the past 2 years.Results: According to the echocardiographic findings of all the 50 patients (29 male and 21 female with an age range of 11-35 years (mean = 17.98 y, 46% were classified in group 1, 54% in group 2, and none in group 3. The NT-proBNP level was 1070 ± 566 ng/mL in group 1 and 974 ± 515 ng/mL in group 2. The t-test showed no significant difference between groups 1 and 2 in the NT-proBNP level (p value = 0.536. Conclusions: Due to specific conditions in thalassemia major patients, the correlation between the serum NT-proBNP level and the severity of diastolic dysfunction seems to be not meaningful.

  13. Changes of Plasma MMP-9,NT-proBNP Levels in Children with Kawasaki Disease and Its Clinic Significance%川崎病患儿血浆MMP-9、NT-proBNP水平变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    吴镇宇; 姚丽萍

    2016-01-01

    Objective:To explore the changes and clinic significance of plasma matrix metalloproteinase-9(MMP-9) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in children with Kawasaki disease(KD).Method:Forty two children with KD in our hospital from January 2015 to January 2016 were collected and divided into two groups according to the results of echocardiography,the coronary artery lesion(CAL) group(n=18) and the non-coronary artery lesion(NCAL) group (n=24).Thirty febrile children with respiratory tract infection and twenty healthy children in the same period were chosen as the control group.The plasma MMP-9 and NT-proBNP protein levels were measured respectively.Result:The plasma MMP-9 and NT-proBNP levels in the acute phase of KD patients were all higher than those in the two control group(P<0.01),and which were significantly higher in the CAL group than in the NCAL group,the differences were statistically significant(P<0.05 ).The plasma MMP-9 and NT-proBNP levels in remission stages were siginificantly lower after treatment,and the protein level of NT-proBNP in the CAL group was still higher than that of the NCAL group,the differences were statistically significant(P<0.05).There was a positive correlation between plasma MMP-9 and NT-proBNP levels in the acute phase of KD(r=0.57,P<0.05).Conclusion:The plasma MMP-9 and NT-proBNP levels are closely related to KD cardiovascular damage,combined detection of them may have critical value for the early diagnosis of KD and the prediction of CAL.%目的:探讨基质金属蛋白酶-9(MMP-9)与N末端脑利钠肽(NT-proBNP)在川崎病(KD)患儿血浆中的变化及其意义。方法:选取2015年1月-2016年1月本院明确诊断的KD患儿42例为研究对象,根据心脏彩超分为冠状动脉损伤(CAL)组18例、无冠状动脉损伤(NCAL)组24例,另选取同期伴有发热的呼吸道感染患儿30例和门诊健康体检儿童20例作为对照组,分别测定各组MMP-9、NT-proBNP蛋白水平

  14. Plasma myeloperoxidase, NT-proBNP, and troponin-I in patients on CAPD compared with those on regular hemodialysis.

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    Al-Hweish, Abdulla; Sultan, Sherif S; Mogazi, Khaled; Elsammak, Mohamed Y

    2010-07-01

    Myeloperoxidase (MPO) is a hemoprotein that is released during inflammation and may lead to irreversible protein and lipid modification, increasing levels of oxidized low density lipoprotein, and promoting athrogenesis. Recently, it has been considered as a risk factor for cardiovascular diseases. Similarly, the measurement of carotid intima-media thickness gives an indication about the degree of atherosclerosis and prediction of clinical cardiovascular events. Elevated white blood cells counts may indicate a state of acute inflammation and follow its progression. Dialysis patients are at a high risk of developing cardiovascular disease compared with healthy subjects. The role of N-terminal pro-brain natriuretic peptide and increased cardiac troponin in identification and prognostication of cardiovascular diseases in end-stage renal disease patients has been investigated. The current study aimed to evaluate plasma MPO and its possible relationship with carotid intima-media thickness, troponin I, N-terminal pro-brain natriuretic peptide (NT-proBNP), and insulin resistance as measured by homeostatic model assessment (HOMA index) in a cohort of Saudi patients who are undergoing hemodialysis (HD) vs. continuous ambulatory peritoneal dialysis for end-stage renal disease. Plasma MPO was significantly higher in patients on continuous ambulatory peritoneal dialysis (CAPD) than in those on HD and in normal subjects (P0.05). However, plasma MPO level correlated positively with the white blood cell count in patients on CAPD and in those on HD (P<0.05). Our findings suggest an increased oxidative stress in CAPD patients compared with HD patients, while the reported difference in plasma NT-proBNP and troponin-I may be related to the rapid decline of residual renal function in HD and type of membrane used in the HD dialysis procedure itself.

  15. Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure

    NARCIS (Netherlands)

    Hogenhuis, Jochern; Voors, Adriaan A.; Jaarsma, Tiny; Hoes, Arno W.; Hillege, Hans L.; Kragten, Johannes A.; van Veldhuisen, Dirk J.

    2007-01-01

    Background: Anaemia may affect 13-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (1417) patients without the exclusion of patients with renal dysfunction. Aims: To study the influence of both anaemia and renal function o

  16. Serum NT-proBNP Levels Are Not Related to Vitamin D Status in Young Patients with Congenital Heart Defects

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    E. Passeri

    2016-01-01

    Full Text Available Context. Hypovitaminosis D frequently occurs in early life and increases with age. Vitamin D has been suggested to influence cardiac performance and N-terminal-pro-type B natriuretic peptide (NT-proBNP release in adults with heart failure. Objectives. To assess the vitamin D status and the impact of hypovitaminosis D on circulating NT-proBNP levels in young patients with congenital heart defects (CHD. Design and Patients. This cross-sectional study included the assessment of serum 25-hydroxyvitamin D (25OHD, parathyroid function markers, and NT-proBNP levels in a series of 230 young in-patients (117 females, 113 males; 6.4 (4.0–9.1 years (median, interquartile range with CHD. Results. Serum 25OHD levels 30 ng/mL occurred in 25% of patients. Serum 25OHD levels inversely correlated with age (r=-0.169, P=0.013 and height standard deviation score (r=-0.269, P=0.001. After correction for age, 25OHD negatively correlated with serum PTH levels (β=-0.200, P=0.002. PTH levels above the upper quartile (44 pg/mL occurred in 32% of hypovitaminosis D patients. Serum NT-proBNP levels were not correlated with 25OHD and PTH levels. Conclusions. Half of the young CHD patients were diagnosed with 25OHD deficiency and a third of hypovitaminosis D patients experienced hyperparathyroidism. Nonetheless, serum NT-proBNP levels were not associated with hypovitaminosis D as well as hyperparathyroidism.

  17. Aminoterminal Pro B-Type Natriuretic Peptide (NT-proBNP Levels for Monitoring Interventions in Paediatric Cardiac Patients with Stenotic Lesions

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    Eva Welisch

    2009-01-01

    Full Text Available Background. Serum concentration of NT-proBNP correlates well with the severity of cardiac disease in adults. Few studies have been performed on the applicability of NT-proBNP for monitoring children with congenital heart disease. Objective. To assess the potential of NT-proBNP for monitoring the success of interventions in children with stenotic cardiac lesions. Methods. NT-proBNP was measured in 42 children aged 1 day to 17 years (y before and 6 to 12 weeks after surgical or interventional correction of obstructive lesions of the heart. Comparison is made with the clinical status and echocardiographic data of the child. Results. NT-proBNP levels (median 280, range 10–263,000 pg/mL were above the reference value in all but 6 patients (pts prior to the intervention. Higher levels were found in more compromised patients. The 35 children with clinical improvement after the procedure showed a decline of their NT-proBNP level in all but 4 patients, whose levels remained unchanged. Five patients with unchanged gradients despite a therapeutic intervention also demonstrated unchanged NT-proBNP levels after the intervention. Thus, the success rate of the procedure correlated well to clinical and echocardiographic findings. Conclusion. NT-proBNP can be used to assess the efficiency of an intervention.

  18. Preserved cardiorespiratory function and NT-proBNP levels before and during exercise in patients with recent onset of rheumatoid arthritis: the clinical challenge of stratifying the patient cardiovascular risks.

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    Zoli, A; Bosello, S; Comerci, G; Galiano, N; Forni, A; Loperfido, F; Ferraccioli, G F

    2017-01-01

    Rheumatoid arthritis (RA) is associated with an increased risk of myocardial infarction and congestive heart failure. In RA patients, elevated NT-proBNP levels have been reported to be a prognostic marker of left ventricular dysfunction. In this study, we evaluated cardiorespiratory functional capacity and NT-proBNP levels before and during cardiopulmonary exercise test in early RA (ERA) patients. Twenty ERA patients and 10 healthy controls were studied by color Doppler echocardiography to evaluate ventricular systolic and diastolic function. Arterial stiffness and wave reflections were quantified non-invasively using applanation tonometry of the radial artery. Cardiopulmonary treadmill test was performed to measure peak VO2 and VE/VCO2 parameters. NT-proBNP plasma levels were measured before and at the exercise peak during cardiopulmonary exercise. The peak oxygen uptake [VO2 (ml/min/kg)], the ventilatory equivalents for carbon dioxide (EqCO2), respiratory exchange ratio and arterial stiffness were similar between patients and controls during cardiopulmonary exercise test. Basal and peak cardiopulmonary exercise NT-proBNP plasma levels were comparable in ERA patients with respect to healthy controls. When we analyzed patients according to disease characteristics and cardiovascular risk factors, ERA patients with high disease activity, BMI > 25 kg/m(2) and ACPA positivity presented significantly higher baseline and exercise peak NT-proBNP levels. Cardiorespiratory function is preserved in patients with recent onset of rheumatoid arthritis. The increased basal and exercise peak NT-proBNP plasma levels in patients with negative disease prognostic factors represent a possible marker to stratify the cardiovascular risk in patients with early rheumatoid arthritis.

  19. Serum levels of N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP) in twin pregnancy.

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    Yamada, Takashi; Koyama, Takahiro; Furuta, Itsuko; Takeda, Masamitsu; Nishida, Ryutaro; Yamada, Takahiro; Morikawa, Mamoru; Minakami, Hisanori

    2013-01-16

    Twin pregnancy differs considerably from singleton pregnancy in many aspects and it is unknown how serum NT-proBNP level behaves in women with twin pregnancies. Serum NT-proBNP levels were determined longitudinally at gestational weeks (GW) 24 and 35 in normotensive women with 13 twin and 99 singleton pregnancies. The effects of maternal demographic characteristics on NT-proBNP levels were also analyzed. The serum NT-proBNP levels (pg/ml) in twin pregnancies, which were not different from those in singleton pregnancies at 24 GW (26±15 vs. 40±27, respectively, P=0.0718), increased significantly (P=0.0038) and were significantly higher than those in singleton pregnancies at 35 GW (72±49 vs. 34±24, Ptwin pregnancy were likely to exhibit an increase in serum NT-proBNP levels in the late stage of pregnancy, especially in lean and nulliparous women. The relative greater blood volume expansion occurring in twin than in singleton pregnancies was considered to be responsible for this phenomenon.

  20. NT-proBNP

    DEFF Research Database (Denmark)

    Andersen, Charlotte; Mellemkjær, Søren; Hilberg, Ole;

    2016-01-01

    BACKGROUND: Pulmonary hypertension (PH) is a serious complication to interstitial lung disease (ILD) and has a poor prognosis. PH is often diagnosed by screening with echocardiography followed by right heart catheterisation. A previous study has shown that a value of NT-pro-brain natriuretic...... patients and obtain data from echocardiography, NT-proBNP, diagnosis and lung function. Signs of PH on echocardiography were defined as a tricuspid pressure gradient (TR) ≥40 mmHg, decreased right ventricular systolic function or dilatation. Sensitivity, specificity, negative predictive value (NPV...

  1. Changes of glomerular filtration rate and plasma NT-proBNP level in mild heart disfunctional patients%轻度心功能不全患者肾小球滤过率及血浆N末端脑钠肽前体水平的变化

    Institute of Scientific and Technical Information of China (English)

    董静; 黄亚萍; 赵玉兰

    2013-01-01

    NYHAⅢ-Ⅳ as group C,and addition of the healthy for 40 as group A,which was incorporated as control group.Then detected the GFR,plasm NT-proBNP level,left ventricular inner diastolic diameter (LVIDd) change,left ventricular ejection fraction (LVEF) change in every group,and analysed the data with statistics sortware by SPSS 17.0.Results The GFR in each group analysed as group A>group B>group C,was (121.14±5.03),(87.26±4.33),(76.01±3.83) mL/(min· 1.73 m2) respectively.The Plasma NT-proBNP level in the each group analysed as group A<group B<group C,was (81.98±18.19),(753.13 ± 198.06),(2321.31 ±644.24) pg/mL respectively,the LVEF change analysed as group A >group B >group C,was (65.70±8.11)%,(51.86±7.68)%,(37.59±8.44)% respectively and all of the different change was statistical significance (P< 0.05).However the LVIDd levels in the 3 groups analysed as group A< group B<group C,was (48.44±7.82),(51.70±7.01),(57.68±9.30) mm,the difference between group A and group B was not statistical significance (P > 0.05),the difference between group C and group B was not statistical significance (P > 0.05),the difference between group A and group C was statistical significance (P < 0.05).The correlation analysis in the two groups with cardiac insufficiency as the correlation between LVIDd and GFR was negative (r =-0.289,P < 0.05),the correlation between LVEF and GFR was positive (r =0.461,P < 0.01),the correlation between LVIDd and NT-proBNP was positive (r =0.287,P < 0.05),and the correlation between LVEF and NT-proBNP was negative (r =-0.637,P < 0.01).These data showed that GFR was decreased in the patients with cardiac insufficiency,and NT-proBNP was up-regulation.And this phenomenon also emerged in mild heart dysfunctional patients.Conclusion The study suggestes that GFR decreased and plasm NT-proBNP level increased in mild heart dysfunctional patients,which could be as a diagnostic criteria for clinical doctors.

  2. NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Wiinberg, Niels;

    2012-01-01

    Intensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P-NT-proBNP and the put......Intensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P-NT......-proBNP and the putative residual abnormalities in such patients are not well described. This study examined echocardiographic measurements of LV hypertrophy, atrial dilatation and LV dysfunction and their relation to P-NT-proBNP levels or subclinical coronary artery disease (CAD) in type 2 diabetic patients...

  3. Levels and prognostic significance of NT-ProBNP,hs-CRP in chronic heart failure%慢性心力衰竭NT-ProBNP、hs-CRP变化及其预后价值

    Institute of Scientific and Technical Information of China (English)

    周金锋; 程自平

    2013-01-01

    目的 探讨B型钠尿肽前体(NT-ProBNP)和高敏C反应蛋白(hs-CRP)联合检测对心力衰竭诊断、病情评估和预后判断的价值.方法 测定该院2010年1月-2012年11月103例明确诊断为充血性心力衰竭(CHF)的患者,测定入院时、出院时血浆NT-ProBNP 和血清hs-CRP水平,进行治疗前后对比观察,并随机抽取该院35名健康体检者作对照组比较,随访6月观察患者心脏事件再发生的情况.结果 血浆NT-ProBNP和血清hs-CRP和水平在心衰不同心功能分级组和健康对照组之间差异有统计学意义,心功能越差,其浓度越高(P<0.05);治疗前后比较,差异均也有统计学意义(P<0.05);出院后发生心脏事件组血浆NT-ProBNP 和血清hs-CRP水平浓度明显高于未发生心脏事件组(P<0.05).结论 心衰患者中NT-ProBNP 、hs-CRP明显升高,二者联合检测对心衰诊断、病情评估和预后判断有应用意义.%Objective To observe the value of B-type natriuretic peptide precursor (NT -ProBNP)and high-sensitivity C-eactive protein (hs-CRP)on patients of heart failure in diagnosis , illness evaluation and prognosis through jointed detection . Methods From January 2010 to November 2012,103 cases of CHF patients were measured plasma NT -ProBNP and hs -CRP serum levels on admission and at discharge. Before and after treatment comparison observations were made ,35 health were selected randomly for control. The patients were followed up for 6 months to observe it cardiac events happen again . Results NT-ProBNP and hs -CRP serum and plasma levels in different heart failure cardiac function grading group had statistically significant difference from healthy control group . The poorer heart function , the higher concentration ( P < 0.05 ) ; Before and after treatment, difference had statistical significance ( P < 0.05 ) ; Concentrations of plasma NT -ProBNP and hs -CRP level were significantly higher in cardiac evento after discharge group than those without cardiac

  4. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score=400, carotid intima...

  5. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score≥400, carotid intima...

  6. Changes in Serum NT-Pro BNP and Left Atrial BNP Levels after Percutaneous Transvenous Mitral Commissurotomy in Sinus Rhythm Versus Atrial Firilation

    Directory of Open Access Journals (Sweden)

    Leili Pourafkari

    2014-10-01

    Full Text Available Introduction: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS due tohigh left atrium (LA pressure and pulmonary artery pressure (PAP. Percutaneous transvenousmitral commissurotomy (PTMC if successful is pursued by a rapid decrease in LA pressure andsubsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptidelevels could be affected with heart rhythm.Methods: Forty five patients with severe rheumatic MS undergoing PTMC were enrolled. Weevaluated the serum NT-Pro BNP levels before and 24 hours after PTMC. BNP levels were alsomeasured from the blood samples obtained from LA before and 20 minutes after the procedure.Changes in biomarkers were assessed based on heart rhythm and success of the procedure.Results: While serum NT-Pro BNP levels showed significant decrease 24 hours after theprocedure (P= 0.04, BNP levels taken 20 minutes after PTMC from LA were similar to theirbaseline concentrations (P= 0.26. NT-Pro BNP levels decreased 51.7±182.86 pg/ml for SR and123.4±520 pg/ml for AF (P= 0.68.Conclusion: Immediate changes in BNP levels did not predict the success of procedure probablydue to the additional balloon inflation attempts in LA in several patients and half-life of BNP. BNPlevels obtained later may be of more value considering the half-life of this marker. Heart rhythmwas not found to influence the changes in biomarker levels. BNP and NT-pro BNP changes werenot found to predict success of the procedure.

  7. Influence of anaemia on levels of NT-proBNP and BNP in patients with heart failure%贫血对慢性心力衰竭患者血浆NT-proBNP和BNP水平的影响

    Institute of Scientific and Technical Information of China (English)

    赵枫; 孙一奎; 王峰; 王卫华; 曲静伟; 曹超

    2012-01-01

    目的:探讨贫血对慢性心力衰竭患者血浆氮末端—前体脑钠肽(NT-proBNP)、羧基端活性段脑钠肽(BNP)的影响.方法:研究对象为76例因心功能不全入院的慢性心力衰竭患者,其中31例贫血.测定血浆NT-proBNP、BNP、血常规、肾功能等.结果:1)两组NT-proBNP比较差别没有统计学意义(P>0.05).但是,BNP在两组中差别有统计学意义(P<0.05).2)相关性分析示血红蛋白浓度与BNP呈现负相关(r=-0.687),与NT-proBNP无关.结论:研究表明在评价心力衰竭患者NT-proBNP、BNP水平时需考虑其贫血等相关影响因素.%Objective:To study the influence of anaemia on BNP and NT - proBNP levels in a large group of hospitalised HF patients. Methods: 76 patients hospitalised for HF were studied. Of these patients, 31 were anaemic. BNP and NT - proBNP levels were measured in all patients before discharge. Blood routine test and renal function test were also carried out on these patients. Results: 1. NT - proBNP levels had no difference in the patients with a-naemia and patients without anaemia (P >0. 05) . BNP level of anaemia patients was signifcantly higher than that in patients without anaemia(P <0. 05) . 2. Pearson analysis showed plasma haemoglobin level had negative correlation with the levels of BNP. Conclusion: These results indicate that anaemia should be taken into consideration during the interpretation of BNP and NT - proBNP levels in HF patients.

  8. N-terminal fragment of B-type natriuretic peptide (NT-proBNP, a marker of cardiac safety during antipsychotic treatment

    Directory of Open Access Journals (Sweden)

    Schneider Udo

    2005-05-01

    Full Text Available Abstract Background The potential cardiotoxicity of antipsychotic drugs is well known. The N-terminal fragment of B-type natriuretic peptide (NT-proBNP is considered to be a possible biomarker in clinical practice for the diagnosis and prognosis in patients with suspected heart failure. This pilot evaluation tests the influence of antipsychotic drugs on NT-proBNP concentration in view of the hypothesis that NT-proBNP could be used as marker for the tolerability and safety of antipsychotic medications. Methods On a routine basis, patient's blood samples were examined for NT-proBNP on days 0, 7 and 21 after initiation of a new antipsychotic monotherapy. All plasma samples were analysed for NT-proBNP using an electrochemiluminiscence immunoassay "ECLIA" (proBNP kit, Roche Diagnostics, Mannheim, Germany on an Elecsys 2010 analyser. Results A difference was found in NT-proBNP values at day 0 between patients younger versus older than 40 years. Also women had comparatively lower NTproBNP on days 7 and 21. Smokers' levels of NT-proBNP values decreased more from day 0 to day 7. Conclusion Our results suggest that antipsychotic medication influences the plasma concentration of NT-proBNP, suggesting a possible method to identify high-risk-patients for cardiovascular adverse effects due to antipsychotic medication. Larger studies should further test this hypothesis.

  9. The Effect of Maximal and Submaximal Exercise Testing on NT-proBNP Levels in Patients with Systolic Heart Failure

    Directory of Open Access Journals (Sweden)

    Zdrenghea Dumitru Tudor

    2014-03-01

    Full Text Available Premise. La pacienţii cu insuficienţǎ cardiacǎ, testele de efort submaximale (testul de mers 400 metri şi testul de efort 6 minute reprezintǎ o alternativǎ a testului de efort clasic pe cicloergometru. Scopul studiului este de a compara creşterea la efort a peptidului natriuretic-NT-proBNP dupǎ testul de mers 400 m, respectiv testul de efort 6 minute faţă de testul clasic de efort pe cicloergometru. Material şi metodă. Au fost studiaţi 20 de pacienți cu insuficienţă cardiacă (fracţie de ejecţie <40% , cu vârste între 37 şi 70 de ani, 16 bărbaţi şi 4 femei. Dupǎ retrocedarea fenomenelor congestive, toţii pacienţii au efectuat în trei zile consecutive, cele trei tipuri de teste: testul de efort clasic pe cicloergometru, testul de mers 400 de metri, respectiv testul de efort de 6 minute. Valorile NT-pro BNP au fost determinate utilizând metoda ELISA înainte şi dupǎ cele trei teste de efort. Rezultate. Valorile medii ale NT-proBNP au fost crescute în repaus în toate cele trei zile, crescând apoi semnificativ, indiferent de tipul de test de efort efectuat: de la 688±72 fmol/ml la 1869±91 fmol/ml (p<0.05 în cazul testului de efort clasic, de la 843±90 fmol/ml la 977±93 fmol/ml (15%, p<0.05 în cazul testului de efort 6 minute şi de la 676±63 fmol/ ml la 927±95 fmol/ml (37%, p<0.05 pentru tesul de mers 400 de metri. Totodatǎ au existat corelaţii semnificative între valorile maxime ale NT-proBNP din cursul efortului pe cicloergometru /test de efort 6 minute (r=0.71, cicloergometeru/ test de mers 400 metri, (r=0.71, respectiv test de mers 400 metri/test de efort 6 minute (r=0.81, p<0.01. În concluzie concentraţia NT-proBNP creşte semnificativ şi similar la bolnavii cu insuficienţǎ cardiacǎ, atât în cursul efortului maximal cât şi în cursul efortului submaximal. Atât testul de efort 6 minute cât şi la testul de mers 400 metri, sunt suficiente ca intensitate pentru eliberarea de hormoni

  10. The estimate of prognosis in ACS patients of unobese after PCI by NT-proBNP level%NT-proBNP评估非肥胖ACS患者PCI术预后

    Institute of Scientific and Technical Information of China (English)

    聂浩; 刘红; 杨德辉

    2013-01-01

    Objective To investigate the clinical prognostic value of major abnormal cardiacevents (MACE) in unobese patients of acute coronary syndrome (ACS) patients before percutaneous coronary intervention (PCI )by plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP).Methods A total of 101 unobese patients of acute coronary syndrome,which were divided into ≤80pg/ml group of 31 patients and 〉80pg/ml group of 70 patients . follow-up major abnormal cardiac events (including death,cardiogenic shock, recurrent angina pectoris, non-fatal re-infarction, non-fatal heart failure,arrhythmia,target vessel revascularization, re-admitted to hospital composite end point) within 6 months after PCI.Results 1.In un-obese patients,MACE、death and CHF times of patients with NT-proBNP>80pg /ml were significantly higher than these times of patients with NT-proBNP≤ 80 pg/ml (P<0.05);2.in patients unobese,NT-proBNP levels predicted MACE、death and CHFwas significant (P<0.001),Con-clusion This clinical study results show that NT-proBNP can predicted MACE、death and CHF in unobese pa-tients within 6 moths after PCI.%  目的:探讨N 端脑钠肽前体(NT-proBNP)对非肥胖急性冠状动脉综合征(ACS)经皮冠脉介入(PCI)术后主要不良心脏事件(MACE)的预测价值。方法:因ACS 行PCI手术的非肥胖患者101例,分为低NT-proBNP水平组(NT-proBNP≤80 pg/ml)31例,高NT-proBNP水平(NT-proBNP>80 pg/ml)组70例,统计并分析患者PCI术后6个月内MACE发生率。结果:高NT-proBNP水平组PCI术后MACE发生率高于低NT-proBNP水平组;NT-proBNP可独立预测非肥胖ACS患者PCI术后MACE发生率、死亡率、和心衰的发生率。结论:血浆NT-proBNP水平可用于评估非肥胖ACS患者冠脉病变的范围PCI术后短期(6个月内)的预后。

  11. Polymorphisms in the B-type natriuretic peptide (BNP) gene are associated with NT-proBNP levels but not with diabetic nephropathy or mortality in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Lajer, Maria Stenkil; Tarnow, Lise; Jorsal, Anders

    2007-01-01

    of diabetes 28 +/- 8.0 years, glomerular filtration rate 67 +/- 28 ml/min/1.73 m2}, and a matched control group of 183 patients with longstanding type 1 diabetes and persistent normoalbuminuria (111 men, age 43 +/- 10.0 years, duration of diabetes 27 +/- 8.3 years) were followed for 12.6 (0.0-12.9) years....../A of the BNP gene, plasma NT-proBNP levels and mortality prognosis in 380 type 1 diabetic patients with and without diabetic nephropathy. METHODS: In a prospective observational follow-up study, 197 type 1 diabetic patients with diabetic nephropathy {121 men, age [mean (SD)] 41 +/- 9.5 years, duration....... Plasma NT-proBNP concentration was determined by immunoassay at baseline. The BNP genotypes were determined by TaqMan chemistry based assays. RESULTS: The two polymorphisms were in almost complete linkage disequilibrium (r2 = 0.883) and thus only the results of the -381T/C promoter polymorphism are shown...

  12. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...... levels are associated with low frequency of coronary artery disease (CAD) and good prognosis. The underlying causes of poor prognosis in patients with elevated NT-proBNP are not known; thus, we investigated the role of putative asymptomatic CAD in type 2 diabetic patients with UAER >30 mg/24 h...... and elevated P-NT-proBNP and/or CCS....

  13. Troponin T, NT-pro BNP, and Incidence of Stroke: The Atherosclerosis Risk in Communities (ARIC) Study

    Science.gov (United States)

    Folsom, Aaron R.; Nambi, Vijay; Bell, Elizabeth J.; Oluleye, Oludamilola W.; Gottesman, Rebecca F.; Lutsey, Pamela L.; Huxley, Rachel R.; Ballantyne, Christie M.

    2013-01-01

    Background and Purpose Increased levels of plasma troponins and natriuretic peptides are associated with increased risk of cardiovascular disease, but only limited information exists on these biomarkers and stroke occurrence. In a prospective epidemiological study, we tested the hypothesis that high-sensitivity troponin T (TnT) and N-terminal pro B-type natriuretic peptide (NT-proBNP) are associated positively with incidence of stroke. Methods The Atherosclerosis Risk in Communities (ARIC) Study measured plasma TnT and NT-proBNP in 10,902 men or women initially free of stroke and followed them for a mean of 11.3 years for stroke occurrence (n=507). Results Both biomarkers were associated positively with total stroke, nonlacunar ischemic, and especially, cardioembolic stroke, but not with lacunar or hemorrhagic stroke. For example, after adjustment for prevalent risk factors and cardiac diseases, the hazard ratios (95% confidence intervals) for jointly high values of TnT and NT-proBNP (versus neither biomarker high) were 2.70 (1.92, 3.79) for total stroke and 6.26 (3.40, 11.5) for cardioembolic stroke. Associations with stroke appeared somewhat stronger for NT-proBNP than TnT. Strikingly, approximately 58% of cardioembolic strokes occurred in the highest quintile of pre-stroke NT-proBNP, and 32% of cardioembolic strokes occurred in participants who had both NT-proBNP in the highest quintile and were known by ARIC to have atrial fibrillation sometime before their cardioembolic stroke occurrence. Conclusions In the general population, elevated plasma TnT and NT-proBNP concentrations are associated with increased risk of cardioembolic and other nonlacunar ischemic strokes. PMID:23471272

  14. Diagnostic Accuracy of NT-ProBNP for Heart Failure with Sepsis in Patients Younger than 18 Years.

    Directory of Open Access Journals (Sweden)

    Chun-Wang Lin

    Full Text Available This clinical study investigated plasma NT-proBNP levels as a potential predictor of heart failure in pediatric patients with sepsis. Plasma NT-ProBNP levels of 211 pediatric patients with sepsis and 126 healthy children were measured. Patients were stratified as with heart failure (HF or without heart failure (non-HF. Patients were graded as having sepsis, severe sepsis, or septic shock. The optimal cut-off values of plasma NT-ProBNP for heart failure were determined by analyzing the receiver operating characteristic (ROC. In the HF, non-HF and control groups, the median plasma NT-proBNP levels were 3640, 656, and 226 ng/L, respectively. For all patients with sepsis, the optimal diagnostic cut-off value was 1268 ng/L for differentiating heart failure. In the severe sepsis patients and septic shock patients, the optimal diagnostic cut-off values were 1368 ng/L and 1525 ng/L, respectively. This report is the first one to reveal that NT-proBNP may predict heart failure in children with sepsis. It provides an important clinical reference for the diagnosis of heart failure in pediatric patients with sepsis, and enables monitoring septic children for cardiac involvement.

  15. The correlation study between plasma NT-proBNP concentration and severity of untreated hypertension%血浆NT-proBNP浓度与未治疗高血压严重程度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    田可港; 孙玉娟; 聂亚红; 牟晓峰; 张磊; 张蓉

    2016-01-01

    目的:评估血浆NT-proBNP水平与高血压严重程度的关系。方法:在134例未经治疗及未发生心衰的原发性高血压患者中检测血浆NT-proBNP浓度和临床各指标之间的关系(平均年龄57.0±10.6,平均血压:160.4±14.2/97.1±9.2 mmHg;平均NT-proBNP浓度为221.1±228.1pg/ml)。依据NT-proBNP浓度将患者分为两组,正常组:125pg/ml,平均浓度为347.5±273.1, n=75)。分别检测两组的多项临床指标。结果:增高组与正常组相比有更高的心电图电压指数(SV1+RV5:3.49±1.12VS 2.96±0.83 mV ,P=0.0031);更高的心胸比(CTR)(47.1±4.8VS 44.9±4.5%,P=0.0039);更高的左心室质量指数(LVMI)(120±30VS 101±24g/m2,P=0.0005);更高的减速时间(DT)(221±35 VS 188±26 ms,P=0.0001);此外还有更小的E波/V波比值(0.78±0.21VS 0.94±0.26,P=0.0002)。两组的血压和BMI无明显的差异。运用多重线性回归分析方法,发现肾素和DT与NT-proBNP相关。结论:NT-proBNP可能是早期原发性高血压患者的一个指示因子。%Objective:To discuss the relationship between plamsa NT-proBNP and the severity of untreated hypertension. Methods:The relationship between the plasma NT-proBNP level and various clinical parameters was examined in 134 untreated hypertensive patients without heart failure or atrial fibrillation (mean age: 57.0±10.6; mean blood pressure: 160.4±14.2 /97.1±9.2mmHg; mean NT-proBNP: 221.1±228.1 pg/ml). The patients were divided into 2 groups based on NT-proBNP: normal (125pg/ml, mean 347.5±273.1, n=75).Results: The elevated NT-proBNP group had a significantly greater electrocardiographic voltage index (SV 1 +RV 5 ;3.49±1.12VS 2.96±0.83 mV ,P=0.0031), cardiothoracic ratio/chest radiography (CTR; 47.1±4.8VS 44.9±4.5%,P=0.0039), left ventricular mass index (LVMI; 120±30VS 101±24g/m2,P=0.0005 ) and deceleration time (DT; 221±35 VS 188±26 ms,P=0.0001), as well as a smaller E-wave to A-wave (E

  16. NT-ProBNP and cardiac troponin I in virulent canine babesiosis.

    Science.gov (United States)

    Lobetti, Remo; Kirberger, Robert; Keller, Ninette; Kettner, Frank; Dvir, Eran

    2012-12-21

    Although cardiac pathology and consequently elevated serum cardiac troponin I (cTnI) have been reported, clinically it remains difficult to diagnose cardiac involvement in canine babesiosis. Thus the use of cardiac biomarkers would be useful in determining if a dog with babesiosis also has concurrent cardiac dysfunction. The objectives of this study were to determine plasma N terminal brain natriuretic peptide (NT-proBNP) in canine babesiosis and if it is correlated with cTnI. Three groups of dogs with babesiosis were used: mild uncomplicated (Group 1), severe uncomplicated (Group 2), and complicated (Group 3), and a control group (Group 4) with 15 dogs per group. Each animal had the following determined: serum urea and creatinine, urea: creatinine ratio, cystatin-C, cTnI, blood lactate, plasma NT-proBNP, fractional shortening (FS), and blood pressure. The median NT-proBNP value in Groups 1-4 was 246, 650, 638, and 106 pmol/l. All 3 babesiosis groups had a statistically elevated NT-proBNP level compared to the control group and Groups 2 and 3 showed significantly higher values compared to Group 1. Median cTnI in Group 1-3 was 0.39, 0.4, and 1.45 ng/ml, respectively with the control group having concentrations below the detection limit (0.2 ng/ml). There was a significant difference in cTnI concentration between the control group and group 3 but no statistical difference between the other babesiosis groups. The study concluded that dogs with babesiosis showed elevated levels NT-proBNP and the more severe the disease process the greater the elevation. This elevation is earlier or independent of the increased cTnI. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. The relation between electrocardiographic ST-T changes and NT-proBNP in patients with acute ischemic stroke

    DEFF Research Database (Denmark)

    Jensen, Jesper K; Korsholm, Lars; Høilund-Carlsen, Poul Flemming

    2007-01-01

    BACKGROUND: ST-segment depression and T-wave inversion (ST-T changes) in the electrocardiogram (ECG) and raised levels of natriuretic peptide have been observed in acute ischemic stroke patients. It is unknown whether any relation between ST-T changes and raised levels of natriuretic peptides...... in patients with an acute ischemic stroke exists. METHODS: Serial measurements of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 12-lead ECGs were obtained in 192 consecutive patients with an acute ischemic stroke without ischemic heart disease, atrial fibrillation, heart- or renal failure......-T changes in the ECG remained associated with increased levels of NT-proBNP (beta=76.5, p=0.011). CONCLUSIONS: ST-T changes suggestive of myocardial ischemia are independently associated with the levels of NT-proBNP in patients with acute ischemic stroke. The clinical importance of this observation remains...

  18. NT-proBNP and diastolic left ventricular function in patients with Marfan syndrome

    Directory of Open Access Journals (Sweden)

    Petra Gehle

    2016-09-01

    Conclusions: MFS patients presenting with normal ejection fraction show disturbed diastolic function and higher NT-proBNP levels, which is partly explained by aortic Z-score. Assessment of diastolic function and NT-proBNP levels may therefore detect early abnormalities and guide surveillance and prevention management of patients with MFS.

  19. 急性心肌梗死给予脑钠肽前体检测对溶栓治疗预后的评价%The Thrombolysis Treatment Prognosis Evaluation about Plasma NT-proBNP in the AMI Patients

    Institute of Scientific and Technical Information of China (English)

    朱自强; 于力

    2014-01-01

    Objective:To observe whether early cardiovascular events occurred in patients with successful thrombolysis to explore the differences of NT-proBNP,and to detect its correlation with serum troponin T,CK,CK-MB,left ventricular ejection fraction,left ventricular end-diastolic volume,and discuss the value of plasma NT-proBNP for severity and prognostic significance in the AMI patients with successful thrombolysis.Method:The plasma NT-proBNP collecting before thrombolytic therapy in 61 patients with AMI was measured by enzyme-lined imunosorbent assay. All patients were followed up for 30 days,the occurrence of cardiovascular death,heart failure,recurrent AMI in 30 days,post-infarction angina,etc were observed. Result:Index of age, gender, height, weight, smoking, hypertension, diabetes and the incidence of myocardial infarction site of two groups had no difference(P>0.05),there were positive correlation between logNT-proBNP level and cTnT, CK, CK-MB,LVEDV(P0.05),logNT-proBNP水平与cTnT、CK、CK-MB、LVEDV存在正相关(P<0.05),与LVEF存在负相关(P<0.05)。结论:测定入院时血浆NT-proBNP水平对评估AMI经过成功溶栓治疗的患者30 d内发生心血管事件有重要的临床价值。

  20. Relationship between renalase and N-terminal pro-B-type Natriuretic Peptide (NT pro-BNP in haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Marcin Dziedzic

    2014-03-01

    Full Text Available Introduction. Our knowledge in the field of cause of deaths in dialysis patients is rapidly expanding, yet we still do not fully understand how renalase regulates the processes of cardiovascular disease developing in end-stage renal disease. Increased sympathetic nerve activity observed in chronic kidney diseases due to raised catecholamines in plasma results from the absence of renalase. Renalase synthesized and secreted by the kidneys participate in the regulation of sympathetic tone and blood pressure. A family of natriuretic peptides has been identified – NT pro-BNP – which seems to be the best predictor of clinical outcome and marker of extracellular fluid overload, as well as predicting mortality, irrespective of renal function. Objective. The aim of the presented study was to investigate renalase concentration and investigate associations between NT-proBNP, as well as analyzed parameters in haemodialysis patients. Materials and method. The study was conducted among residents of the municipality and neighbouring villages in the province of Lublin, central-eastern Poland. 49 male subjects on haemodialysis, aged 65.3 ± 14.2 years, median time on haemodialysis: 37.5 months, were included. All study subjects underwent haemodialysis 3 times a week. The mean concentration of renalase in the entire study population was 126.59 ± 32.63 ng/mL. The circulating levels of NT-proBNP was 813.64 ± 706.96 pg/mL. A significant inverse correlation was found between NT-proBNP and renalase plasma levels (R = –0.3, P = 0.03. Conclusions. Inverse correlation between NT-proBNP and renalase plasma levels in haemodialysis patients were due to impaired kidney function, accompanied by increased sympathetic nerve activity, which have an impact on the development of hypertension and cardiovascular complications.

  1. NT-proBNP and potential vascular calcification in Black and Caucasian African men

    DEFF Research Database (Denmark)

    Kruger, Ruan; Schutte, Rudolph; Huisman, Hugo W;

    2012-01-01

    The N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is a reliable marker of cardiac strain. In hypertensive heart disease, NT-proBNP levels increase and may lose its protective function. Simultaneously, the vasculature is also subject to hemodynamic stress, resulting in vascular matrix...... remodeling and stiffening which contribute to further cardiac alterations. Alkaline phosphatase (ALP) is a marker of osteoblast activity and is involved in vascular calcification. We explored the link between NT-proBNP and ALP in Black and Caucasian African men....

  2. Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Nielsen, Per H;

    2006-01-01

    BACKGROUND: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation. AIMS: Week-to-week total variance (CV(T)), unexplained...... variation (CV(I)), reference change values (RCV), index of individualities (IOI) and number of samples (N) with week-to-week intervals needed to estimate the underlying homeostatic set point (+/-15%) for BNP and NT-proBNP were calculated in pre-specified stable CHF patients. METHODS AND RESULTS: We measured...... plasma concentrations of BNP and NT-proBNP, clinical and laboratory variables in 20 CHF patients with a 7-days interval. Only patients considered to be in steady state were included. The CV(I) was 15% (BNP) and 8% (NT-proBNP). CV(T) was 16% (BNP) and 8% (NT-proBNP) and RCV was 43% (BNP) and 23% (NT...

  3. Hypertension-Related Gene Polymorphisms of G-Protein-Coupled Receptor Kinase 4 Are Associated with NT-proBNP Concentration in Normotensive Healthy Adults

    Directory of Open Access Journals (Sweden)

    Junichi Yatabe

    2012-01-01

    Full Text Available G protein-coupled receptor kinase 4 (GRK4 with activating polymorphisms desensitize the natriuric renal tubular D1 dopamine receptor, and these GRK4 polymorphisms are strongly associated with salt sensitivity and hypertension. Meanwhile, N-terminal pro-B-type natriuretic peptide (NT-proBNP may be useful in detecting slight volume expansion. However, relations between hypertension-related gene polymorphisms including GRK4 and cardiovascular indices such as NT-proBNP are not clear, especially in healthy subjects. Therefore, various hypertension-related polymorphisms and cardiovascular indices were analyzed in 97 normotensive, healthy Japanese adults. NT-proBNP levels were significantly higher in subjects with two or more GRK4 polymorphic alleles. Other hypertension-related gene polymorphisms, such as those of renin-angiotensin-aldosterone system genes, did not correlate with NT-proBNP. There was no significant association between any of the hypertension-related gene polymorphisms and central systolic blood pressure, cardioankle vascular index, augmentation index, plasma aldosterone concentration, or an oxidative stress marker, urinary 8-OHdG. Normotensive individuals with GRK4 polymorphisms show increased serum NT-proBNP concentration and may be at a greater risk of developing hypertension and cardiovascular disease.

  4. 快速免疫荧光法检测血浆NT-proBNP的分析性能评价%Evaluation of performance of a rapid immunofluorescence method for assaying plasma NT-proBNP

    Institute of Scientific and Technical Information of China (English)

    唐筑灵; 徐国宾

    2010-01-01

    Objective To analyze the performance of a rapid immunofluorescence assay for plasma NT-proBNP. Methods Human plasma NT-proBNP was measured by RAMP in 264 healthy cases and 78 patients with heart failure. The precision, stability, linearity and interference factors of RAMP were evaluated according to the protocold from America CLSI. Meanwhile, the results were compared with those obtained by Elecsys. Results Functional sensitivity of RAMP in 20% CV and 10% CV were 48 ng/L and 57 ng/L respectively. The linear range was 18-8 000 ng/L. NT-proBNP in plasma samples detected by RAMP were stable at room temperature for 24 hours, 4 ℃ for 3 days and - 20 ℃ for 20 days. No influences on results were observed throughout three freeze-thaw cycles. The results measured by RAMP were compared between EDTA-K2 anticoagulant plasma and heparin anticoagulant plasma, which showed that YEDTA-K2 =0. 953 9 Xheparin + 0. 365 2 ( R2 = 0. 982, P < 0. 01, n = 40 ). The results of EDTA-K2 and heparin anticoagulant plasma using RAMP and Elecsys showed no significant difference( P >0. 05). Slight hemolysis( Hb 2 g/L)had small effect on the results of PAMP and Elecsys assays and deviations of them were below 5%. However median and heavy hemolysis( Hb 3-4 g/L )obviously influenced the results with deviation were more than 15%. The values measured by RMAP fell from 390 ng/L to 82 ng/L, and those measured by Elecsys method fell from 390 ng/L to 178 ng/L when 3 different concentrations of triacylglycerol were added, the values measured by two methods fell from 7 777 ng/L to 7 741 ng/L when bilirubin ( 16-330 μmol/L) was added. The anti-interference ability of RAMP method was similar to Elecsys. Results detected with two methods in 45 EDTA-K2 anticoagulant plasma samples were analyzed with Passing and Bablok regression.The regression equation was YRAMP = 0. 972 8XElecsys - 0. 035 2 (R2 = 0. 994, P > 0. 05, n = 45 ). When heparin anticoagulant plasma samples increased to 78 samples, Passing and

  5. Serum levels of NT- pro ANP, BNP, NT-pro BNP and function of the left atrium in patients with heart failure and preserved ejection fraction after myocardial infarction

    Science.gov (United States)

    Shurupov, V.; Suslova, T.; Ryabov, V.

    2015-11-01

    The objective of our study was to evaluate the levels of natriuretic peptides in patients (pts) with heart failure with preserved ejection fraction (HFpEF) in 12 month after ST elevation myocardial infarction (STEMI) with a focus on the function of left atrium (LA) and left ventricular (LV) filling pressure. 55 pts were included in the study. 6-minute walk test was performed. Echo exam was performed by the diagnostic system VIVID 7. BNP in whole blood was determined using the Triage ® Meter BNP test. The serum levels of NT-pro BNP, NT-pro ANP («Biomedica», Austria) were determined in blood samples by enzyme-linked immune-sorbent assay (ELISA). LA volume index were differences (16.03±3.39 ml/m2; 25.36±8.26 ml/m2; 29.41±9.46 ml/m2 accordingly I, II, III class) depending on severity of HF. Well as E/E' ratio were differences (7.5±1.4; 9.8±5.1; 13.5±7.6 accordingly I, II, III class) depending on severity of HF. The LA volume index correlated with levels of NT-pro ANP (R=0.29; p=0.04), levels of NT-pro BNP (R=0.37; p=0.01), levels of BNP (R=0.51; p=0.0001). The LV filling pressure correlated with levels of NT-pro ANP (R=0.45; p=0.002), levels of NT-pro BNP (R=0.49; p=0.001), levels of BNP (R=0.37; p=0.01).

  6. 血浆NT-proBNP水平对脓毒症合并心肌损伤的诊断价值%Diagnostic value of plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP) in patients with sepsis combined with myocardial injury

    Institute of Scientific and Technical Information of China (English)

    贺红霞; 胡苏萍; 黄毅

    2011-01-01

    目的 观察N-末端B型利钠肽原(NT-proBNP)在脓毒症及其脓毒症合并心肌损伤患者的水平变化.方法 武汉大学人民医院住院的脓毒症患者37例,其中并心肌损伤者17例(A组),非心肌损伤者20例(B组),健康对照者20例(C组).测定入院后24 h内血浆NT-proBNP水平及肌钙蛋白I的水平,对比各组之间血浆NT-proBNP水平,并将NT-proBNP水平与肌钙蛋白I进行相关性分析.结果 A、B、C组NT-proBNP水平入院后分别为(3180.6±1420.57)pg/ml,(746.66±225.63)pg/ml,(60.195±28.305)pg/ml.对比各组入院后NT-proBNP的水平,有统计学意义(P<0、01).且脓毒症并心肌损伤组肌钙蛋白I为3.8822±1.8221 ng/ml,与NT-proBNP成正相关.结论 NT-proBNP在脓毒症患者血浆中水平升高,且在心肌损伤组与非心肌损伤组中有差异,血浆NT-proBNP与肌钙蛋白I成正相关,两者升高越明显病情越危重,可作为判断心肌是否受损的指标.%Objective To observe the variation of NT-proBNP level in patients with sepsis and sepsis combined with myocardial injury. And search for the early diagnostic index of myocardial injury. Methods We recruited 37 patients received a diagnosis of sepsis according to the diagnosis and treatment program of septicemia in 2003 by the American College of Chest Physicians and the Society of Critical Care Medicine(ACCP/SCCM). The 37 cases were divided into myocardial injury group (group A ) and non-myocardial injury group ( group B). Meanwhile,twenty non-sepsis patients were enrolled as control group( group C). We measured NT-proBNP in plasma in these 57 patients and then analyzed the differences of its level among the 3 groups. Meanwhile,the results were compaired to troponin Ⅰ in group A. Results There were significant differences among NT - proBNP levels in plasma of the 3 groups: ( 3180. 6 ± 1420. 57 ) pg/ml in group A, (746. 66 ± 22.5.63 ) pg/ml in group B, and (60. 195 ± 28. 305 ) pg/ml in group C( P < 0. 01 ). Conclusion The

  7. NT-proBNP on Cobas h 232 in point-of-care testing

    DEFF Research Database (Denmark)

    Gils, Charlotte; Ramanathan, R.; Breindahl, T.;

    2015-01-01

    Background. NT-proBNP may be useful for ruling out heart failure in primary health care. In this study we examined the analytical quality of NT-proBNP in primary health care on the Cobas h 232 point-of-care instrument compared with measurements performed in a hospital laboratory. Materials...... and methods. Blood samples requested for NT-proBNP were collected in primary health care (n = 95) and in a hospital laboratory (n = 107). NT-proBNP was measured on-site on Cobas h 232 instruments both in primary health care centres and at the hospital laboratory and all samples were also analyzed...... with a comparison method at the hospital. Precision, trueness, accuracy, and lot-variation were determined at different concentration levels and evaluated according to acceptance criteria. Furthermore user-friendliness was assessed by questionnaires. Results. For Cobas h 232 repeatability CV was 8...

  8. Introduction of an NT-proBNP assay to an acute admission unit--a 2-year audit.

    LENUS (Irish Health Repository)

    Murtagh, Gillian

    2012-02-01

    BACKGROUND: The differential diagnosis of dyspnoea is difficult due to the low predictive value of clinical and laboratory parameters. The elevated levels of NT-proBNP in congestive heart failure may improve diagnostic accuracy. We have evaluated the effect of the introduction of an NT-proBNP assay on hospital length of stay (LOS) and mortality. METHODS: There were 11,853 AMAU patient episodes in the 22 months study period (March 2005-Dec 2006). An NT-proBNP assay was requested in 657 (5.5%) of these. Comparison between categorical variables such as diagnosis, NT-proBNP testing, LOS, and in-hospital mortality was made using Chi-square tests. Literature review suggested that an NT-proBNP cut-off >or=5000 ng\\/L should predict acute in-patient mortality. Logistic regression analysis was used to examine the association between such an elevated NT-proBNP level and outcomes. RESULTS: Of the 396 patients with NT-proBNP <5000 ng\\/L, 8.1% died compared with 22.5% of the 178 patients dying with values >or=5000 ng\\/L (p<0.0001). An NT-proBNP >or=5000 ng\\/L was predictive of both LOS >or=9 days (odds ratios (OR) 1.54 (95% CI 1.06, 2.24: p=0.02) and LOS >or=14 days (OR=1.87 (95% CI 1.29, 2.71: p=0.0009). NT-proBNP requests increased over time, from 2.6% to 8.2% of all patients; the result fell in the diagnostic range for CHF in 60% of requests. CONCLUSION: The introduction of an NT-proBNP was reflected in an appropriate but rapidly increasing pattern of requests from clinicians. High NT-proBNP levels predicted in-hospital mortality and longer LOS in an acute medical population.

  9. NT-proBNP in severe chronic heart failure: rationale, design and preliminary results of the COPERNICUS NT-proBNP substudy.

    Science.gov (United States)

    Hartmann, Franz; Packer, Milton; Coats, Andrew J S; Fowler, Michael B; Krum, Henry; Mohacsi, Paul; Rouleau, Jean L; Tendera, Michal; Castaigne, Alain; Trawinski, Jürgen; Amann-Zalan, Ildiko; Hoersch, Silke; Katus, Hugo A

    2004-03-15

    Neither profiles nor prognostic value of cardiac N-terminal proBNP (NT-proBNP) have been prospectively evaluated in a sufficient number of patients with severe chronic heart failure (CHF) treated with carvedilol or placebo. Baseline and follow-up plasma concentrations of NT-proBNP were measured in the European part of the COPERNICUS Trial. This study enrolled patients with an ejection fraction <25% and symptoms of CHF at rest or on minimal exertion, equally randomized to placebo or carvedilol. NT-proBNP concentrations were increased at baseline (mean+/-S.D.=579+/-822 pmol/l, median=322.5 pmol/l) with a marked decrease during follow-up in the carvedilol, but not in the placebo group. One-year mortality rates were 3.9, 12 and 27.9% in the lower, middle and upper tertiles of NT-proBNP, respectively. When mortality was calculated separately in the placebo and carvedilol group, rates were 0.8, 6.3 and 19.1% in the carvedilol treated but 6.7, 17.9 and 36.9% in the placebo treated patients. NT-proBNP was a powerful predictor of subsequent all-cause mortality in patients with severe CHF. This marker should therefore be further evaluated for risk stratification and monitoring of therapy in CHF.

  10. NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Wiinberg, Niels;

    2012-01-01

    -NT-proBNP and the putative residual abnormalities in such patients are not well described. This study examined echocardiographic measurements of LV hypertrophy, atrial dilatation and LV dysfunction and their relation to P-NT-proBNP levels or subclinical coronary artery disease (CAD) in type 2 diabetic patients...

  11. 血浆NT-pro BNP和Big ET-1在冠心病的代谢变化及其临床价值%Study on Clinical Value of Changes of Plasma NT-proBNP and Big ET-1 in Patients with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    陈剑雄; 彭紫元; 张琼丽; 李延武; 屠洪; 李卓成

    2011-01-01

    目的:探讨冠心病(CHD)患者血浆N末端脑钠肽原(NT-proBNP)与大内皮素-1(Big ET-1)水平的变化及其与心功能的关系.方法:采用酶联免疫吸附试验双抗体夹心法对136例CHD患者及55例健康对照者进行血浆NT-proBNP和Big ET-1测定,同时以彩色多普勒超声心电动仪测定CHD患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF),并与血浆NT-proBNP和Big ET-1水平进行相关性分析.结果:CHD患者血浆NT-proBNP和Big ET-1水平均明显高于健康对照者(P<0.01),且不同心功能患者之间的血浆NT-proBNP和Big ET-1含量亦存在显著性差异(P<0.01);CHD患者血浆NT-proBNP水平与LVEF、LVESD、LVEDD呈现良好的相关性(r分别为-0.63、+0.57和+0.61,P均<0.01),而血浆Big ET-1水平与LVEF、LVESD、LVEDD的变化亦密切相关(r分别为-0.51、+0.46和+0.49,P均<0.01);血浆NT-proBNP和Big ET-1水平呈正相关(r=+0.47,P<0.01).结论:NT-proBNP和Big ET-1可能参与了CHD及心功能损伤的病理生理过程,血浆NT-proBNP升高与Big ET-1的变化呈正相关.%Objective To investigate the changes of plasma levels of N-terminal irobrain natriuredc peptide( NT-proBNP ) and Big endotbelin-1 ( Big ET-1 ) and their relationship with cardiac function in patients with coonary heart disease (CHD ). Methods The levels of plasma NT-ptoBNP and Big ET-1 were measured by double antibedy enzyme linked immumescrbent assay in 136 patients with CHD and 55 healthy subjects. Lift ventricular ejection fracfion( LVEF ), left ventricular end systolic diameter ( LVESD ) and left ventricular end diastolic diameter ( LVEDD ) were determined by color Doppler ultra.sonograghy in CHD patients. And the relation between plaama levels of NT-proBNP and Big ET-1. as well as the values of LVEF , LVESD and LVEDD were studied in CHD patients. ResUlts Plasma levels of NT-proBNP and Big ET-1 were markedly increased in patients with CHD as compared with

  12. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...

  13. Long-term clinical variation of NT-proBNP in stable chronic heart failure patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kjaer, Andreas;

    2007-01-01

    AIMS: Here, the aim is to assess long-term clinical variation (CV) of N-terminal pro-brain natriuretic peptide (NT-proBNP) in stable chronic heart failure (CHF) patients. The proposed use of NT-proBNP for monitoring of CHF patients will require accurate information about long-term CV of the peptide...... months after the second follow-up were included. A total of 78 patients fulfilled the criteria, and year-to-year CV was calculated to 30% (median) (range: 0-111%) (% changes range: -87 to 397%). Log transformation of NT-proBNP (skewed to the right) reduced the year-to-year CV to 4.7% (range: 0......-22%) (% changes range: -18 to 38%). CONCLUSION: Long-term CV of plasma concentrations of NT-proBNP in stable CHF patients is 30%, but the variation is substantial. Therefore, high long-term CV of NT-proBNP does not necessarily carry prognostic significance within the subsequent 12 months. Plasma concentrations...

  14. 血浆脑钠肽及N端脑钠肽前体与心力衰竭的研究新进展%The Newest Research on Relationship of Heart Failure and Plasma BNP/NT-proBNP

    Institute of Scientific and Technical Information of China (English)

    阿米娜・马合木提(综述); 马建军(审校)

    2015-01-01

    Chronic heart failure is a common clinical cardiovascular disease with a high incidence ,and can be accompanied with sudden death,arrhythmia and other cardiovascular diseases.Plasma brain natriuretic pep-tide (BNP) and N-terminal pro-BNP(NT-proBNP) are currently available as a polypeptide with a variety of biological functions of hormones for disease of heart failure,ischemic cardiomyopathy,hypertension,and pulmo-nary heart disease,playig the role of diuresis,natriuresis,expanding the tube through the heart capacity,load and ventricular wall tension.BNP/NT-proBNP can be used as the detection index of cardiovascular diseases.%慢性心力衰竭是临床上常见的心血管疾病,可伴发猝死、心律失常等其他心血管疾病,具有较高的发病率。血浆脑钠肽(BNP)及 N 端 BNP 前体(NT-proBNP)目前可作为心力衰竭、缺血性心肌病、高血压以及肺源性心脏病等疾病一种具有多种生物功能的多肽类激素,能够通过心脏的容量、负荷以及室壁张力而发挥利尿、排钠、扩管的作用。 BNP/NT-proBNP可作为心血管疾病的检测指标。

  15. Pulmonary valve replacement in chronic pulmonary regurgitation in adults with congenital heart disease: impact of preoperative QRS-duration and NT-proBNP levels on postoperative right ventricular function.

    Science.gov (United States)

    Westhoff-Bleck, Mechthild; Girke, Stefan; Breymann, Thomas; Lotz, Joachim; Pertschy, Stefanie; Tutarel, Oktay; Roentgen, Philipp; Bertram, Harald; Wessel, Armin; Schieffer, Bernhard; Meyer, Gerd Peter

    2011-09-15

    Chronic severe pulmonary regurgitation (PR) causes progressive right ventricular (RV) dysfunction and heart failure. Parameters defining the optimal time point for surgery of chronic PR are lacking. The present study prospectively evaluated the impact of preoperative clinical parameters, cardiorespiratory function, QRS duration and NT-proBNP levels on post operative RV function and volumes assessed by cardiac magnetic resonance imaging (CMR) in patients with chronic severe PR undergoing pulmonary valve replacement. CMR was performed pre- and 6 months postoperatively in 27 patients (23.6 ± 2.9 years, 15 women) with severe PR. Postoperatively, RV endsystolic (RVESVI) and enddiastolic volume indices (RVEDVI) decreased significantly (RVESVI pre 78.2 ± 20.4 ml/m² BSA vs. RVESVI post 52.2 ± 16.8 ml/m²BSA, pfunction and volumes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Time and age dependent decrease of NT-proBNP after septal myectomy in hypertrophic obstructive cardiomyopathy.

    Science.gov (United States)

    Cui, Hao; Wu, Xi; Wang, Shuiyun; Tang, Bing; Zhu, Changsheng; Chen, Haibo; Zhou, Xiaohui; Wu, Rong; Yu, Qinjun; Huang, Xiaohong

    2017-08-28

    NT-proBNP level is a predictive factor in hypertrophic cardiomyopathy patients, in which left ventricular outflow tract obstruction contributes to an increased NT-proBNP level. However, studies regarding the influence of septal myectomy on NT-proBNP level in hypertrophic obstructive cardiomyopathy are lacking. One hundred and eighty-two patients who underwent septal myectomy in Fuwai Hospital from May 2011 to March 2016 and were included in the present study. Preoperative and follow-up NT-proBNP was retrospectively collected. Correlation analysis was performed to determine the factors affecting preoperative NT-proBNP and postoperative decrease. The cohort had a median age of 46.2 [IQR: 36.5-53.1] years, and 106 (58.2%) patients were male. NT-proBNP decreased to 816.5 [IQR: 400.3-1661.8] pg/mL from preoperative 1732.4 [IQR: 819-3296.5] pg/mL (pdecrease was positively correlated with age (pdecrease after myectomy. Myectomy significantly reduced NT-proBNP level in hypertrophic obstructive cardiomyopathy patients, in which a time-dependent manner of decrease indicated myocardial remodeling of the heart after myectomy.

  17. 不同类型心力衰竭患者血尿酸与NT-proBNP、hs-CRP的关系%Correlation between plasma uric acid and NT-proBNP, hs-CRP in patients with different clinical types of chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    曹丹丹; 张菲斐; 韩战营; 邱春光; 黄振文

    2013-01-01

    mol/L] and control group [(387.63 ± 119.19) μmol/L] (both P<0.05),while HFPEF group had no statistical significance compared with control group.②Plasma level of NT-proBNP and hs-CRP in HFREF group were higher than those in HFPEF group (both P<0.05),and both experiment groups were significantly higher than those in control group (both P<0.05).③The UA was positively correlated with NT-proBNP and hs-CRP in HFREF group (r=0.649,0.532 respectively,both P<0.05),while UA had no obvious correlation with NT-proBNP and hs-CRP in HFPEF group.Conclusion:Plasma UA can be used as an effective biological parameter for assessing the severe degree of CHF and a good index of the existence of inflammatory response.

  18. High NT-proBNP is a strong predictor of outcome in elderly heart failure patients

    DEFF Research Database (Denmark)

    Andersson, Sven; Edvinsson, Marie-Louise; Björk, Jonas;

    2008-01-01

    All patients older than 65 years (184 men; mean age, 78+/-0.8 years/181 women; mean age, 82+/-0.6 years) seeking medical attention at the Lund University Hospital Emergency Clinic during a 2-year period who had an N-terminal prohormone brain natriuretic peptide (NT-proBNP) value >2000 pg/mL were...... followed up for survival. Mortality in the entire population was 21% after 3 months, 35% after 1 year, and 40% after 2 years. Multivariate analysis indicated that the NT-proBNP level and the New York Heart Association (NYHA) functional class were stronger predictors of mortality than were echocardiographic...... that in this population, NT-proBNP level together with assessment of NYHA class gives the best prognostic information of 1-year mortality....

  19. Effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after PCI

    Institute of Scientific and Technical Information of China (English)

    Jing Peng; Li Chen

    2016-01-01

    Objective:To study the effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after percutaneous coronary intervention (PCI).Methods:A total of 130 angina pectoris patients who received PCI treatment in our hospital from May 2012 to October 2015 were selected for study, patients' medical records were retrospectively analyzed, they were divided into the experimental group and the control group based on the different medication schemes after PCI, experimental group received routine treatment combined with salvianolate and meglumine adenosine cyclphosphate treatment after operation, and control group received conventional medical treatment after operation. The changes of perioperative blood viscosity, inflammatory factor and NT-proBNP content were compared between two groups.Results:After PCI, the blood viscosity indexes as well as inflammatory factor and NT-proBNP levels of experimental group were significantly lower than those before PCI (P0.05), inflammatory factor and NT-proBNP levels were significantly lower than those before PCI (P<0.05); 7 days after PCI, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity and aggregation index as well as TNF-α, sICAM-1, sVCAM-1, LP-PLA2, NT-proBNP, D-dimer and PTEN levels of experimental group were significantly lower than those of control group (P<0.05).Conclusions: Salvianolate combined with meglumine adenosine cyclphosphate can reduce the blood viscosity of patients with angina pectoris after PCI, and can also reduce inflammation and improve heart pump function.

  20. Short-term teriparatide treatment does not affect NT-proBNP, a marker of cardiac disease

    DEFF Research Database (Denmark)

    Ellegaard, Maria; Schwarz, Peter; Hansen, Ann Caroline;

    2012-01-01

    of cardiovascular disease (CVD) is seen in PHPT patients. The N-terminal fragment of the pro-peptide of Brain Natriuretic peptide (NT-proBNP), a risk marker of CVD, has been shown to be elevated in PHPT patients, indicating that continuously high concentrations of PTH affect the heart. Therefore the aim...... of this study was to investigate whether teriparatide treatment is associated with changes in plasma NT-proBNP....

  1. Significance of NT-pro-BNP in acute exacerbation of COPD patients without underlying left ventricular dysfunction.

    Science.gov (United States)

    Adrish, Muhammad; Nannaka, Varalaxmi Bhavani; Cano, Edison J; Bajantri, Bharat; Diaz-Fuentes, Gilda

    2017-01-01

    B-type natriuretic peptide (BNP) and the N-terminal fragment of pro-BNP (NT-pro-BNP) are established biomarkers of heart failure. Increased levels of natriuretic peptide (NP) have been associated with poor outcomes in acute exacerbation of COPD (AECOPD); however, most studies did not address the conditions that can also increase NT-pro-BNP levels. We aimed to determine if NT-pro-BNP levels correlate with outcomes of AECOPD in patients without heart failure and other conditions that can affect NT-pro-BNP levels. We conducted a retrospective study in patients hospitalized for AECOPD with available NT-pro-BNP levels and normal left ventricular ejection fraction. We compared patients with normal and elevated NT-pro-BNP levels and analyzed the clinical and outcome data. A total of 167 of 1,420 (11.7%) patients met the study criteria. A total of 77% of male patients and 53% of female patients had elevated NT-pro-BNP levels (P=0.0031). NT-pro-BNP levels were not associated with COPD severity and comorbid illnesses. Log-transformed NT-pro-BNP levels were positively associated with echocardiographically estimated right ventricular systolic pressure (r=0.3658; 95% confidence interval [CI]: 0.2060-0.5067; Ppro-BNP levels were more likely to require intensive care (63% vs 43%; P=0.0207) and had a longer hospital length of stay (P=0.0052). There were no differences in the need for noninvasive positive pressure ventilation (P=0.1245) or mechanical ventilation (P=0.9824) or in regard to in-hospital mortality (P=0.5273). Patients with AECOPD and elevated NT-pro-BNP levels had increased hospital length of stay and need for intensive care. Based on our study, serum NT-pro-BNP levels cannot be used as a biomarker for increased mortality or requirement for invasive or noninvasive ventilation in this group of patients.

  2. 慢性心力衰竭患者血浆视黄醇结合蛋白、胱抑素、NT-proBNP 浓度与体质量指数的关系%Relationship among plamsa retinol binding protein, cystatin C, N-teminal pro-brain natriuretic peptides levels with body mass index in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    古忆; 卢新政; 周建松; 夏思良; 黄红娟; 郑宏健; 秦晓毅; 曹克将; 黄峻

    2011-01-01

    目的 探讨慢性心力衰竭患者血浆视黄醇结合蛋白(RBP)、胱抑素(Cys-C)、NT-proB-NP 浓度与体质量指数(BMI)的关系,及其对慢性心力衰竭患者心功能、预后评估的价值.方法 135例慢性心力衰竭患者(男70 例,女65 例,左心室射血分数28 kg/m2 ),测定慢性心力衰竭患者血浆RBP、Cys-C、NT-proBNP 浓度,探讨其与BMI 的相关性及其对慢性心力衰竭患者心功能、预后的影响.结果 (1)肥胖组患者血浆RBP 水平[(70.45 ±8.74)mg/L]明显高于BMI 正常组[(56.45 ±7.15)mg/L]及超重组[(64.61 ±7.24)mg/L],胱抑素水平[(2.78 ±0.38)mg/L]明显高于BMI 正常组[(1.90 ±0.48)mg/L]及超重组[(2.39 ±0.41)mg/L],血浆NT-proBNP 水平[(1536 ±69)ng/L]明显低于BMI 正常组[(1857 ±145)ng/L]及超重组[(1726 ±115)ng/L](P 均<0.01);(2)慢性心力衰竭患者血浆RBP、Cys-C 与BMI 之间存在显著正相关(r =0.621,P <0.01;r =0.680,P <0.01),且随肥胖程度加重而逐渐增高;NT-proBNP 与BMI 之间存在显著负相关(r =-0.865,P <0.01).结论 慢性心力衰竭患者血浆RBP、Cys-C 水平均随BMI 增加而增加,而NT-proBNP 随BMI 增加而降低,联合检测血浆NT-proBNP靇_氋;_岪、Cys-C、RBP 水平有利于肥胖合并慢性心力衰竭的诊断及预后评估.%Objective To explore the relationship among levels of plasma retinol binding protein , cystatin C,N-teminal pro-brain natriuretic peptide(NT-proBNP) with body mass index(BMI) ,and to identify whether the simultaneous determination of the three markers is valuable to evaluate the cardiac function and prognosis for patients with chronic heart failure. Methods 135 patients with chronic heart failure were enrolled in this study (70 males ,65 females and LVEF <50% ) ,and height and weight of each patient were measured and BMI were calculated with these parameter. The patients were divided into 3 groups according to BMI; normal group (BMI <24 kg/m2) , overweight group (BMI 24-27. 9 kg/m2) and obese group

  3. N-terminal pro b-type natriuretic peptide (NT-pro-BNP) -based score can predict in-hospital mortality in patients with heart failure.

    Science.gov (United States)

    Huang, Ya-Ting; Tseng, Yuan-Teng; Chu, Tung-Wei; Chen, John; Lai, Min-Yu; Tang, Woung-Ru; Shiao, Chih-Chung

    2016-07-14

    Serum N-terminal pro b-type natriuretic peptide (NT-pro-BNP) testing is recommended in the patients with heart failure (HF). We hypothesized that NT-pro-BNP, in combination with other clinical factors in terms of a novel NT-pro BNP-based score, may provide even better predictive power for in-hospital mortality among patients with HF. A retrospective study enrolled adult patients with hospitalization-requiring HF who fulfilled the predefined criteria during the period from January 2011 to December 2013. We proposed a novel scoring system consisting of several independent predictors including NT-pro-BNP for predicting in-hospital mortality, and then compared the prognosis-predictive power of the novel NT-pro BNP-based score with other prognosis-predictive scores. A total of 269 patients were enrolled in the current study. Factors such as "serum NT-pro-BNP level above 8100 mg/dl," "age above 79 years," "without taking angiotensin converting enzyme inhibitors/angiotensin receptor blocker," "without taking beta-blocker," "without taking loop diuretics," "with mechanical ventilator support," "with non-invasive ventilator support," "with vasopressors use," and "experience of cardio-pulmonary resuscitation" were found as independent predictors. A novel NT-pro BNP-based score composed of these risk factors was proposed with excellent predictability for in-hospital mortality. The proposed novel NT-pro BNP-based score was extremely effective in predicting in-hospital mortality in HF patients.

  4. NT-proBNP as a useful tool in diagnosing incomplete Kawasaki disease

    Directory of Open Access Journals (Sweden)

    Dong Won Lee

    2010-04-01

    Full Text Available Purpose : To determine the efficacy of the N-terminal fragment of B-type natriuretic peptide (NT-proBNP as a useful diagnostic method in children with incomplete Kawasaki disease (KD. Methods : Ninety-six patients who were diagnosed as having KD between January 2008 and June 2009 were enrolled in the study. American Heart Association recommendations for diagnosis were used, and patients were divided into the complete KD and incomplete KD groups. Blood tests including NT-proBNP were performed on admission day. Nineteen patients who had other febrile diseases other than KD were enrolled as control. Results : Thirty-three patients (34% had incomplete KD. Change in the lips and oral cavity and conjunctivitis were the most common clinical features, but their frequency was lower than complete KD (76% vs 98%, 76% vs 90%. Patients with incomplete KD exhibited significantly higher NT-proBNP level than that of control (1,407.7¡?#?633;.5 pg/mL vs 126.2¡?#?35.;5 pg/mL, P &lt;0.001. An NT-proBNP cutoff value of 158 pg/mL provided a sensitivity of 81% and a specificity of 74% for diagnosis of incomplete KD. Conclusion : NT-proBNP assay can be clinically useful for the diagnosis of incomplete KD, if the patient has persistent fever, change in the lips and oral cavity, and conjunctivitis, and if the patient with those symptoms is suspected to have incomplete KD.

  5. Relationship of pneumonia severity index with serum levels of NT?proBNP and D?Dimer in elderly patients with community?acquired pneumonia%老年社区获得性肺炎患者PSI分级与NT-proBNP及血清D-二聚体的关系

    Institute of Scientific and Technical Information of China (English)

    邱建凯; 尹占良; 张芳芳; 李令娟; 姚海珍

    2016-01-01

    目的 探讨老年社区获得性肺炎(CAP)患者肺炎严重度指数(PSI)分级与血清N末端脑钠肽前体(NT-proBNP)和D-二聚体(D-Dimer)水平的关系.方法 选择本院收治的162例老年CAP患者为老年肺炎组,正常对照组为50例无基础疾病的健康体检人群.患者入院后24 h内进行临床数据收集,评估PSI,根据入院后28 d内是否死亡分为存活组与死亡组.同时检测老年肺炎组及正常对照组血清NT-proBNP与D-Dimer浓度,分析并比较CAP患者PSI分级与血清NT-proBNP及D-Dimer水平的关系.结果 (1)老年肺炎组血清NT-proBNP、D-Dimer水平明显高于正常对照组(P<0.05).(2)老年肺炎组患者血清NT-proBNP及D-Dimer水平随PSI分级增加而升高.不同PSI分级患者间NT-proBNP及D-Dimer水平比较,差异均有统计学意义(P<0.05).CAP患者死亡率随PSI分级增加而上升(P<0.05).(3)死亡组在入院时PSI评分、血清NT-proBNP及D-Dimer水平均明显高于存活组,差异有统计学意义(P<0.05).结论 NT-proBNP、D-Dimer不仅可作为诊断老年CAP的有效指标,而且与老年CAP患者PSI分级有一定的关系.%Objective To explore the relationship of pneumonia severity index(PSI) with serum levels of NT-proBNP and D-Dimer in elderly patients with community-acquired pneumonia ( CAP ) . Methods 162 elderly cases of CAP in our hospital were chosen as senile pneumonia group from March 2012 to July 2015. Fifty cases of healthy people without basic diseases were selected as normal control group. Clinical data of CAP patients were collected within 24 h after admission and PSI was assessed. All the patients were divided into survival group and death group within 28 d after admission. Serum levels of NT-proBNP and D-Dimer were detected in two groups. The relationship of PSI with serum levels of NT-proBNP, D-Dimer was analyzed. Results ( 1) Serum levels of NT-proBNP and D-Dimer in senile pneumonia group were significantly higher than those in normal control group( P

  6. Survey and analysis on sources of reference intervals and distribution of medical decision levels in NT-proBNP, BNP and homocysteine%中国N末端B型利钠肽原、B型利钠肽和同型半胱氨酸参考区间来源及决定限的分布

    Institute of Scientific and Technical Information of China (English)

    张路; 王薇; 钟堃; 何法霖; 王治国

    2015-01-01

    Objective To analyze the sources of reference intervals and distribution of medical decision levels in NT-proBNP,BNP and homocysteine (Hcy) based on the feedback of laboratories which participated in the 2014 External Quality Assessment (EQA) program in China.Methods Information of reference intervals and medical decision levels was collected from the 2014 EQA programs in NT-proBNP,BNP and Hcy.All the abnormal values and errors were eliminated.Data were analyzed by SPSS 13.0 and Microsoft Excel 2007 in terms of referring to sources of reference intervals and distribution of medical decision levels.Values were further grouped based on instrument system for NT-proBNP and BNP,reagent manufacturers for Hcy.Results There were 330,119 and 339 laboratories submitting the data on the reference intervals of NT-proBNP,BNP and Hcy.Only 133,54 and 102 laboratories provided iffformation about medical decision levels.Most reference sources were derived from reagent manufactures (NT-proBNP 76.97% (254/330),BNP 89.08% (106/119),Hcy 83.19% (282/339)).Approximately,36.53% (122/334),45.38% (54/119) and 47.95% (164/342) of the laboratories validated the reference intervals of NT-proBNP,BNP and Hcy.According to the surveys,the mean and median values were not close to each other (NT-proBNP 507.99ng/L and 300.00ng/L,BNP 342.72ng/L and 100.00ng/L,Hcy 17.34μmoL/L and 15.00μmol/L).Variation of P2.5 and P97.5 was as follows:(NT-proBNP 125.00-1800.00ng/L,BNP 87.50-4562.50ng/L,Hcy 4.15-50.00μmol/L).The ranges were NT-proBNP 60.00-7000.00ng/L,and BNP 80.00-7000.00ng/L,and Hcy 1.5-52.00μmol/L.Pvalues of rank sum test for NT-proBNP,BNP and Hcy were 0.449,0.208 and 0.754.Conclusions Medical decision levels of NT-proBNP,Hcy and BNP showed large variation among laboratories and the sources of reference interval were not unified.Thus,urgent efforts should be made to establish appropriate reference intervals for Chinese people and promote harmonization and standardization of reference

  7. Levels of NT-proBNP, markers of low-grade inflammation, and endothelial dysfunction during spironolactone treatment in patients with diabetic kidney disease

    DEFF Research Database (Denmark)

    Nielsen, Stine; Schjoedt, Katrine J; Rossing, Kasper;

    2013-01-01

    Renin-angiotensin-aldosterone system (RAAS) blockade may reduce levels of biomarkers of chronic low-grade inflammation and endothelial dysfunction. We investigated the effect of spironolactone added to standard RAAS blockade on these biomarkers in an analysis of four original studies. MATERIALS...... AND METHODS: The studies were double-blind, randomised, placebo-controlled studies in 46 type 1 and 23 type 2 diabetic patients with micro- or macroalbuminuria treated with angiotensin-converting enzyme inhibitor (ACE inhibitor) or angiotensin receptor blocker (ARB), and randomised to additional treatment...

  8. Prediction of perioperative cardiac events through preoperative NT-pro-BNP and cTnI after emergent non-cardiac surgery in elderly patients.

    Science.gov (United States)

    Ma, Jinling; Xin, Qian; Wang, Xiujie; Gao, Meng; Wang, Yutang; Liu, Jie

    2015-01-01

    Clinical risk stratification has an important function in preoperative evaluation of patients at risk for cardiac events prior to non-cardiac surgery. The aim of this study was to determine whether the combined measurement of pre-operative N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac troponin I (cTnI) could provide useful prognostic information about postoperative major adverse cardiac events (MACE) within 30 days in patients aged over 60 years undergoing emergent non-cardiac surgery. The study group comprised 2519 patients aged over 60 years that were undergoing emergent non-cardiac surgery between December 2007 and December 2013. NT-pro-BNP and cTnI were measured during hospital admission. The patients were monitored for MACE (cardiac death, non-fatal myocardial infarction, or cardiac arrest) during the 30-day postoperative follow-up period. MACE occurred in 251 patients (10.0%). Preoperative NT-pro-BNP and cTNI level were significantly higher in the individuals that experienced MACE than in those who did not (P 917 pg/mL (OR 4.81, 95% CI 3.446-6.722, P 917 pg/mL and cTnT ≥ 0.07 ng/mL had worse event-free survival than individual assessments of either biomarker. Preoperative plasma NT-proBNP and cTnI are both independently associated with an increased risk of MACE in elderly patients after emergent non-cardiac surgery. The combination of these biomarkers provides better prognostic information than using either biomarker separately.

  9. NT-proBNP as a predictor of all-cause mortality in a population of insurance applicants.

    Science.gov (United States)

    Clark, Michael; Kaufman, Valerie; Fulks, Michael; Dolan, Vera F; Stout, Robert L

    2014-01-01

    Quantify the independent value of NT-proBNP in predicting all-cause mortality for individual life insurance applicants and establish risk-based reference ranges. By use of the Social Security Death Master File and multivariate analysis, relative mortality was determined for 144,027 life insurance applicants tested (almost all routinely rather than for cause) for NT-proBNP along with other laboratory testing and measurement of BP and BMI. Risk increased substantially for NT-proBNP values > 300 pg/mL in women and > 200 pg/mL in men after age, smoking status and other cardiovascular risk factors were accounted for. The relative risk reached > 10 fold at NT-proBNP levels > 1000 pg/mL. For those age 50 to 89 and denying a history of heart disease, this level occurred in only 0.5% of applicants but was present in 7% of all deaths. NT-proBNP is a strong independent predictor of all-cause mortality but values associated with increased risk vary by sex.

  10. 血清NT-proBNP、hs-TnT及hs-CRP水平与急性心肌梗死的相关性研究%Correlation between serum NT-proBNP, hs-TnT and hs-CRP levels and acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    符明昌; 周莲; 羊文芳; 苏显都

    2016-01-01

    2013 to June 2015. Serum NT-proBNP, hs-TnT and hs-CRP levels were detected in AMI group at 3 hours, 12 hours, 1 day, 3 days, 7 days, and then compared with those in the control group. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of NT-proBNP, hs-TnT and hs-CRP in AMI. Logistic regression model was ap-plied to analyze the independent risk factors of AMI. Results The serum levels of NT-proBNP, hs-TnT and hs-CRP in AMI group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The serum NT-proBNP, hs-TnT and hs-CRP levels in AMI patients reached the peak at 12 hours, 1 day, and 3 days. Logistic regression model was used for univariate and multivariate analysis. NT-proBNP, hs-TnT and hs-CRP were the independent risk factors for AMI, with OR and 95%CI of 1.012 (0.874~1.136), 1.350 (1.026~1.724), 1.168 (1.014~1.337), respectively. ROC curves showed that the AUC and 95%CI of NT-proBNP, hs-TnT, hs-CRP and joint detection were 0.860 (0.784~0.975), 0.834 (0.762~0.905), 0.748 (0.668~0.817), 0.885 (0.794~0.971). Spearman correlation analy-sis showed significantly positive correlation between NT-proBNP and hs-TnT (r=0.679, P<0.05), NT-proBNP and hs-CRP (r=0.602, P<0.05), hs-TnT and hs-CRP (r=0.568, P<0.05). Conclusion NT-proBNP, hs-TnT and hs-CRP are in-dependent predictors of AMI. Combined detection can improve the accuracy of AMI diagnosis, and it is helpful to early treatment and prognosis improvement.

  11. Research on the Correlation Between Plasma Concentration of NT-proBNP and Myocardial Ischemia%N端——脑钠肽前体与心肌缺血相关性的研究

    Institute of Scientific and Technical Information of China (English)

    王述琦; 丛培培

    2008-01-01

    目的:探讨N端-脑钠肽前体(NT-proBNP)与心肌缺血的相关性.方法:78例不稳定型心绞痛(UA)患者根据Braunwald分级进行分组,检测血浆心肌肌钙蛋白1(cTNI)和NT-proBNP.结果:UA患者血浆NT-proBNP水平随着Braundwald分级增高而增高,各组间差异均有统计学意义(P<0.05).cTNI测定值亦随Braundwald分级增高而增高,但BraundwaldⅠ级和Ⅱ级之间差别无统计学意义(P>0.05);而BraundwaldⅡ级和Ⅲ级之间差异有统计学意义(P<0.05);BraundwaldⅠ级和Ⅲ级之间差异有统计学意义(P<0.05).结论:血浆NT-proBNP水平能较好地反映心肌缺血的程度.

  12. Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus

    Science.gov (United States)

    Sadlecki, Pawel; Grabiec, Marek; Walentowicz-Sadlecka, Malgorzata

    2016-01-01

    Common complications of pregnancy include preeclampsia (PE), gestational hypertension (GH) and gestational diabetes mellitus (GDM). Hypertensive disorders (PE/GH) and GDM may result in greater maternal, fetal and neonatal morbidity and mortality. Women with PE/GH, one of the most common causes of heart burden in an obstetrical setting, present with elevated serum levels of BNP and NT-proBNP. The aim of this study was to shed more light on the role of NT-proBNP in pathophysiology of PE, GH and GDM. The study included 156 pregnant women with singleton pregnancies. A total of 26 women developed arterial hypertension during pregnancy, 14 were diagnosed with PE, and GDM was detected in 81 patients. The control group included 35 women with uncomplicated pregnancies, normal arterial blood pressure and normal glucose concentrations. Patients with GH presented with significantly higher serum concentrations of NT-proBNPthan normotensive women (65.5 vs. 37.4 pg/ml; p = 0.0136). Serum levels of NT-proBNP in patients with PE were the highest of all the analyzed subsets, being significantly higher than in women without this condition (89.00 vs. 37.4pg/ml,p = 0,0136). However, women with and without GDM did not differ significantly in terms of their serum NT-proBNPconcentrations. Serum NT-proBNP (pg/ml) (p = 0.0001) and BMI (p<0.0001) turned out to be independent predictors of GH on multivariate logistic regression analysis.Moreover, serum NT-proBNP (pg/ml) was identified as an independent indicator of PE (p = 0.0016). A significant inverse correlation was found between birth weight and maternal serum NT-proBNP concentrations. In our opinion, NT-proBNP can be a useful clinical marker of GH and PE. Determination of NT-proBNP levels may be helpful in identification of patients with PE and GH and in their qualification for intensive treatment; this in turn, may be reflected by better neonatal outcomes. PMID:27685993

  13. 关注BNP与NT-proBNP的临床应用%Role of BNP and NT-proBNP in clinical application

    Institute of Scientific and Technical Information of China (English)

    袁慧

    2012-01-01

    The precursor of B-type natriuretic peptide (proBNP) is cleaved by a specific enzyme into the biologically active BNP and biologically inactive N-terminal fragment (NT-proBNP).Plasma BNP and NT-proBNP concentrations are affected by gender,age,obesity (higher BMI) and renal function.BNP is primary metabolized by "clearance receptors",NT-proBNP is suggested by renal excretion,so plasma concentrations of NT-proBNP are more affected by renal function than that of BNP.The differential diagnosis of acute dyspnea and acute heart failure (AHF) is one of the most important clinical applications of BNP and NT-proBNP.Two cut-off points were used:a lower one with a high negative predictive value to reliably exclude acute heart failure (AHF) as the cause of acute dyspnoea (rule-out cutoff value),and a second higher one with a high positive predictive value to "rule in" AHF as the cause of dyspnoea (rule-in cutoff value).The rule-in cutoff values of NT-proBNP divided into three levels according to the age,these cutoff values apply irrespective of gender,obesity and renal function,but the rule-in cutoff point of BNP need to be corrected by obesity and renal function.In addition,BNP/NT-proBNP has been shown to provide diagnosis,prognosis and therapy-guiding information in chronic heart failure and coronary heart disease.%急性或慢性心力衰竭的诊断与治疗是具有挑战性的、费用较高的临床问题.B型利钠肽是一种主要由心室细胞分泌的心脏激素,具有促尿钠排泄、舒张血管、舒缓心肌的生物活性.B型利钠肽(包括活性形式BNP与无活性形式N端-proBNP)被证实是诊断或排除急性、慢性心力衰竭高度敏感的标志物.二者的水平与心力衰竭的严重程度具有很强的相关性,并能对患者进行危险分层、预后判断,指导患者治疗.有一些因素影响血浆利钠肽水平,如年龄、性别、肥胖、肾功能,临床应用中需加以考虑.利钠肽对急性冠脉综合征的诊断价

  14. The relationship of NT-proBNP and dialysis parameters with outcome of incident haemodialysis patients: results from the membrane permeability outcome study.

    Science.gov (United States)

    Locatelli, Francesco; Hannedouche, Thierry; Martin-Malo, Alejandro; Jacobson, Stefan H; Vanholder, Raymond; Ronco, Claudio; La Milia, Vincenzo; Lopez Gomez, Juan M; Stefoni, Sergio; Maheut, Hervé; Klinger, Marian; Krummel, Thierry; Dhondt, Annemie; Berdud, Isabel; Gauly, Adelheid

    2013-01-01

    The association of raised levels of natriuretic peptides with elevated risk of mortality was investigated in the present analysis of the Membrane Permeability Outcome study. N-terminal probrain type natriuretic peptide (NT-proBNP) was measured in 618 incident haemodialysis patients, randomised to either high-flux or low-flux. Characteristics of patients with NT-proBNP levels below or above the median were descriptively analysed and survival analysis was performed. Median NT-proBNP value was 2,124 pg/ml, with 1,854 pg/ml in the high-flux and 2,919 pg/ml in the low-flux group. Survival probability was lowest in patients with both a history of cardiovascular disease and NT-proBNP values above the median (p dialysis suggest a possible biological link to improved survival in this group. Copyright © 2013 S. Karger AG, Basel.

  15. NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

    DEFF Research Database (Denmark)

    Rathcke, C.N.; Kjøller, Erik; Fogh-Andersen, N.;

    2010-01-01

    with an intermediate risk of CAD or with known CAD with renewed suspicion of ischemia were referred to MPI. Blood samples were analyzed for N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP), YKL-40, IL-6, matrix metalloproteinase 9 (MMP-9) and high sensitive C-reactive protein (hs......CRP). Patients with myocardial perfusion defects had elevated levels of NT-proBNP (p95% regardless of existing CAD. Conclusions: 20-25% of patients suspected of CAD could have been spared a MPI by using a NT-proBNP cut-off concentration at 25 ng/l with a negative predictive value >95%. NT-proBNP has...

  16. The\tRelationship\tBetween\tNt-ProBNP\tand\tVolume\tOverload\tin\tDiabetic Nephropathy\tProgression

    Directory of Open Access Journals (Sweden)

    Yaşar Yıldırım

    2016-12-01

    Full Text Available Objectives: The\tearly\tdiagnosis of volume overload\tin\tchronic kidney\tdisease (CKD\tis very\timportant.\tN-terminal\tprobrain natriuretic\tpeptide\t(NT-proBNP\tis\ta\tvaluable\tbiomarker\tfor\tthis\tpurpose.\tOur\tstudy\taimed\tto\tdetect\tthe\trelationship between NT-proBNP and left ventricular hypertrophy (LVH, hypertension (HT, GFR, and proteinuria among diabetic patients\twith\tstage\t3-4\tCKD. Methods: 160\tdiabetic\tpatients\twith\tstage\t3-4\tCKD\t[80\tpatients\tin\tstage\t3\tCKD\t(group\t1\tand\t80\tpatients\tin\tstage\t4\tCKD (group 2] were enrolled. NT-proBNP levels were evaluated in serum, and proteinuria was determined from 24-hour collected urine. Left ventricular hypertrophy was evaluated by M-mode echocardiography. NT-proBNP levels were compared\taccording\tto\ttheir\tleft\tventricular\thypertrophy,\thypertension,\tand\tproteinuria\tlevels. Results: NT-proBNP\tlevels\twas\tsignificantly\thigher,\tand\tGFR\twas\tlower\tin\tgroup\t2\tcompared to\tgroup1 (p\t<\t0.05.\tNTproBNP was higher in patients with LVH (+ HT (+ and proteinuria ≥ 1gr/d than patients with LVH (-, HT (-, and proteinuria\t<\t1g/d\t(p\t<\t0.05.\tWe\tfound\ta\tsignificant\tcorrelation\tbetween\tNT-proBNP\tlevels\tand\tleft\tventricular\tposterior wall thickness, diastole (LVPWTd, proteinuria, SBP, and DBP. Proteinuria was the major contributor to increased NTproBNP levels\tamong\tthe\tindependent\tvariables. Conclusion: We\tdetected\tthat\tNT-proBNP\tlevels\tare\tincreased\tduring\tthe\tprogression\tof\tCKD,\tand\tproteinuria\tis\tthe\tmajor cause\tof\tincreased\tNT-proBNP\tlevels\tamong\tthe\tindependent\tvariables.

  17. Descenso de los niveles de propéptido natriurético de tipo B-N terminal luego de la reversión de pacientes con fibrilación auricular y función ventricular conservada NT-Pro-BNP levels performance before and after reversion to sinus rhythm in patients with preserved ventricular function

    Directory of Open Access Journals (Sweden)

    Claudio Higa

    2011-04-01

    Full Text Available El objetivo fue comparar los niveles de Pro Péptido Natriurético tipo B-N terminal (Pro-BNP-NT basales y post reversión en pacientes con fibrilación auricular solitaria (FAS de comienzo reciente y con función ventricular izquierda conservada. Se determinaron niveles del Pro BNP NT antes y después de su reversión en treinta pacientes con FAS de comienzo reciente y fracción de eyección de ventrículo izquierdo ≥ 50%. Basalmente, los niveles de Pro BNP NT fueron significativamente más elevados respecto a un grupo control sano: 529 pg/ml (157-1763 versus 31.5 pg/ml (24-76, p Our objective was to evaluate changes of N-terminal pro-BNP (NT-Pro-BNP levels at baseline and after restoration to sinus rhythm in hemodynamic stable patients with lone atrial fibrillation (LAF with preserved left ventricular function. NT-Pro-BNP levels were obtained before and after cardioversion in thirty hemodynamic stable patients with LAF and preserved left ventricular function. At baseline levels of NT-Pro BNP levels were significatively higher than a normal control group. NTPro-BNP levels decreased significantly following cardioversion from 529 (157-1763 to 318 (98-870 pg/ml, p < 0.0001. Decreasing of N-terminal pro-BNP concentrations was observed after any mode of cardioversion: electrical or pharmacologic, 345 (153-1151 pg/ml to 169 (86-407 pg/ml, p: 0.02 and from 1624 (541-4010 pg/ml to 856 (532-1160 pg/ml, p < 0.001, respectively. N-terminal pro-BNP decreasing was observed mainly in patients with length of LAF longer than 8 hours: 1289 (338-2103 to 410 (169-905 pg/ml, p < 0.001 but no difference was detected when such length was less than 8 hours: 274 (137-2300 to 286 (82-1440, p = NS. Our study showed that baseline levels of NT-pro-BNP decreased shortly after reversion of patients with LAF to sinus rhythm. This performance occurs predominantly in patients with LAF length of at least eight hours.

  18. NT-proBNP as Early Marker of Subclinical Late Cardiotoxicity after Doxorubicin Therapy and Mediastinal Irradiation in Childhood Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Amal Zidan

    2015-01-01

    Full Text Available Background. Childhood cancer survivors treated with anthracyclines and mediastinal irradiation are at risk for late onset cardiotoxicity. Aims of the Study. To assess the role of N-terminal pro-brain natriuretic peptide (NT-proBNP and tissue Doppler imaging (TDI as early predictors of late onset cardiotoxicity in asymptomatic survivors of childhood cancer treated with doxorubicin with or without mediastinal irradiation. Methods. A cross-sectional study on 58 asymptomatic survivors of childhood cancer who received doxorubicin in their treatment protocols and 32 asymptomatic Hodgkin’s lymphoma survivors who received anthracycline and mediastinal irradiation. Levels of NT-proBNP, TDI, and conventional echocardiography were determined. Results. Thirty percent of survivors had abnormal NT-proBNP levels. It was significantly related to age at diagnosis, duration of follow-up, and cumulative dose of doxorubicin. TDI detected myocardial affection in 20% more than conventional echocardiography. Furthermore, abnormalities in TDI and NT-pro-BNP levels were more common in Hodgkin lymphoma survivors receiving both chemotherapy and radiotherapy. Conclusions. TDI could detect early cardiac dysfunction even in those with normal conventional echocardiography. Measurement of NT-proBNP represents an interesting strategy for detecting subclinical cardiotoxicity. We recommend prospective and multicenter studies to validate the role of NT-proBNP as an early marker for late onset doxorubicin-induced cardiotoxicity.

  19. Development and Evaluation of Up-Converting Phosphor Technology-Based Lateral Flow Assay for Quantitative Detection of NT-proBNP in Blood

    Science.gov (United States)

    Hao, Qingfang; Zou, Deyong; Zhang, Xiaoli; Zhang, Liping; Li, Hongmei; Qiao, Yong; Zhao, Huansheng; Zhou, Lei

    2017-01-01

    A newly assay, up-converting phosphor technology-based lateral flow (UPT-LF) assay, was developed for rapid and quantitative detection of N-terminal fragment of B-type natriuretic peptide precursor (NT-proBNP), one of the most important serum molecular maker of heat failure, in plasma samples as a point of care testing (POCT) method for diagnosis of acute heart failure. Human plasma from 197 patients with acute heart failure and 200 healthy controls was assessed using the UPT-LF assay, in a comparison with a Roche Elecsys assay. The limit of detection of the UPT-LF assay, with a coefficient of variation (CV) of less than 15%, was 116 ng/L, which is lower than the clinical diagnosis cutoff (150 ng/mL). The linear range was 50–35,000 ng/L. The CVs were less than 10% for both UPT-LF and Roche Elecsys assays for plasma samples under different storages, demonstrating the good stability and reproducibility. There are certain linear correlations between the results of UPT-LF and Roche Elecsys assay for EDTA-K2 and heparin-anticoagulated plasma, as well as for serum samples. For UPT-LF assay, there is a significant correlation between the values derived from analysis of EDTA-K2 and heparin-anticoagulated plasma samples (R = 0.995). No statistically significant difference was found between serum and plasma samples for UPT-LF assay. Our results demonstrate that NT-proBNP levels in healthy adults are elevated with age and had a relationship with sex, and with the age increase the NT-proBNP levels of females are significantly higher than those of males (p<0.01). The UPT-LF assay has a high reproducibility, stability, sensitivity, specificity, and is consistent with Roche Elecsys assay, and therefore it could be used as a POCT method for the quantitative detection of NT-proBNP in blood for clinical diagnosis and research of acute heart failure. PMID:28151978

  20. The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study.

    Science.gov (United States)

    Safi, Morteza; Bayat, Fariba; Ahmadi, Zahra; Shekarchizadeh, Masood; Khaheshi, Isa; Naderian, Mohammadreza

    2017-06-01

    The change in the level of NT-pro-BNP (N-terminal-pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-pro-BNP reduction and post-PTMC echocardiography parameters. Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. All patients underwent echocardiography before and also 24 to 48 hours after PTMC. Peripheral blood samples were taken for measurement of NT-pro-BNP before as well as 24 to 48 hours after PTMC. The patients were also classified in group with normal sinus rhythm or having atrial fibrillation (AF) based on their 12-lead electrocardiogram. It was shown a significant decrease in the parameters of PPG (Peak Pressure Gradient), MPG (Mean Pressure Gradient), PHT (Pressure Half Time), PAP (Pulmonary Arterial Pressure), LAV (Left Atrial Volume), and also a significant increase in MVA (Mitral Valve Area) RVS (Right Ventricular S velocity), and strains of lateral, septal, inferior and anterior walls of LA following PTMC. The mean LVEF remained unchanged after PTMC. The mean NT-pro-BNP before PTMC was 309.20 ± 17.97 pg/lit that significantly diminished after PTMC to 235.72 ± 22.46 pg/lit (p = 0.009). Among all echocardiography parameters, only MPG was positively associated with the change in NT-pro-BNP after PTMC. Comparing the change in echocardiography indices between the patients with normal rhythm and those with AF, lower change in PAP was shown in the group with AF. However, more change in the level of NT-pro-BNP after PTMC was shown in the patients with AF compared to those without this arrhythmia. PTMC procedure leads to reduce the level of NT-pro-BNP. The

  1. Effect of tirofiban on plasma concentration of NT-proBNP in acute coronary syndrome patients%替罗非班对急性冠状动脉综合征患者血浆氨基酸N末端脑钠肽原浓度的影响

    Institute of Scientific and Technical Information of China (English)

    潘翠先

    2016-01-01

    Objective To investigate the effect of tirofiban on plasma concentration of NT-proB-NP in acute coronary syndrome(ACS)patients. Methods From September 2011 to October 2015,168 patients with acute coronary syndrome( ACS )combined with unstable angina( UA )or acute myocardial infarction( AMI)were selected. The UA and AMI patients were graded according to Braunwal and Killip ( each grade was divided into two groups)by collecting venous blood samples. The plasma concentration of NT-proBNP was mesured with fluorescent immune adsorption method. Results The plasma concentra-tion of NT-proBNP was significantly decreased of tirofiban in the treatment of patients that were graded and grouped according to Braunwal and Killip( P﹤0. 05 ). Conclusions The tirofiban in the treatment of ACS patiens had correlation with decreasing the plasma concentration of NT-proBNP.%目的:探讨替罗非班治疗急性冠状动脉综合征( ACS)时对患者血浆氨基酸N末端脑钠肽原( NT-proBNP)浓度的影响。方法选取2011年9月至2015年6月住院治疗的不稳定性心绞痛( UA)和急性心肌梗死( AMI)ACS患者168例。对UA和AMI患者通过采集静脉血样分别进行Braunwald和Killip分级并将每级分成两组;用荧光免疫吸附法检测静脉滴注替罗非班前后患者血浆中NT-proBNP的浓度变化。结果替罗非班能显著降低Braunwald分级及分组UA患者和Killip分级及分组AMI患者血浆中NT-proBNP浓度,且差异有统计学意义( P﹤0.05)。结论替罗非班治疗急性冠状动脉综合征与降低患者血浆中的NT-proBNP浓度有关。

  2. Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial.

    Science.gov (United States)

    van Diepen, Sean; Roe, Matthew T; Lopes, Renato D; Stebbins, Amanda; James, Stefan; Newby, L Kristin; Moliterno, David J; Neumann, Franz-Josef; Ezekowitz, Justin A; Mahaffey, Kenneth W; Hochman, Judith S; Hamm, Christian W; Armstrong, Paul W; Theroux, Pierre; Granger, Christopher B

    2012-07-01

    Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory mediators in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) is not well described. Of 5,745 STEMI patients treated with primary PCI in the APEX-AMI trial, we evaluated the relationship between baseline NT-proBNP levels and baseline levels of inflammatory markers and markers of myonecrosis in a subset of 772 who were enrolled in a biomarker substudy. Spearman correlations (r (s)) were calculated between baseline NT-proBNP levels and a panel of ten systemic inflammatory biomarkers. Interleukin (IL)-6, a pro-inflammatory cytokine, was significantly positively correlated with NT-proBNP (r (s) = 0.317, P < 0.001). In a sensitivity analysis excluding all heart failure patients, the correlation between baseline IL-6 and NT-proBNP remained significant (n = 651, r (s) = 0.296, P < 0.001). A positive association was also observed with high sensitivity C-reactive protein (r (s) = 0.377, P < 0.001) and there was a weak negative correlation with the anti-inflammatory cytokine IL-10 (r (s) = -0.109, P = 0.003). No other significant correlations were observed among the other testes inflammatory cytokines and chemokines. In STEMI patients undergoing primary PCI, the pro-inflammatory cytokine IL-6 was modestly correlated with baseline NT-proBNP levels. This relationship remained significant in patients without heart failure. This finding is consistent with pre-clinical and clinical research suggesting that systemic inflammation may influence NT-proBNP expression independently of myocardial stretch.

  3. 曲美他嗪对老年心力衰竭并贫血患者肾功能及N末端前脑钠肽的影响%Effects of Trimetazidine on Renal Function and Level of NT-ProBNP in Elderly Patients with Heart Failure Complicating Anemia

    Institute of Scientific and Technical Information of China (English)

    祝河忠; 潘庆敏; 严洁; 陈佳娟

    2015-01-01

    Objective To investigate the effects of trimetazidine on the cardiac and renal functions, and hemoglobin ( Hb ) parameters in the elderly patients with chronic heart failure ( CHF ) complicating anemia. Methods 87 patients with CHF ( NYHA gradeⅡ-Ⅳ) compli-cating anemia were randomized to the treatment group ( n=44 ) and control group ( n=43 ) . All patients received the conventional treat-ment of heart failure. On this basis the control group was given only oral iron preparation, while the treatment group received oral iron preparation plus trimetazidine. The changes of Hb, serum creatinine, creatinine clearance, plasma NT-proBNP and cardic function were ob-served after 4-week treatment in the two groups. Results Compared with before treatment, Hb after treatment in the treatment group was significantly increased [ ( 98. 3 ± 4. 2 ) g/L vs. ( 113. 2 ± 1. 5 ) g/L, P< 0. 05 ] , serum creatinine level was significant decreased [ ( 196. 2 ± 40. 7 )μmol/L vs. ( 163. 4 ± 38. 7 )μmol/L, P<0. 05 ] , the creatinine clearance was increased [ ( 38. 0 ± 7. 8 ) mL/L vs. ( 42. 8 ± 7. 1 ) mL/min, P< 0. 05 ] , the NYHA cardiac functional grade was significant improved [ ( 3. 3 ± 0. 7 ) vs. ( 2. 1 ± 0. 5 ) ] , the plasma NT-proBNP was significant decreased [ ( 2 215. 3 ± 950. 2 ) ng/L vs. ( 1 236. 1 ± 430. 7 ) ng/L, P<0. 05 ] , the above parameters in the con-trol group were improved to some extent, but the differences between the two groups had no statistical significance. Conclusion Trimetazidine combined with oral iron preparation can improve the cardiac function, on this basis can further correct anemia, improve the renal function and reduce the plasma NT-proBNP level in treating elderly patients with CHF complicating anemia, which deserves to be clinically promoted.%目的:观察曲美他嗪对老年慢性心力衰竭( CHF )合并贫血患者心功能、肾功能、血红蛋白水平的影响。方法将87例心功能Ⅱ~Ⅳ级( NYHA )的慢性心力衰

  4. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, A.S.; Kim, W.Y.; Tarnow, L.;

    2008-01-01

    OBJECTIVES: To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS: In a cross......-sectional study, all patients with type 1 diabetes underwent cardiovascular magnetic resonance imaging. We included 63 patients with diabetic nephropathy and 73 patients with normoalbuminuria. RESULTS: All patients had normal global LVF. LVM was increased in patients with diabetic nephropathy compared...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk Udgivelsesdato: 2008/5...

  5. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, Anne Sofie; Kim, Won Yong; Tarnow, Lise

    2008-01-01

    -sectional study, all patients with type 1 diabetes underwent cardiovascular magnetic resonance imaging. We included 63 patients with diabetic nephropathy and 73 patients with normoalbuminuria. RESULTS-All patients had normal global LVF. LVM was increased in patients with diabetic nephropathy compared...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk....

  6. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure.

    Science.gov (United States)

    Madamanchi, Chaitanya; Alhosaini, Hassan; Sumida, Arihiro; Runge, Marschall S

    2014-10-20

    Many advances have been made in the diagnosis and management of heart failure (HF) in recent years. Cardiac biomarkers are an essential tool for clinicians: point of care B-type natriuretic peptide (BNP) and its N-terminal counterpart (NT-proBNP) levels help distinguish cardiac from non-cardiac causes of dyspnea and are also useful in the prognosis and monitoring of the efficacy of therapy. One of the major limitations of HF biomarkers is in obese patients where the relationship between BNP and NT-proBNP levels and myocardial stiffness is complex. Recent data suggest an inverse relationship between BNP and NT-proBNP levels and body mass index. Given the ever-increasing prevalence of obesity world-wide, it is important to understand the benefits and limitations of HF biomarkers in this population. This review will explore the biology, physiology, and pathophysiology of these peptides and the cardiac endocrine paradox in HF. We also examine the clinical evidence, mechanisms, and plausible biological explanations for the discord between BNP levels and HF in obese patients.

  7. The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Fu S

    2013-04-01

    Full Text Available Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP and renal function, and compare the ability and cut-off thresholds of NT-proBNP to detect chronic heart failure (CHF and predict mortality in elderly Chinese coronary artery disease (CAD patients with and without chronic kidney disease (CKD. Methods: The study included 999 CAD patients older than 60 years. The endpoint was all-cause mortality over a mean follow-up period of 417 days. Results: The median age was 86 years (range: 60–104 years, and the median NT-proBNP level was 409.8 pg/mL. CKD was present in 358 patients. Three hundred and six patients were positive for CHF. One hundred and ten CKD patients and 105 non-CKD patients died. Not only CKD, but also estimated glomerular filtration rate independently affected NT-proBNP. NT-proBNP detected CHF with a cut-off value of 298.4 pg/mL in non-CKD patients and a cut-off value of 435.7 pg/mL in CKD patients. NT-proBNP predicted death with a cut-off value of 369.5 pg/mL in non-CKD patients and a cut-off value of 2584.1 pg/mL in CKD patients. The NT-proBNP level was significantly related to the prevalence of CHF and all-cause mortality in CAD patients with and without CKD; this effect persisted after adjustment. The crude and multiple adjusted hazard ratios of NT-proBNP to detect CHF and predict mortality were significantly higher in patients with CKD compared with the remainder of the population. The addition of NT-proBNP to the three-variable and six-variable models generated a significant increase in the C-statistic. Conclusion: Amongst elderly Chinese CAD patients, there was an independently inverse association between NT-proBNP and renal function. With the higher cutoff points, NT-proBNP

  8. 脑钠肽前体对急性心肌梗死溶栓治疗预后的评价%Evaluate of NT-proBNP in Prognostic Evaluation in Patients with Successful Thrombolysis

    Institute of Scientific and Technical Information of China (English)

    刘爱华; 王绪芳

    2014-01-01

    目的:本研究旨在观察成功溶栓患者中是否发生早期心血管事件,比较其NT-proBNP的差异,并研究其与血清肌钙蛋白T(cTnT)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、左室射血分数(LVEF)、左室舒张末期直径(LVEDD)之间的相关性,探讨测定血浆NT-proBNP水平在评价急性心肌梗死(AMI)成功溶栓治疗的患者病情严重程度和预后的意义。方法:采用酶联免疫吸附法对61例ST段抬高型AMI患者应用瑞替普酶静脉溶栓治疗前测定NT-proBNP。随访30 d,观察30 d内是否发生心血管死亡、心力衰竭、再发心肌梗死、梗死后心绞痛等情况。结果:血浆NT-proBNP水平在早期有心血管事件组高于无心血管事件组,两组比较差异有统计学意义(P<0.05)。血浆NT-proBNP水平与cTnT、CK、CK-MB、LVEDD存在正相关(P<0.05),与LVEF存在负相关(P<0.05)。结论:测定入院时血浆NT-proBNP水平对评估AMI经过成功溶栓治疗的患者30 d内发生心血管事件有重要的临床价值。%Objective:To observe whether early cardiovascular events occurred in patients with successful thrombolysis to explore the differences of NT-proBNP,and to detect its correlation with cTnT,CK,CK-MB,LVEF, LVEDD,and discuss the value of plasma NT-proBNP for severity and prognostic significance in the AMI patients with successful thrombolysis.Method:The plasma NT-proBNP collecting before thrombolytic therapy in 61patients with AMI was measured by enzyme-lined imunosorbent assay. All patients were followed up for 30 days,the occurrence of cardiovascular death,heart failure,recurrent AMI in 30 days,post-infarction angina,etc were observed. Result:The plasma NT-proBNP levels in the occurred vascular events group in the early periods were significantly higher than the non-occurred vascular events group,the difference was significant(P<0.05). The plasma NT-proBNP level with cTnT,CK, CK-MB,LVEDD existed

  9. Right ventricular dysfunction in acute pulmonary embolism: NT-proBNP vs. troponin T.

    Science.gov (United States)

    Cotugno, Marilena; Orgaz-Molina, Jacinto; Rosa-Salazar, Vladimir; Guirado-Torrecillas, Leticia; García-Pérez, Bartolomé

    2017-04-21

    Dysfunction of the right ventricle (RV) is a parameter of severity in acute pulmonary embolism (PE). Echocardiographic assessment is not always possible in accident and emergency, hence the need to predict the presence of RV dysfunction using easily measurable parameters. To analyse the value of NT-proBNP and troponin T as markers of RV dysfunction in patients with acute PE. Secondarily, to assess the relationship between RV failure and clinical parameters related to PE. Analytical, observational, cross-sectional and retrospective study comparing the values NT-proBNP, troponin T and presenting symptoms of PE among patients with and without RV dysfunction. One hundred seventy-two patients (52 with RV failure,120 without) were included. All symptoms occurred with similar frequency between the 2groups except dyspnea and syncope (more common in the group with RV failure). Both NT-proBNP and troponin T had significantly higher values in the group of patients with RV dysfunction. However, in the multivariate analysis, NT-proBNP had a higher explanatory value for RV failure than troponin T. NT-proBNP is a diagnostic parameter of RV dysfunction with higher sensitivity in the context of acute PE. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  10. BNP and NT-proBNP, Predictors of 1-Year Mortality in Nursing Home Residents

    NARCIS (Netherlands)

    Barents, Maaike; Hillege, Hans H. L.; van der Horst, Iwan C. C.; de Boer, Rudolph A.; Koster, J.; Muskiet, Frits A. J.; de Jongste, Mike J. L.

    2008-01-01

    Objectives: To investigate 1-year mortality prediction of B type natriuretic peptide (BNP) and N terminal-proBNP (NT-proBNP) in institutionalized elderly with multiple morbidities. Design: Prospective cross-sectional study. Setting: One nursing home. Participants: Ninety-three residents (mean age 81

  11. NT-proBNP is associated with fibulin-1 in Africans

    DEFF Research Database (Denmark)

    Kruger, R; Schutte, R; Huisman, H W;

    2012-01-01

    The N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is involved in the regulation of volume load and secreted when systemic cardiac overload occurs. Fibulin-1 on the other hand is a component of many extracellular matrix proteins including those present in atherosclerotic lesions, ex...

  12. HFPEF患者左心室舒张功能与NT-proBNP的相关性研究%Relationship between the left ventricular diastolic function and the NT-proBNP level in chronic heart failure patients with preserved ejection fraction

    Institute of Scientific and Technical Information of China (English)

    主有峰; 韦建瑞; 尹海燕; 张锐

    2014-01-01

    目的 分析射血分数保留的心力衰竭患者(HFPEF)的左心室舒张功能与N末端脑钠肽前体(NT-proBNP)的改变情况,并对以上指标进行初步评价.方法 选取2009年12月至2013年3月入本院心内科及ICU的HFPEF患者66例以及心功能正常患者43例,测定两组患者左心室舒张功能参数及NT-proBNP,然后进行统计学分析.结果 HFPEF患者组与对照组相比,NT-proBNP、LVMI、E/Em明显升高(P<0.05),两组患者E/Em与NT-proBNP值呈显著正相关(Pearson相关系数r为0.576).结论 E/Em、NT-proBNP、LVMI三者均可反映HFPEF患者的舒张功能,上述指标对诊断HFPEF有一定参考价值.NT-proBNP cut-off取90pg/mL时对HFPEF具有较高的阴性预测值(92.7%).

  13. Design and methodology of the NorthStar Study: NT-proBNP stratified follow-up in outpatient heart failure clinics -- a randomized Danish multicenter study

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars;

    2008-01-01

    BACKGROUND: Randomized clinical trials have shown that newly discharged and symptomatic patients with chronic heart failure (CHF) benefit from follow-up in a specialized heart failure clinic (HFC). Clinical stable and educated patients are usually discharged from the HFC when on optimal therapy....... It is unknown if risk stratification using natriuretic peptides could identify patients who would benefit from longer-term follow-up. Furthermore, data on the use of natriuretic peptides for monitoring of stable patients with CHF are sparse. AIMS: The aims of this study are to test the hypothesis that clinical...... stable, educated, and medical optimized patients with CHF with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels > or = 1,000 pg/mL benefit from long-term follow-up in an HFC and to assess the efficacy of NT-proBNP monitoring. METHODS: A total of 1,250 clinically stable, medically optimized...

  14. Effect of PCI on inflammatory factors, cTnI, MMP-9 and NT-pro BNP in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Ke-Tong Liu; Xin Wang; Di Zhao

    2016-01-01

    Objective:To investigate the effect of PCI on inflammatory factors, cTnI, MMP-9and NT-pro BNP in patients with unstable angina pectoris.Methods:A total of 80 unstable angina pectoris patients were divided into observation group (40 cases) and control group (40 cases). The observation group was given the therapy of PCI, and the control group was given coronary angiography. To observe the of inflammatory factors, cTnI, MMP-9 and NT-pro BNP were tested and compared before and after operation.Results:At 24 h after operation, CRP and IL-18 levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups; At 24 h after operation, cTnI, MMP-9 and NT-pro BNP levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups.Conclusion: PCI therapy can induce inflammation and myocardial injury in patients with unstable angina pectoris.

  15. Elevated plasma levels of N-terminal pro-brain natriuretic peptide in patients with chronic hepatitis C during interferon-based antiviral therapy

    Institute of Scientific and Technical Information of China (English)

    J(o)rg Bojunga; Christoph Sarrazin; Georg Hess; Stefan Zeuzem

    2006-01-01

    AIM: To investigate plasma levels of N-terminal probrain natriuretic peptide (NT-proBNP), an established marker of cardiac function, in patients with chronic hepatitis C during interferon-based antiviral therapy.METHODS: Using a sandwich immunoassay, plasma levels of NT-proBNP were determined in 48 patients with chronic hepatitis C at baseline, wk 24 and 48 during antiviral therapy and at wk 72 during follow-up.RESULTS: Plasma NT-proBNP concentrations were significantly increased (P < 0.05) at wk 24, 48 and 72 compared to the baseline values. NT-proBNP concentrations at baseline and wk 24 were closely correlated (r = 0.8; P < 0.001). At wk 24, 7 (14.6%)patients had NT-proBNP concentrations above 200 ng/L compared to 1 (2%) patient at baseline (P = 0.059).Six of these 7 patients had been treated with high-dose IFN-α induction therapy. In multiple regression analysis,NT-proBNP was not related to other clinical parameters,biochemical parameters of liver disease or virus load and response to therapy.CONCLUSION: Elevated levels of NT-proBNP during and after interferon-based antiviral therapy of chronic hepatitis C may indicate the presence of cardiac dysfunction, which may contribute to the clinical symptoms observed in patients during therapy. Plasma levels of NT-proBNP may be used as a diagnostic tool and for guiding therapy in patients during interferonbased antiviral therapy.

  16. Can NT-proBNP be used as a criterion for heart failure hospitalization in emergency room?

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk

    2011-01-01

    Conclusions: NT-proBNP can be used as an easy diagnostic method for congestive heart failure. A certain cut-off value may be determined in further multi-centre controlled trials with larger patient groups.

  17. Diagnosis and predictive value of NT-proBNP in cardiac insufficiency after acute myocardial infarction%NT-proBNP对急性心肌梗死后心功能不全的诊断及预测价值

    Institute of Scientific and Technical Information of China (English)

    胡光振

    2014-01-01

    Objective to study the diagnosis and predictive value of nt- proBnP in cardiac insufficiency after acute myocardial infarction.Methods 96 cases of incipient acute myocardial infarction patients selected were analyzed and the patients' Killip classification of heart function within 24 h were recorded. and plasma nt - proBnP concentration were measured.Results NT-proBNP concentration increased with the rising grade according to the Killip classiifcation for cardiac function, and the level of nt- proBnP and lnnt- proBnP increased with heart function declining, the difference was statistically signiifcant (P<0.01).Conclusion The concentration of plasma NT-proBNP increased signiifcantly in high risk patients after acute myocardial infarction with cardiac insufifciency, and it has a signiifcant association with acute cardiac Killip classiifcation. Therefore, NT-proBNP can be used in diagnosis and prediction in patients with cardiac insufifciency after acute myocardial infarction.%目的:研究aMi后nt-proBnP水平的变化对心功能不全的诊断及预测价值。方法选取96例初发aMi患者进行分析,记录24h内患者的心功能Killip分级等项目,并测定血浆nt-proBnP浓度。结果根据心功能Killip分级的各组的nt-proBnP浓度均随着级别的升高而增加,nt-proBnP和lnnt-proBnP随着心功能的减退而显著升高,差别有统计学意义(P<0.01)。结论血浆中nt-proBnP在aMi后心功能不全的高危患者中显著升高,与急性期心功能Killip分级有明显联系,可以用于aMi后心功能不全的早期诊断及预测。

  18. Plasma concentration of NT-proBNP in patients with acute coronary syndrome correlated with the severity of the diseases?%急性冠状动脉综合征严重程度与血浆氨基酸N末端脑钠肽原浓度相关性的研究

    Institute of Scientific and Technical Information of China (English)

    曹雅旻; 胡大一; 闫丽

    2005-01-01

    目的探讨急性冠状动脉综合征(ACS)患者血浆氨基酸N末端脑钠肽原(NT-proBNP)浓度与疾病严重程度是否相关,观察NT-proBNP是否可作为ACS疾病严重程度的客观生化指标.方法入选2003年10月至2004年6月之间,在我院心内科监护室住院的ACS患者(包括不稳定性心绞痛和急性心肌梗死)89例, 年龄34~85岁;采集静脉血样的同时对不稳定性心绞痛(UA)患者进行Braunwald分级,对急性心肌梗死患者进行Killip分级;用ELISA方法检测血浆NT-proBNP浓度;用SPSS软件包进行统计学分析.结果 ACS患者血浆NT-proBNP浓度与疾病严重程度存在良好的相关性:随着Braunwald分级增高,UA患者血浆NT-proBNP浓度逐渐增高(三级之间及每两级之间的NT-proBNP浓度的差异均有统计学意义,P<0.05 );随着Killip分级增高,急性心肌梗死患者血浆NT-proBNP 浓度也逐渐增高(三级之间以及每两级之间的NT-proBNP浓度差异均有统计学意义,P<0.05 );而且在NYHA 心功能都是Ⅰ级的时候急性心肌梗死患者血浆NT-proBNP浓度高于UA患者(P<0.05).结论 ACS患者血浆NT-proBNP浓度与疾病的严重程度有一定的相关性,NT-proBNP可能会成为ACS疾病严重程度的生化指标之一.

  19. NT-proBNP, C-reactive protein and soluble uPAR in a bi-ethnic male population

    DEFF Research Database (Denmark)

    Kruger, Ruan; Schutte, Rudolph; Huisman, Hugo W

    2013-01-01

    This cross-sectional study aimed to investigate associations between a marker of cardiac strain, the N-terminal prohormone B-type natriuretic peptide (NT-proBNP), and inflammation as reflected by either a conventional or novel inflammatory marker in a bi-ethnic South African cohort.......This cross-sectional study aimed to investigate associations between a marker of cardiac strain, the N-terminal prohormone B-type natriuretic peptide (NT-proBNP), and inflammation as reflected by either a conventional or novel inflammatory marker in a bi-ethnic South African cohort....

  20. Highly sensitive detection of NT-proBNP by molecular motor

    Directory of Open Access Journals (Sweden)

    Jie Zhang

    2017-03-01

    Full Text Available FoF1-ATPase is an active rotary motor, and generates three-ATP for each rotation. At saturated substrate concentration, the motor can achieve about 103 r.p.m, which means one motor can generate about 105 ATP molecules during 30 min. Here, we constituted a novel nanodevice with a molecular rotary motor and a “battery”, FoF1-ATPase and chromatophore, and presented a novel method of sandwich type rotary biosensor based on ε subunit with one target-to-one motor, in which one target corresponds 105 ATP molecules as detection signals during 30 min. The target such as NT-proBNP detection demonstrated that this novel nanodevice has potential to be developed into an ultrasensitive biosensor to detect low expressed targets.

  1. NT-ProBNP Independently Predicts Long-Term Mortality in Patients Admitted for Coronary Angiography

    DEFF Research Database (Denmark)

    Ruwald, Martin Huth; Goetze, Jens Peter; Bech, Jan

    2014-01-01

    angiography (CAG). A total of 337 patients with suspected CAD who underwent elective or acute CAG were followed up for a mean period of 6.7 years. Primary end points were all-cause mortality (ACM) and the combined end point of ACM, nonfatal myocardial infarction, and revascularization. In all, 53 (16......%) patients died and 88 (26%) patients reached the combined end point. Preprocedural NT-proBNP above 32 pmol/L independently predicted ACM (hazard ratio [HR] 3.11; confidence interval [CI]: 1.60-6.07; P = .001) and the combined end point (HR 2.44 [CI: 1.50-3.97]; P ...-proBNP is an independent predictor of ACM on long-term follow-up. N-terminal-proBNP is a reliable predictive marker of mortality in the setting of stable or unstable angina....

  2. NT-proBNP对呼吸衰竭、慢性肺源性心脏病的预后评估价值%Prognostic evaluation value of NT-proBNP in respiratory failure and chronic cor pulmonale

    Institute of Scientific and Technical Information of China (English)

    刘艺菲; 杜道兵

    2015-01-01

    目的 观察NT-proBNP在呼吸衰竭及慢性肺源性心脏病合并呼吸衰竭患者中的水平变化,评价NT-proBNP对呼吸衰竭、呼吸衰竭并慢性肺源性心脏病的严重程度、预后评估的价值.方法 选择2012年1月至2013年12月我科收治的55例呼吸衰竭患者,50例呼吸衰竭并慢性肺心病患者,测定入院时NT-proBNP血清浓度,比较两组患者NT-proBNP数值变化,再次以NT-proBNP 2000 pg/ml为截点,分为两组(A组为浓度高者,B组为浓度低者),观察两组患者住院天数、8个月内不良事件发生数.结果 呼吸衰竭并慢性肺心病患者NT-proBNP水平显著高于呼吸衰竭患者,差异有统计学意义(P<0.05),NT-proBNP≥2000 pg/ml组8月内不良事件发生率高,差异有统计学意义(P<0.01).结论 NT-proBNP水平变化对呼吸衰竭、慢性肺源性心脏病诊断及预后有一定的临床评价意义.%Objective To observe serum NT-proBNP level in patients with respiratory failure (RF) and patients with RF combined with chronic cor pulmonale,investigate the value of NT-proBNP in evaluation of severity and prognosis in RF and RF combined with chronic cor pulmonale.Methods 55 cases of RF and 50 cases of RF combined with chronic cor pulmonale in our department from Jan.2012 to Dec.2013 were selected.Tested and compared serum NT-proBNP concentration in two groups.All patients were divided into two groups according to serum NT-proBNP concentration (group A:serum NT-proBNP concentration ≥ 2000 pg/ml; group B:serum NT-proBNP concentration < 2000 pg/ml).Hospitalization day and the incidence of adverse events within 8 months were compared between two groups.Results Serum NT-proBNP concentration in patients with RF combined with chronic cor pulmonale was significantly higher than that in patients with RF (P < 0.05).The rate of adverse events within 8 months in group A was significantly higher than that in group B (P < 0.01).Conclusion Serum NT-proBNP concentration is helpful

  3. NT-pro-BNP is an independent predictor of mortality in patients with end-stage renal disease

    DEFF Research Database (Denmark)

    Svensson, M.; Gorst-Rasmussen, Anders; Schmidt, Erik Berg;

    2009-01-01

    Aim: Patients with end-stage renal disease (ESRD) have an increased mortality from cardiovascular disease (CVD). N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is an independent predictor of mortality in patients with ischemic heart disease and congestive heart failure. Previous data have...

  4. NT-pro-BNP during hypoglycemia and hypoxemia in normal subjects: Impact of renin-angiotensin system activity

    NARCIS (Netherlands)

    R. Due-Andersen (Rikke); U. Pedersen-Bjergaard (Ullrik); T. Høi-Hansen (Thomas); N.V. Olsen; C. Kistorp; J. Faber (Joerg); F. Boomsma (Frans); B. Thorsteinsson (Birger)

    2008-01-01

    textabstractBrain-derived natriuretic peptide (BNP) is a cardioprotective peptide released, together with the inactive NH2-terminal part of its prohormone (NT-pro-BNP), in response to different kinds of myocardial stress. Hypoglycemia and hypoxemia are conditions that threaten cellular function and

  5. NT-pro-BNP during hypoglycemia and hypoxemia in normal subjects: impact of renin-angiotensin system activity

    DEFF Research Database (Denmark)

    Due-Andersen, R; Pedersen-Bjergaard, U; Høi-Hansen, T;

    2008-01-01

    Brain-derived natriuretic peptide (BNP) is a cardioprotective peptide released, together with the inactive NH2-terminal part of its prohormone (NT-pro-BNP), in response to different kinds of myocardial stress. Hypoglycemia and hypoxemia are conditions that threaten cellular function and hence...... potentially stimulate BNP release. BNP interacts with the renin-angiotensin system (RAS). The aim of this study was, therefore, to explore if basal RAS activity has an impact on NT-pro-BNP concentrations during myocardial stress induced by hypoglycemia and hypoxemia. From a cohort of 303 healthy young men, 10...... (mean nadir Po-2 5.8 +/- 0.5 kPa), and 3) normoglycemic normoxia (control). NT-pro-BNP was measured at baseline, during the stimuli, and in the recovery phase. Hypoxemia was associated with a 9% increase in NT-pro-BNP from 2.2 +/- 1.5 pmol/l at baseline to 2.4 +/- 1.5 pmol/l during hypoxemia (P

  6. Improving Prediction of Postoperative Myocardial Infarction With High-Sensitivity Cardiac Troponin T and NT-proBNP.

    Science.gov (United States)

    Kopec, Michael; Duma, Andreas; Helwani, Mohammad A; Brown, Jamie; Brown, Frank; Gage, Brian F; Gibson, David W; Miller, J Philip; Novak, Eric; Jaffe, Allan S; Apple, Fred S; Scott, Mitchell G; Nagele, Peter

    2017-02-01

    This study sought to determine whether preoperatively measured high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) improve cardiac risk prediction in patients undergoing major noncardiac surgery compared with the standard risk indices. In this ancillary study to the Vitamins in Nitrous Oxide trial, patients were included who had preoperative hs-cTnT and NT-proBNP measured (n = 572). Study outcome was the incidence of postoperative myocardial infarction (MI) within the first 3 postoperative days. hs-cTnT was considered elevated if >14 ng/L and NT-proBNP if >300 ng/L. Additional cutoff values were investigated on the basis of receiver operating characteristic statistics. Biomarker risk prediction was compared with Lee's Revised Cardiac Risk Index (RCRI) with the use of standard methods and net reclassification index. The addition of hs-cTnT (>14 ng/L) and NT-proBNP (>300 ng/L) to RCRI significantly improved the prediction of postoperative MI (event rate 30/572 [5.2%], Area under the receiver operating characteristic curve increased from 0.590 to 0.716 with a 0.66 net reclassification index [95% confidence interval 0.32-0.99], P sensitivity compared with 300 ng/L (0.87 vs 0.53). Sensitivity, specificity, positive, and negative predictive value for hs-cTnT were 0.70, 0.60, 0.09, and 0.97 and for NT-proBNP were 0.53, 0.68, 0.08, and 0.96. The addition of cardiac biomarkers hs-cTnT and NT-proBNP to RCRI improves the prediction of adverse cardiac events in the immediate postoperative period after major noncardiac surgery. The high negative predictive value of preoperative hs-cTnT and NT-proBNP suggest usefulness as a "rule-out" test to confirm low risk of postoperative MI.

  7. NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study

    NARCIS (Netherlands)

    Schoonbeek, R.C.; Pieper, P.G.; Slooten, Y.J. van; Freling, H.G.; Sieswerda, G.T.; Dijk, A.P.J. van; Jongbloed, M.R.; Post, M.C.; Bouma, B.J.; Berger, R.M.; Ebels, T.; Melle, J.P. van

    2016-01-01

    OBJECTIVES: N-terminal Btype natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients wit

  8. NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve : a multicentre PROSTAVA study

    NARCIS (Netherlands)

    Schoonbeek, R C; Pieper, P G; van Slooten, Y J; Freling, H G; Sieswerda, G T; van Dijk, A. P. J.; Jongbloed, M R M; Post, M. C.; Bouma, B. J.; Berger, R M F; Ebels, T; van Melle, J P

    2016-01-01

    OBJECTIVES: N-terminal B‑type natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients wi

  9. Níveis NT-Pro-BNP e resposta ao exercício em pacientes com fluxo lento coronariano

    Directory of Open Access Journals (Sweden)

    Mustafa Yurtdaş

    Full Text Available FUNDAMENTO: Os peptídeos natriuréticos são liberados pelo coração em resposta ao estresse da parede. OBJETIVO: As concentrações de NT-Pro-BNP em pacientes com Fluxo Lento Coronariano (FLC foram avaliadas antes e depois do teste de exercício e comparados com os valores dos controles saudáveis. MÉTODOS: A população do estudo foi de 34 pacientes com FLC [22 homens (64,7%, com idade 51,0 ± 6,2 anos], e 34 indivíduos normais com artérias coronarianas normais [21 homens (61,8%, com idade 53,2 ± 6,6 anos]. As taxas de fluxo coronariano dos pacientes e controles foram determinadas pelo escore TIMI Trombólise no Infarto do Miocárdio (Thrombolysis in Myocardial Infarction. As amostras de sangue foram coletadas em repouso e após o teste ergométrico. RESULTADOS: As concentrações basais de NT-Pro-BNP nos pacientes com FLC foram superiores às dos indivíduos-controle (NT-Pro-BNP: 49,7 ± 14,2 pg/mL vs. 25,3 ± 4,6 pg/mL p <0,0001, respectivamente, e essa diferença entre os grupos aumentou após o teste de exercício (NT-Pro-BNP: 69,5 ± 18,6 pg/mL vs. 30,9 ± 6,4 pg/mL, p <0,0001. No grupo FLC após o exercício, a concentração de NT-Pro-BNP em 15 pacientes com angina foi maior do que aqueles sem angina (76,8 ± 17,8 pg/mL vs. 63,8 ± 17,5 pg/mL, p = 0,041.A concentração de NT-Pro-BNP em 11 pacientes com infradesnivelamento do segmento ST foi também maior do que aqueles sem infradesnivelamento do segmento ST (82,4 ± 17,3 pg/mL vs. 63,3 ± 16,1 pg/mL, p = 0,004. Os aumentos na mediana pós-exercício no NT-Pro-BNPNT-Pro-BNP foram maiores no grupo FLC do que no grupo de controle (Δ NT-Pro-BNP: 19,8 ± 7,7 pg/mL vs. 5,7 ± 4,5 pg/mL, p < 0,0001. CONCLUSÃO: Os resultados deste estudo sugerem que pode haver uma ligação fisiopatológica importante entre a gravidade do FLC (microvascular ou disfunção da artéria coronária epicárdica e o nível de circulação de NT-Pro-BNP em pacientes com FLC.

  10. EFFECTS OF DIABETES ON THE AMINO TERMINAL PROBRAIN TYPE NATRIURETIC PEPTIDE (NT-PROBNP LEVELS IN ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    Muzaiyan Ahmed Khan

    2012-02-01

    Full Text Available The Amino terminal portion of the precursor of brain natriuretic peptide (NT-proBNP has been reported to be elevated in left ventricular dysfunction. The NT-proBNP is a split product from the proBNP molecule, and its level in the circulation is not, as the mature Brain type natriuretic peptide, dependent on the peripheral number of brain natriuretic peptide (BNP receptors. We aimed to test the hypothesis that asymptomatic left ventricular dysfunction (ALVD, as estimated by NT-proBNP, would be more prevalent in patients with type 2 diabetes without overt cardiovascular disease in comparison with matched control subjects. The study population consisted of [N=100] out of which 75 patients including Type-II diabetes and 25 matched control subjects aged 40–70 years heart disease from OPD Escorts Heart Institute and Research centre Okhla New Delhi. NT-proBNP was measured in plasma by competitive enzyme immunosorbent assay. Patients with type-II diabetes were shown to have higher NT-proBNP values than control subjects. NT-proBNP levels were independently related to diabetes after adjustment for age, sex, systolic and diastolic blood pressure, BMI, heart rate, drug treatment, serum creatinine, and cystatin-C. The secretion of NT-proBNP is increased in type-II diabetic patients, suggesting that type 2 diabetes is associated with a higher prevalence of ALVD. NT-proBNP may thus serve as a screening tool to select patients with type-II diabetes who could benefit from an echocardiographical examination.

  11. NT-ProBNP Detection and Selection of Strategy for Patients with Atrial Fibrillation%NT-ProBNP检测与房颤患者治疗策略的选择

    Institute of Scientific and Technical Information of China (English)

    石运生; 张利民; 董茂盛; 贾关亮; 李妍辰; 苟晓丽; 张波; 常美丽

    2015-01-01

    目的:探讨房颤患者复律治疗前后NT-ProBNP水平变化与房颤复发之间的关系。方法:选择房颤患者50例,入院后复律前、后均检测NT-ProBNP,比较复律成功组和复律不成功组治疗前后的NT-ProBNP水平,以及随访期窦律维持组和房颤复发组NT-ProBNP水平。结果:复律未成功组复律前、后NT-ProBNP均明显高于转复成功组复律前、后NT-ProBNP水平,比较差异有统计学意义(P<0.01)。房颤复发组复律治疗后NT-ProBNP水平高于窦律维持组,比较差异有统计学意义(P<0.01)。结论:复律前NT-ProBNP水平异常增高者及复律后仍高于正常者复律成功的可能较小,控制心室率即可;复律后NT-ProBNP水平迅速恢复正常者更容易维持窦律。房颤患者复律后的NT-ProBNP水平可以作为预测房颤是否复发的指标。%Objective:To explore the relationship between the level of NT-ProBNP before and after cardioversion treatment in patients with the recurrence of atrial fibrillation(AF). Method:50 patients with AF were tested NT-ProBNP before and after admission. NT-ProBNP was compared between the successful cardioversion group and the failure group,coupled with that between the Maintenance of sinus rhythm group and the recurrence of atrial fibrillation group. Result:NT-ProBNP before and after treatment in failure group was significantly higher than the successful group (P<0.01). NT-ProBNP after treatment in the recurrence of atrial fibrillation group was significantly higher than the maintenance of sinus rhythm group(P<0.01). Conclusion:The probability of successful cardioversion for those who had higher level of NT-ProBNP before and after cardioversion treatment is lower while controlling ventricular rate was desirable;it is easier to maintain sinus rhythm for those whose NT-ProBNP rapid returned to normal after treatment. The content of NT-ProBNP after treatment in patients with AF can act as the index to predict

  12. NT-proBNP和hs-CRP在急性冠脉综合征诊断中的价值%The value of NT-proBNP and hs-CRP in acute coronary syndrome diagnosis

    Institute of Scientific and Technical Information of China (English)

    李茂

    2014-01-01

    Objective:To explore the levels of NT-proBNP and hs-CRP in serum of patients with acute coronary syndrome. Methods:50 cases of ACS were as the observation group;40 cases of healthy persons were as the control group.We detected the changes in the levels of NT-proBNP and hs-CRP in serum of the two groups.Results:In the observation group,the levels of NT-proBNP and hs-CRP in serum were significantly increased.Compared with the control group,the difference was statistically significant(P<0.05).Conclusion:The detection of NT-proBNP and hs-CRP is of great significance in the diagnosis of acute coronary syndrome.%目的:观察急性冠脉综合征(ACS)患者血清中NT-proBNP和hs-CRP水平。方法:50例ACS患者作观察组,40例健康者作对照组,检测两组血清中NT-proBNP和hs-CRP水平的变化。结果:观察组血清中NT-proBNP与hs-CRP水平均显著升高,与对照组相比差异有统计学意义(P<0.05)。结论:NT-proBNP和hs-CRP的检测对急性冠脉综合征的诊断具有重要意义。

  13. Application of NT-proBNP in judging the severity of traumatic brain injury%应用N末端脑钠肽前体判断颅脑创伤严重程度

    Institute of Scientific and Technical Information of China (English)

    姜大鹏; 张利远

    2014-01-01

    目的:观察N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)在颅脑创伤患者早期(创伤后24 h)血浆中的浓度,探讨其在评估创伤严重程度及预后中的应用价值.方法:选择66例颅脑创伤患者,依入院时格拉斯哥昏迷评分(Glasgow coma scale,GCS)分为轻度(GCS 13~15,n=27)、中度(GCS 9 ~ 12,n=21)、重度(GCS3~8,n=18)颅脑创伤3组;检测创伤早期血浆NT-proBNP,血糖,白细胞,比较GCS评分,头部简明创伤评分(abbreviated injury score,AIS),格拉斯哥预后评分(Glasgow outcome scale,GOS).依患者出院时GOS将其分为预后不良组(GOS 1 ~2,n=16)和预后良好组(GOS 3~5,n=50);比较各组NT-proBNP浓度,绘制受试者特征曲线,分析NT-proBNP对预后判断的价值及其与GCS、头部AIS评分及血糖水平、白细胞计数相关性.结果:重度组NT-proBNP浓度明显高于轻、中度组(P均<0.05),预后不良组NT-proBNP浓度明显高于预后良好组(P<0.05);NT-proBNP判断预后的最佳阈值为112 pg/mL(灵敏度0.875、特异度0.900),其与头部AIS评分、血糖水平、白细胞计数呈正相关,与GCS评分呈负相关.结论:NT-proBNP在早期颅脑创伤患者血浆中的浓度可作为评估患者严重程度和预后的参考指标.%Objective:To detect the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in patients with early traumatic brain injury (TBI) in order to discuss the application in evaluating the severity and prognosis.Methods:Sixty-six early TBI patients were selected in the study and divided into mild group(GCS 13-15,n =27),moderate group(GCS 9-12,n =21),severe group (GCS 3-8,n =18) according to the initial Glasgow coma score (GCS).The levels of NT-proBNP,glucose (Glu),white blood cell(WBC),GCS,head abbreviated injury score (AIS) and Glasgow outcome scale (GOS) were determined.According to the discharge GOS score,patients were divided into poor prognosis group (GOS 1-2,n =16) and good prognosis group (GOS

  14. Statin treatment is associated with a negative correlation between NT-proBNP and insulin resistance in patients without history of heart failure.

    Science.gov (United States)

    Wang, Jun-Sing; Lee, Chia-Lin; Lee, Wen-Jane; Lee, I-Te; Lin, Shih-Yi; Lee, Wen-Lieng; Liang, Kae-Woei; Sheu, Wayne Huey-Herng

    2016-08-01

    We investigated the effect of statin treatment on the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and insulin resistance in patients without history of heart failure. Patients without history of heart failure and diabetes were recruited to undergo an oral glucose tolerance test. Blood samples were collected for measurements of NT-proBNP, glucose, and insulin. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Linear mixed model analysis was used to examine the correlation between NT-proBNP and HOMA-IR. A total of 219 patients (mean age 61.1±11.8y, median NT-proBNP 64.3 [32.1-154.5] pg/ml) were analyzed. Overall, NT-proBNP was negatively correlated with HOMA-IR after an adjustment for confounders (β coefficient -0.335, 95% CI [-0.516, -0.153], p=0.001). This correlation was significant in patients on statin treatment (n=91, β coefficient -0.558, 95% CI [-0.802, -0.312], pnegative correlation between NT-proBNP and insulin resistance in patients without history of heart failure. Our findings suggest that NT-proBNP may be related to insulin resistance associated with statin treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Evaluative Significance of Serum NT-proBNP Determation for Prognosis and Death Risk in Patients with Acute Myocardial Infarction%血清NT-proBNP检测对AMI患者预后和死亡风险评估的意义

    Institute of Scientific and Technical Information of China (English)

    戴丽萍

    2013-01-01

    目的:评估氨基末端B型钠尿肽原(NT-proBNP)浓度变化对急性心肌梗死(AMI)患者预后和死亡风险评估的意义.方法:采用双向侧流免疫法检测84例AMI患者、40名健康对照者以及AMI患者治疗后第3d、第7d血清NT-proBNP水平.所有患者平均随访180 d,观察随访期间发生的主要不良心脏事件(MACE).结果:AMI组患者入院时血清NT-proBNP水平较健康对照组明显升高(P2376.23 ng/L组患者随访期内出现MACE的例数明显高于NT-proBNP≤2376.23 ng/L组(P0.05).结论:血清NT-proBNP水平与AMI患者预后和死亡风险密切相关,观察AMI患者早期血清NT-proBNP水平及其在治疗过程中的动态变化对AMI患者预后和死亡风险评估有重要价值.%Objective To assess the significance of serum N-terminal pro-B-type natriuretic peptide( NT-proBNP) level for prognosis and death risk in patients with acute myocardial infarction( AMI). Methods The serum NT-proBNP level of 84 patients with AMI,40 healthy controls and the patients with AMI treated on the 3rd and 7th day was measured by bi-directional lateral flow immuno-assay. The main adverse cardiovascular events( MACE) were tallowed up for 180d. Results The serum NT-proBNP level in the AMI group was significantly higher than the control group(P 2376.23ng/L expressed prominently higher than that with NT-proBNP 0.05). Conclusion The serum NT-proBNP are closely correlated with prognosis and death risk in patients with AMI. Observing the early serum NT-proBNP and the change of serum NT-proBNP level in the course of treatment possess important significance in the prognosis and evaluation of death risk.

  16. N-terminal pro-brain natriuretic peptide levels and short term prognosis in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Vandanapu Naveen

    2015-01-01

    Full Text Available Background: Sparse published data are available regarding the prognostic importance of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP in patients with acute ischemic stroke. Materials and Methods: We prospectively studied 74 consecutive patients presenting with acute ischemic stroke within 24 hours of onset. All of them underwent laboratory and imaging evaluation and were treated as per guidelines. In all subjects, plasma NT-proBNP levels were measured at initial admission and again on day 7. Results: Their mean age was 54 ± 13.5years; there were 49 males; 18 (24% patients died during the hospital stay. A statistically significant negative correlation between log NT-proBNP and Glasgow coma scale (GCS score (P < 0.001; and a significant positive correlation between log NT-proBNP and National Institutes of Health Stroke Scale (NIHSS score (P < 0.001 were observed. Baseline log NT-proBNP levels were higher among non-survivors compared with survivors (6.7 ± 0.47 vs. 5.37 ± 0.62; P = 0.06; day 7 log NT-proBNP levels were significantly higher in non-survivors compared with survivors (7.3 ± 0.26 vs. 4.5 ± 0.4; P = 0.000. In survivors, there was a statistically significant decline in log NT-proBNP levels from baseline to day 7 (5.3710 ± 0.620 vs. 4.5320 ± 0.451; P < 0.001. In contrast, among non-survivors, log NT-proBNP levels showed a statistically significant increase from baseline to day 7 (4.5322 ± 0.451 vs. 7.2992 ± 0.263; P < 0.001. On receiver operator characteristic curve (ROC analysis, at a cut-off value of ≥ 6.0661, log NT-proBNP had a sensitivity and specificity of 98.2 and 88.9, respectively, in predicting death. Conclusions: Plasma log NT-pro-BNP level appears to be a useful biological marker for predicting in-hospital mortality inpatients presenting with acute ischemic stroke.

  17. Hormone therapy with tamoxifen reduces plasma levels of NT-B-type natriuretic peptide but does not change ventricular ejection fraction after chemotherapy in women with breast cancer

    Directory of Open Access Journals (Sweden)

    F.B. Silva

    2015-02-01

    Full Text Available The objective of this study was to evaluate the effect of tamoxifen on the plasma concentration of NT-pro-B-type natriuretic peptide (NT-proBNP in women undergoing chemotherapy for breast cancer and to correlate changes in NT-proBNP with the left ventricular ejection fraction (LVEF. Over a period of 12 months, we followed 60 women with a diagnosis of breast cancer. The patients were separated into a group that received only chemotherapy (n=23, a group that received chemotherapy + tamoxifen (n=21, and a group that received only tamoxifen (n=16. Plasma levels of NT-proBNP were assessed at 0 (T0, 6 (T6, and 12 (T12 months of treatment, and echocardiography data were assessed at T0 and T12. Plasma NT-proBNP levels were increased in the chemotherapy-only group at T6 and T12, whereas elevated NT-proBNP levels were only found at T6 in the chemotherapy + tamoxifen group. At T12, the chemotherapy + tamoxifen group exhibited a significant reduction in the peptide to levels similar to the group that received tamoxifen alone. The chemotherapy-only group exhibited a significant decrease in LVEF at T12, whereas the chemotherapy + tamoxifen and tamoxifen-only groups maintained levels similar to those at the beginning of treatment. Treatment with tamoxifen for 6 months after chemotherapy significantly reduced the plasma levels of NT-proBNP and did not change LVEF in women with breast cancer.

  18. Vasoactive Peptide Levels after Change of Dialysis Mode

    Directory of Open Access Journals (Sweden)

    Fredrik Uhlin

    2015-10-01

    Full Text Available Background/Aims: Plasma concentrations of the N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP are increased in end-stage renal disease. Improvement in hemodynamic stability has been reported when switching from hemodialysis (HD to on-line hemodiafiltration (ol-HDF. The aim of this study was to investigate plasma concentrations of NT-proBNP, BNP and neuropeptide Y (NPY during a 1-year follow-up, after a change from high-flux HD to postdilution ol-HDF. Additional variables were also studied, e.g. pulse wave velocity and ordinary clinical parameters. Method: We conducted a prospective, single-center study including 35 patients who were switched from HD to HDF. Plasma concentrations of NT-proBNP, BNP and NPY before and after dialysis were measured at baseline (i.e. HD and at 1, 2, 4, 6 and 12 months on HDF. Results: All three peptide levels decreased significantly during HD and HDF when comparing concentrations before and after dialysis. Mean absolute value (before/after and relative decrease (% before versus after dialysis was 13.697/9.497 ng/l (31% for NT-proBNP, 62/40 ng/ml (35% for BNP and 664/364 pg/l (45% for NPY. No significant differences were observed when comparing predialysis values over time. However, postdialysis NT-proBNP concentration showed a significant decrease of 48% over time after the switch to HDF. Conclusion: The postdialysis plasma levels of NT-proBNP, BNP and NPY decreased significantly during both dialysis modes when compared to before dialysis. The postdialysis lowering of NT-proBNP increased further over time after the switch to ol-HDF; the predialysis levels were unchanged, suggesting no effect on its production in the ventricles of the heart.

  19. High N-terminal pro-B-type natriuretic peptide levels are associated with reduced heart rate variability in acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Luc Lorgis

    Full Text Available AIM: We investigated the relationships between the autonomic nervous system, as assessed by heart rate variability (HRV and levels of N-terminal Pro-B-type Natriuretic Peptide (Nt-proBNP in patients with acute myocardial infarction (MI. METHODS AND RESULTS: The mean of standard deviation of RR intervals (SDNN, the percentage of RR intervals with >50 ms variation (pNN50, square root of mean squared differences of successive RR intervals (rMSSD, and frequency domain parameters (total power (TP, high frequency and low frequency power ratio (LF/HF were assessed by 24 h Holter ECG monitoring. 1018 consecutive patients admitted <24 h for an acute MI were included. Plasma Nt-proBNP (Elecsys, Roche was measured from blood samples taken on admission. The median (IQR Nt-proBNP level was 681(159-2432 pmol/L. Patients with the highest quartile of Nt-proBNP were older, with higher rate of risk factors and lower ejection fraction. The highest Nt-proBNP quartile group had the lowest SDNN, LF/HF and total power but similar pNN50 and rMSSD levels. Nt-proBNP levels correlated negatively with SDNN (r = -0.19, p<0.001, LF/HF (r = -0.37, p<0.001, and LF (r = -0.29, p<0.001 but not HF (r = -0.043, p = 0.172. Multiple regression analysis showed that plasma propeptide levels remained predictive of LF/HF (B(SE = -0.065(0.015, p<0.001, even after adjustment for confounders. CONCLUSIONS: In conclusion, our population-based study highlights the importance of Nt-proBNP levels to predict decreased HRV after acute MI.

  20. Which method is best for an early accurate diagnosis of acute heart failure? Comparison between lung ultrasound, chest X-ray and NT pro-BNP performance: a prospective study.

    Science.gov (United States)

    Sartini, Stefano; Frizzi, Jacopo; Borselli, Matteo; Sarcoli, Elisabetta; Granai, Carolina; Gialli, Veronica; Cevenini, Gabriele; Guazzi, Gianni; Bruni, Fulvio; Gonnelli, Stefano; Pastorelli, Marcello

    2016-07-11

    Acute heart failure is a common condition among adults presenting with dyspnea in the Emergency Department (ED), still the diagnosis is challenging as objective standardized criteria are lacking. First line work-up, other then clinical findings, is nowadays made with lung ultrasound imaging study, chest X-ray study and brain natriuretic peptide (BNP) level determination; however, it is not clear which is the best diagnostic test to be used and whether there is any real benefit for clinical judgement. We set up this study to compare the performances of these three diagnostic tools; furthermore, we combined them to find the best possible approach to dyspneic patients. This is a prospective observational study based in the ED. We enrolled adults presenting with dyspnea not trauma-related, they underwent lung ultrasound, and chest X-ray studies, and NT pro-BNP level determination. Then we compared the results with the diagnosis of acute heart failure established by an independent panel of experts. 236 patients were enrolled in the study. We find sensitivity and specificity for lung ultrasound of 57.73 and 87.97 %, for chest X-ray 74.49 and 86.26 %, for NT pro-BNP 97.59 and 27.56 %, respectively. Combining together the chest X-ray and lung ultrasound, we find the best overall performance with 84.69 % sensitivity, 77.69 % specificity and 87.07 % negative predictive value. From our results, we could not identify the "best test" to diagnose acute heart failure in an emergency setting, although we could suggest that a stepwise workup combining chest X-ray and lung ultrasound at first, then for those negative, a determination of NT pro-BNP assay would be a reasonable approach to the dyspneic patient.

  1. The expression of NT-proBNP in acute pulmonary contusion patients%急性肺挫伤患者N末端B型钠尿肽前体的动态变化及其意义

    Institute of Scientific and Technical Information of China (English)

    周继光; 李起栋; 洪钰锟; 许月红

    2013-01-01

    Objective To study the clinical changes of N-terminal pro-brain natriuretie peptide(NT-proBNP) in patients with acute pulmonary contusion. Methods 263 patients with acute pulmonary contusion were divided into three different classifications for the sake of comparison in different respects, namely (1)acute pulmonary contusion with ARDS group and acute pulmonary contusion without ARDS group, (2)survival group and non-survival group, and (3)ISS score<20 group and ISS score≥20 group. The levels of serum NT-proBNP were respectively detected by electrochemical luminescence assay(ECLIA) within 24 hours of injury and 3, 5 and 7 days after injury. The regularity of their changes was observed and the correlation factors were analyzed from the data. Results Compared with normal, the levels of serum NT-proBNP were significantly increased in patients with acute pulmonary contusion in all intervals of detection, The levels of serum NT-proBNP was positively correlated with ISS score.The levels of serum NT-proBNP escalated gradually in acute pulmonary contusion with ARDS, and reached significantly higher levels in 5 days and 7 days after injury compared with those without ARDS group (P<0.05). The levels of serum NT-proBNP were higher in nou-survival group than those in survival group(P<0.05). The increase in levels of serum NT-proBNP peaked and then declined in 5 days in ISS score≥20 group, whereas it peaked and declined in 3 days after injury in ISS score<20 group. Conclusions The levels of serum NT-proBNP were increased in patients with severe pulmonary contusion, It was positively correlated with ISS score, reflecting the severity of pulmonary injury(r=0.606, P<0.05). The levels of serum NT-proBNP were the sensitive markers for evaluating the severity of pulmonary injury and the prognosis of ARDS caused by severe pulmonary contusion.%目的:通过检测急性肺挫伤患者血中 N 末端 B 型钠尿肽前体(NT-proBNP)在受伤后不同时间点的水平,揭示其

  2. Biomarcadores plasmáticos y urinarios en pacientes con insuficiencia cardíaca aguda. NT-proBNP y la influencia de la disfunción renal en su aclaramiento y valor pronóstico

    OpenAIRE

    Boronat García, Miguel

    2013-01-01

    OBJETIVOS 1. Evaluar como influye la función renal glomerular, medida por TFGe, en la concentración de NT-proBNP urinario. 2. Evaluar la relación entre las concentraciones de marcadores bioquímicos específicos de función renal glomerular y tubular y las concentraciones de NT-proBNP, para ayudar a identificar su mecanismo de eliminación renal. 3. Evaluar el valor pronóstico de los niveles de NT-proBNP urinario y compararlo con el de NT-proBNP plasmático en pacientes con ICA. MATE...

  3. Significance of combined cTnT,hs-CRP and NT-proBNP detection in diagnosis of acute coronary syndrome%三项生化指标联合检测在急性冠状动脉综合征患者临床诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    支杨; 宋莉红; 杨冬梅

    2012-01-01

    Objective To study the value of combined cTnT,NT-proBNP and hs-CRP detection in clinical diagnosis of acute coronary syndrome. Methods One hundred and thirty-four acute coronary syndrome patients were divided into unstable angina pectoris(UAP) group(n = 49) ,ST elevation myocardial infartion (STEMI) group (n = 37) and non-ST elevation myocardial infartion (NSTEMI) group(n = 48). Their cTnT,NT-proBNP and hs-CRP levels were measured with elec-tro-chemiluminescent double antibody sandwich method and immune transmission turbidity method, respectively. The role of single and combined cTnT,NT-proBNP and hs-CRP detection in diagnosis of UAP, NSTEMI and STEMI was analyzed by plotting ROC curve and establishing logistic regression model. Results The serum cTnT, NT-proBNP and hs-CRP levels were significantly higher in UAP group,NSTEMI group and STEMI group than in control group(P<0. 05). Combined cTnT,NT-proBNP and hs-CRP detection showed the largest area under the ROC curve for acute coronary syndrome and the best sensitivity and specificity than single cTnT, NT-proBNP and hs-CRP dection. Conclusion Comined cTnT,NT-proBNP and hs-CRP detection can significantly improve the diagnosis of UAP with an optimal sensitivity and specificity for NSTEMI and acute myocardial infarction. However,it cannot effectively distinguish NSTEMI from acute myocardial infarction.%目的 探讨心肌肌钙蛋白T(cTnT)和N末端B型钠尿肽前体(NT-proBNP)及高敏C反应蛋白(hs-CRP)3项生化指标联合检测在急性冠状动脉综合征(ACS)临床诊断中的应用价值.方法 选择ACS患者134例,其中不稳定性心绞痛(UAP组)患者49例,ST段抬高心肌梗死(STEMI组)患者37例,非ST段抬高心肌梗死(NSTEMI组)患者48例.用电化学发光双抗体夹心法检测cTnT、NT-proBNP,免疫透射比浊法检测hs-CRP;通过绘制ROC曲线和建立logistic回归模型,分析各指标单独和联合检测在UAP、NSTEMI及STEMI诊疗中的作用.结果UAP组(除外cTnT)、NSTEMI

  4. Relationship between pelvic lymph node metastasis and clinical pathological characteristics of cervical cancer%NT-proBNP 对2型糖尿病患者心率变异性的影响

    Institute of Scientific and Technical Information of China (English)

    张冬梅; 张军; 张亚平; 李伟

    2016-01-01

    analysis.Blood was collected from patients with venous blood, centrifuge analysis of its serum, speed of 3000 r/min, after ten minutes of centrifugal, using the NT-proBNP AQT90 of the company’s production of FLEX. Results The differences of NT-proBNP and HRV levels in the two groups were statistically significant; the time domain analysis index of the two groups were significantly different (DANN), HF, RMSSD, PNN50, VLF, LF and SDNN, LF and VLF. No significant correlation was found between SDNN, PNN50 and HF. Conclusion The level of NT-proBNP in patients with type 2 diabetes associated with HRV, can damage cardiac function of autonomic nervous response in patients with type 2 diabetes in clinic, NT-proBNP can be used as a reference for the diagnosis of type 2 diabetes.

  5. NT-proBNP <95 ng/l can exclude pulmonary hypertension on echocardiography at diagnostic workup in patients with interstitial lung disease

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    Charlotte Andersen

    2016-07-01

    Full Text Available Background: Pulmonary hypertension (PH is a serious complication to interstitial lung disease (ILD and has a poor prognosis. PH is often diagnosed by screening with echocardiography followed by right heart catheterisation. A previous study has shown that a value of NT-pro-brain natriuretic peptide (NT-proBNP 95 ng/l for signs of PH on echocardiography were calculated. The study was approved by the Danish Health Authority. Results: In 118 patients, data from both echocardiography and measurements of NT-proBNP were available. Eleven of these were screened positive for PH on echocardiography. Sensitivity, specificity, NPV and PPV of NT-proBNP <95 ng/l for PH were 100, 44, 16 and 100%, respectively. Furthermore, no patients with left heart failure as the cause of dyspnoea were missed using this cut-off value. Conclusion: NT-proBNP <95 ng/l precludes a positive echocardiographic screen for PH in ILD patients at referral for diagnostic workup.

  6. Is N-terminal pro B-type natriuretic peptide (NT-proBNP) a useful screening test for angiographic findings in patients with stable coronary disease?

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Omland, Torbjørn;

    2006-01-01

    BACKGROUND: Whether N-terminal pro B-type natriuretic peptide (NT-proBNP) is a useful screening tool for angiographic coronary artery disease in patients with angina is not known. Therefore, the purpose of this study was to assess the diagnostic test performance of NT-proBNP in detecting coronary......). The ability of NT-proBNP in detecting clinically significant coronary disease at angiography was modest, however, with sensitivity of 0.61, specificity 0.60, accuracy 61 (95% CI 58-64), positive likelihood ratio 1.5 (95% CI 1.3-1.8), negative likelihood ratio 0.7 (95% CI 0.6-0.8), and area under the ROC curve...... atherosclerotic lesions, as assessed by coronary angiography. METHODS: We examined 1034 patients referred for diagnostic angiography because of symptoms or signs of coronary artery disease. The diagnostic value of NT-proBNP in predicting clinically significant coronary disease was assessed. RESULTS: In a multiple...

  7. Extracellular matrix biomarker, fibulin-1, is closely related to NT-proBNP and soluble urokinase plasminogen activator receptor in patients with aortic valve stenosis (the SEAS study)

    DEFF Research Database (Denmark)

    Kruger, Ruan; Rasmussen, Lars M; Argraves, William S;

    2014-01-01

    BACKGROUND: Fibulin-1, a circulating extracellular matrix glycoprotein, has been associated with arterial disease and elevated N-terminal prohormone B-type natriuretic peptide (NT-proBNP) in diabetes. Soluble urokinase plasminogen activator receptor (suPAR), a marker of inflammation, has been ass...

  8. The value of prognosis of NT-proBNP in severe sepsis and septic shock patients%血浆N末端脑钠肽前体对严重脓毒症和脓毒症休克患者预后判断的价值

    Institute of Scientific and Technical Information of China (English)

    李远华; 宋秀婵; 戚应静; 曾沛扬; 吴苏华; 赖志君; 谢树锋

    2013-01-01

    目的:探讨血浆N末端脑钠肽前体(NT-proBNP)对严重脓毒症和脓毒症休克患者预后的判断价值。方法选择该院收治的脓毒症患者70例,根据患者病情严重程度分为一般脓毒症组(n=23)、严重脓毒症组(n=28)和脓毒症休克组(n=19),于入院1 h内测定患者血浆NT-proBNP、乳酸、C反应蛋白(CRP),并计算24 h急性生理和慢性健康状态评分Ⅱ(APACHEⅡ)。结果(1)严重脓毒症组、脓毒症休克组患者血浆NT-proBNP、乳酸、CRP和 APACHEⅡ明显高于一般脓毒症组(P<0.05);脓毒症休克组患者血浆NT-proBNP、CRP和 APACHEⅡ明显高于严重脓毒症组(P<0.05)。(2)70例脓毒症患者死亡15例,存活55例,死亡组血浆NT-proBNP、乳酸、CRP和APACHEⅡ明显高于存活组(P<0.01)。(3)脓毒症患者入院时NT-proBNP浓度与APACHEⅡ呈正相关(r=0.528,P<0.01)。结论血浆NT-proBNP与脓毒症患者预后密切相关,早期检测血浆NT-proBNP水平有助于评估脓毒症患者预后情况。%Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55

  9. Relationship of plasma N-terminal pro-brain natriuretic peptide and cardiac function in patients with chronic kidney disease%慢性肾脏病患者血浆氨基末端前体脑钠肽与心功能的关系

    Institute of Scientific and Technical Information of China (English)

    向莉; 杨敏; 潘家荣

    2011-01-01

    Objective To study the relationship of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac function in patients with chronic kidney disease(CKD). Methods Plasma NT-proBNP was examined in 152 CKD patients and 20 healthy subjects. The relationship of plasma NT-proBNP and echocardiographic and biochemistry parameter was analyzed. Results Plasma NT-proBNP level of CKD patients with heart failure was much higher than that of CKD cases in same stage but without heart failure. Plasma NT-proBNP level of CKD patients without heart failure increased with the decrease of the level of estimated glomerular filtration rate( eGFR),which was not in CKD patients with heart failure. NT-proBNP level was positively correlated with left atrial diameter (LAD), left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter (LVESD),but negatively correlated with left ventricular ejection frection(LVEF). Conclusion Plasma NT-proBNP is a sensitive marker for diagnosing early symptomless heart failure in CKD patients.%目的 研究血浆氨基末端前体脑钠肽(NT-proBNP)与心功能的关系.方法 采用固相免疫层析法检测152例不同分期慢性肾脏病(CKD)组患者与20例对照组血浆NT-proBNP水平,分析其与心脏彩超各指标、生化指标的关系.结果 伴有心衰的各期CKD患者NT-proBNP水平远高于同一分期无心衰患者;非心衰组CKD患者的NT-proBNP水平随着肾小球滤过率的下降逐渐升高;NT-proBNP水平与左房内径以及左室舒张末内径、左室收缩末内径均呈正相关,与心脏射血分数呈负相关.结论 NT-proBNP是早期诊断CKD患者无症状性心功能不全的敏感指标.

  10. Decrease of plasma N-terminal pro β-type natriuretic peptide as a predictor of clinical improvement after cardiac resynchronization therapy for heart failure

    Institute of Scientific and Technical Information of China (English)

    DING Li-gang; HUA Wei; ZHANG Shu; CHU Jian-min; CHEN Ke-ping; WANG Yang; WANG Fang-zheng; CHEN Xin

    2009-01-01

    Background N-terminal pro β-type natriuretic peptide (NT pro BNP) has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy (CRT).Methods A total of 44 patients with chronic heart failure (34 male and 10 female, mean age of (58±13) years, New York Heart Association (NYHA) class 3.3±0.5, QRS duration (150±14) milliseconds) who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data.Results After a mean of (16.3±5.5) months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP ((1.70±1.28) vs (1.07±0.88) pmol/ml, P <0.001) in responders. Percentage change in NT pro BNP level (△BNP%) was a statistically significant predictor of long term clinical improvement at 3 months of follow-up.Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.

  11. Evaluation of electrical bioimpedance analyzer and NT-proBNP on load capacity and ;cardiac function in patients with MHD/cardiac function in patients with MHD%生物电阻抗分析仪和N末端脑钠肽前体在维持性血液透析患者容量负荷与心功能评估中的应用

    Institute of Scientific and Technical Information of China (English)

    王建爽; 王艳辉; 杨文艳; 安影丹; 朱艳香

    2016-01-01

    groups. The plasma NT-proBNP levels before and after dialysis in dialysis group were determinated by the electrochemical luminescence method. The color doppler ultrasound cardiograph can detect left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic dimension (LVDs), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF). Estimated glomerular filtration rate (eGFR) was determined according to a Modification of Diet in Renal Disease(MDRD) formula. Results:1)The plasma NT-proBNP levels, TBW and ECW/TBW before dialysis were lower obviously than that after dialysis (t=7.462, t=2.321, t=4.605;P0.05) in dialysis group, and it hinted that the capacity load parameter was close to normal level. 3)The plasma NT-proBNP level was positively correlated with ECW/TBW, NYHA classification, LVDd, LVDs, LVPWT and LVMI (r=0.246, r=0.809, r=0.341, r=0.249, r=0.253, r=0.329; P<0.05), and negatively correlated with eGFR and LVEF (r=-0.513, r=-0.360;P<0.05). Conclusion:The electrical bioimpedance and NT-proBNP can be used to assess the capacity load and cardiac function in patients with MHD, and it has certain application value to formulate individualized treatment scheme.

  12. Multimarker Strategy for Heart Failure Prognostication. Value of Neurohormonal Biomarkers: Neprilysin vs NT-proBNP.

    Science.gov (United States)

    Bayes-Genis, Antoni; Barallat, Jaume; Galán, Amparo; de Antonio, Marta; Domingo, Mar; Zamora, Elisabet; Gastelurrutia, Paloma; Vila, Joan; Peñafiel, Judith; Gálvez-Montón, Carolina; Lupón, Josep

    2015-12-01

    Neprilysin breaks down numerous vasoactive peptides. The soluble form of neprilysin, which was recently identified in heart failure, is associated with cardiovascular outcomes. Within a multibiomarker strategy, we directly compared soluble neprilysin and N-terminal pro-B-type natriuretic peptide as risk stratifiers in a real-life cohort of heart failure patients. Soluble neprilysin, N-terminal pro-B-type natriuretic peptide, ST2, and high-sensitivity troponin T levels were measured in 797 consecutive ambulatory heart failure patients followed up for 4.7 years. Comprehensive multivariable analyses and soluble neprilysin vs N-terminal pro-B-type natriuretic peptide head-to-head assessments of performance were performed. A primary composite endpoint included cardiovascular death or heart failure hospitalization. A secondary endpoint explored cardiovascular death alone. Median soluble neprilysin and N-terminal pro-B-type natriuretic peptide concentrations were 0.64ng/mL and 1187 ng/L, respectively. Both biomarkers significantly correlated with age (P<.001) and ST2 (P<.001), but only N-terminal pro-B-type natriuretic peptide significantly correlated with estimated glomerular filtration rate (P<.001), body mass index (P<.001), left ventricular ejection fraction (P=.02) and high-sensitivity troponin T (P<.001). In multivariable Cox regression analyses, soluble neprilysin remained independently associated with the composite endpoint (hazard ratio=1.14; 95% confidence interval, 1.02-1.27; P=.03) and cardiovascular death (hazard ratio=1.15; 95% confidence interval, 1.01-1.31; P=.04), but N-terminal pro-B-type natriuretic peptide did not. The head-to-head soluble neprilysin vs N-terminal pro-B-type natriuretic peptide comparison showed good calibration and similar discrimination and reclassification for both neurohormonal biomarkers, but only soluble neprilysin improved overall goodness-of-fit. When added to a multimarker strategy, soluble neprilysin remained an independent

  13. Diagnostic value of NT-proBNP in identifying aortic stenosis patients with heart failure%N末端B型利钠肽原对单纯主动脉瓣狭窄心力衰竭患者的诊断价值

    Institute of Scientific and Technical Information of China (English)

    吴超; 杨跃进; 赵雪燕; 张健; 黄洁; 韦丙奇; 孙寒松; 王巍; 闫鹏

    2010-01-01

    Objective To evaluate the diagnostic value of NT-proBNP in aortic stenosis (AS) patients with heart failure. Method We measured the whole venous blood of NT-proBNP with enzyme linked immuno sorbent assay (Biomedica, Vienna, Austria) in 40 AS patients with heart failure and 76 normal subjects and assessed the diagnostic value of NT-proBNP for heart failure. Results NT-proBNP levels were significantly higher in AS patients with heart failure compared to controls ( P 0. 05) and significantly (8 times) increased in decompensated heart failure group (P 50 mm group than that in LVEDD^50 mm group (P 60% group than that in LVEF >60% group(P0.05),而临床失代偿心衰升高8倍(P50 mm组显著高于LVEDD≤50mm组(P60%组(P<0.01);在合并心房颤动组显著高于窦性心律组(P<0.05).NT-pmBNP阈值在1360 ng/L时,是诊断心衰(ROC曲线下面积=0.762,P<0.01)及失代偿心衰(ROC曲线下面积=0.997,P<0.01)的最佳阈值;心衰与失代偿心衰诊断的敏感性分别为67.50%和100.00%,特异性均为96.05%,准确性分别为86.21%和95.83%.单因素和多元逐步回归分析一致显示,Log(NT-proBNP)与NYHA分级和LVEF呈显著正、负相关(P<0.05),且呈独立相关.结论 NT-pwBNP对单纯As心衰患者也有重要诊断价值.建议临床采用1360 ng/L作为阈值,诊断单纯AS伴心衰者准确性高达86.21%,尤其对失代偿者准确性高达95.83%.

  14. The role of TNF-α, Fas/Fas ligand system and NT-proBNP in the early detection of asymptomatic left ventricular dysfunction in cancer patients treated with anthracyclines

    Directory of Open Access Journals (Sweden)

    Alexandros Kouloubinis

    2015-03-01

    Conclusion: SFas, sFas-L and NT-proBNP correlate with reductions in LVEF and could be used as sensitive biochemical indices for the detection of asymptomatic left ventricular dysfunction in cancer patients under cardiotoxic chemotherapy.

  15. 急性呼吸窘迫综合征患者NT-proBNP与病情严重程度及预后的关系%Relationship between NT-proBNP and the severity and prognosis of acute respiratory distress syndrome

    Institute of Scientific and Technical Information of China (English)

    周烨强; 华锋

    2015-01-01

    patient APACHEII, Murray, NT-proBNP, creatinine, blood urea nitrogen, fasting glucose, pH value of the differences were statistically significant (P<0.05). APACHEII, Murray, NT-proBNP and severity of ARDS were positively correlated (r=0.595, 0.545, 0.563, P<0.05). APACHEII, Murray was positively correlated with NT-proBNP(r=0.584, 0.544, P<0.05). The differences of age, APACHEII, Murray, NT-proBNP, creatinine, blood urea nitrogen, fasting blood glucose, pH value, oxygenation index, number of extrapul-monary organ failure of survival and nonsurvivors groups were statistically significant (P<0.05). APACHEII, Murray, NT-proBNP, the number of extrapulmonary organ failure were independent risk factor for prognosis ARDS, oxygenation index was a protective factor (P<0.05). The area under the ROC curve for NT-proBNP for prognosis ARDS was 0.798, cut-off point for 333.92 pg/mL, the sensitivity of 81.92% and the specifici ty was 91.89%, Youden index was 0.732. Conclusion Plasma NT-proBNP helps early prognosis of ARDS severity and duration of hospitalization, can be used as markers of clinical predictors.

  16. The Effect of NT ProBNP and Inflammatory Factors in Elderly Patients with Heart Failure%瑞舒伐他汀对老年心衰患者NT-ProBNP及炎症因子的影响

    Institute of Scientific and Technical Information of China (English)

    刘艳娜; 张琼

    2016-01-01

    Objective To study the rui shu laval statin N terminal brain natriuretic peptide in patients with senile heart failure precursor ( NT-ProBNP) and the influence of inflammatory cytokines.Methods Choose 80 cases of eld-erly patients with chronic heart failure as the research object, cardiac function class forⅡ-Ⅳ.To randomly divided in-to control group and observation group, 40 cases in each group, the other randomly selected 40 cases of elderly people as healthy controls.With the control group, patients received conventional drug treatment of chronic heart failure patients in the observation group based on the increased use of shu cut statin calcium, 1/d, treatment of 4 weeks.Testing all chron-ic heart failure patients before and after treatment serum myeloperoxidase ( MPO) , and N terminal ( NT-ProBNP) lev-els of brain natriuretic peptide precursor, detecting serum MPO level of healthy control subjects.Results Serum MPO level before treatment control group and observation group were significantly higher than that of healthy controls ( P0.05).The control group and observation group with a signifi-cant reduction in the NT -ProBNP levels after treatment (P<0.05), 4 weeks after treatment, NT-ProBNP observa-tion group were significantly lower than the control group patients (P<0.05).Conclusions Elderly patients with chro-nic heart failure of serum inflammatory factors tend to rise, it can be as evaluation index of chronic heart failure in devel-opment, rui shu laval statins can significantly reduce serum inflammatory factors in elderly patients with chronic heart failure and the NT-ProBNP level, this may be the drug is biological mechanisms for the treatment of chronic heart fail-ure and improve prognosis.%目的:探讨瑞舒伐他汀对老年心力衰竭患者N末端脑钠肽前体( NT-ProBNP)以及炎症因子的影响。方法选择80例老年慢性心力衰竭患者作为研究对象,心功能分级为Ⅱ-Ⅳ级。将其对随机分为

  17. El NT-pro BNP predice mal pronóstico en pacientes con síndromes coronarios agudos sin elevación del segmento ST y función ventricular conservada

    Directory of Open Access Journals (Sweden)

    Florencia Rolandi

    2006-01-01

    Full Text Available Antecedentes El NT-proBNP se asocia con disfunción ventricular y mala evolución en síndromes coronarios agudos sin elevación del ST (SCA-SEST. La evidencia sobre su valor pronóstico en pacientes con SCA-SEST y función sistólica conservada es escasa. Objetivos Explorar el valor pronóstico del NT-proBNP en pacientes con SCA-SEST sin disfunción ventricular. Material y métodos De una cohorte de pacientes con SCA-SEST sometidos a angiografía se seleccionaron 393 con fracción de eyección del ventrículo izquierdo =?40%. Laboratorios centrales independientes analizaron las angiografías y las determinaciones de NT-proBNP, troponina T, mioglobina y proteína C reactiva. Se empleó un punto de corte de NT-proBNP de 586 pg/ml El punto final primario fue la incidencia de muerte o infarto a los 180 días. Resultados Ochenta y tres pacientes (21% tuvieron NT-proBNP =?586 pg/ml y 310 (79% niveles < 586 pg/ml. Los pacientes con NT-proBNP elevado eran más añosos, con mayor frecuencia de sexo femenino; tuvieron una proporción mayor de marcadores séricos elevados y una proporción mayor de enfermedad coronaria extensa y de lesiones coronarias complejas. Estos pacientes, comparados con aquellos con NT-proBNP < 586 pg/ml, tuvieron una incidencia mayor de muerte (9,6% versus 2,3%; p = 0,002, infarto (9,6% versus 3,2%; p = 0,01 y muerte o infarto (16,9% versus 5,5%; p = 0,001 a los 180 días. Ajustando por variables clínicas, electrocardiográficas y angiográficas, el NT-proBNP resultó ser un predictor independiente del punto final combinado de muerte o infarto a los 6 meses y de muerte por cualquier causa. Conclusiones El NT-proBNP es un predictor independiente de muerte e infarto y de muerte global a los 6 meses en pacientes con SCA-SEST sin disfunción ventricular.

  18. 血清NT-proBNP对危重手足口病儿童病情与生存状况的评估价值%The Evaluate Value of Serum NT-proBNP in the Assessment of Disease and Living Conditions for Children with Severe Hand-foot-mouth Disease

    Institute of Scientific and Technical Information of China (English)

    谢中勇; 姚丰洁; 钟文清; 卢远达

    2016-01-01

    Objective:To investigate the value of serum N-terminal pro brain natriuretic peptide (NT-proBNP) level in children with severe hand-foot-mouth disease.Method:From June 2014 to December 2015,68 cases of critical hand-foot-mouth disease children in our hospital were selected as the research objects, they were divided into the observation group of 26 cases (NT-proBNP>550 pg/mL) and the control group of 42 cases (NT-proBNP≤550 pg/mL).The laboratory indexes,incidence of complications in two groups were compared and NT-proBNP prediction of survival in children were analyzed.Result:The incidence of complications,mortality and laboratory indexes in the observation group were higher than the control group,and the pediatric critical illness score (PCIS) was lower than the control group,the differences were statistically significant(P550 pg/mL are very easy to occur pulmonary edema,circulatory failure and other serious complications,even death.%目的:探讨危重手足口病儿童血清氨基末端脑钠肽前体(NT-proBNP)水平对患儿病情与生存状况的评估价值。方法:选取2014年6月-2015年12月本院收治的68例危重手足口病儿童作为研究对象,根据入院时患儿NT-proBNP水平分为观察组(NT-proBNP>550 pg/mL)26例和对照组(NT-proBNP≤550 pg/mL)42例。比较两组患儿实验室指标、并发症发生率及分析NT-proBNP对患儿生存的预测情况。结果:观察组各项并发症发生率、死亡率和实验室指标水平均高于对照组,小儿危重病例评分(PCIS)低于对照组,比较差异均有统计学意义(P550 pg/mL的重症手足口病患儿极易发生肺水肿、循环衰竭等严重并发症,甚至死亡。

  19. 心功能正常的高龄男性患者血清N末端B型利钠肽升高对心房颤动危险的预测价值%Value of serum NT-proBNP elevation in predicting risk of atrial fibrillation in elderly male patients with normal heart function

    Institute of Scientific and Technical Information of China (English)

    霍霞; 李娜; 李世军

    2013-01-01

    Objective To assess the value of serum NT-proBNP elevation in predicting the risk of atrial fibrillation in elderly male patients with normal heart function. Methods One hundred and ninety-seven elderly male patients with normal heart function were randomly divided into non-at-rial fibrillation group(n = 166) and atrial fibrillation group(n = 31). Their left ventricular long axis cross-section and LVEF were measured by echocardiography. Their serum NT-proBNP level was measured by electrochemiluminescence immunoassay. Results The serum NT-proBNP level was significantly higher in atrial fibrillation group than in non-atrial fibrillation group (P 652. 9 ng/L.%目的 评价血清N末端B型利钠肽(NT-proBNP)水平对于预测心功能正常的高龄男性住院患者发生心房颤动(房颤)危险的价值.方法 随机选择住院的高龄男性患者197例,根据有无房颤分为无房颤组166例和房颤组31例.采用超声心动图检测胸骨旁左心室长轴切面,测量并计算LVE F;采用电化学发光免疫法测定血清NT proBNP水平.结果 房颤组较无房颤组NT-proBNP明显升高(P<0.05).Pearson相关性分析显示,NT-proBNP与心脏超声参数左心房内径、右心室内径、右心房内径和LVEF密切相关(P<0.01).ROC曲线分析显示,血清NT-proBNP预测患者房颤的ROC曲线下面积为0.754,根据Youden指数,诊断最佳界值为:血清NT proBNP=652.9 ng/L,特异性为71.5%,敏感性为74.1%.结论 高龄男性房颤患者血清NT-proBNP水平升高;血清NT-proBNP水平>652.9 ng/L时,在预测房颤发生危险中的价值较低,<652.9 ng/L时,对于预测房颤发生危险具有较高价值.

  20. N-Terminal Pro-B-Type Natriuretic Peptide Plasma Levels as a Potential Biomarker for Cardiac Damage After Radiotherapy in Patients With Left-Sided Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    D' Errico, Maria P., E-mail: patderrico@libero.it [Department of Laboratory Medicine, ' A. Perrino' Hospital, Brindisi (Italy); Grimaldi, Luca [Department of Medical Physics, ' A. Perrino' Hospital, Brindisi (Italy); Petruzzelli, Maria F. [Department of Radiation Oncology, ' A. Perrino' Hospital, Brindisi (Italy); Gianicolo, Emilio A.L. [Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy); Tramacere, Francesco [Department of Radiation Oncology, ' A. Perrino' Hospital, Brindisi (Italy); Monetti, Antonio; Placella, Roberto [Department of Laboratory Medicine, ' A. Perrino' Hospital, Brindisi (Italy); Pili, Giorgio [Department of Medical Physics, ' A. Perrino' Hospital, Brindisi (Italy); Andreassi, Maria Grazia; Sicari, Rosa; Picano, Eugenio [Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy); Portaluri, Maurizio [Department of Radiation Oncology, ' A. Perrino' Hospital, Brindisi (Italy); Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy)

    2012-02-01

    Purpose: Adjuvant radiotherapy (RT) after breast-conserving surgery has been associated with increased cardiovascular mortality. Cardiac biomarkers may aid in identifying patients with radiation-mediated cardiac dysfunction. We evaluated the correlation between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin (TnI) and the dose of radiation to the heart in patients with left-sided breast cancer. Methods and Materials: NT-proBNP and TnI plasma concentrations were measured in 30 left-sided breast cancer patients (median age, 55.0 years) 5 to 22 months after RT (Group I) and in 30 left-sided breast cancer patients (median age, 57.0 years) before RT as control group (Group II). Dosimetric and geometric parameters of heart and left ventricle were determined in all patients of Group I. Seventeen patients underwent complete two-dimensional echocardiography. Results: NT-proBNP levels were significantly higher (p = 0.03) in Group I (median, 90.0 pg/ml; range, 16.7-333.1 pg/ml) than in Group II (median, 63.2 pg/ml; range, 11.0-172.5 pg/ml). TnI levels remained below the cutoff threshold of 0.07 ng/ml in both groups. In patients with NT-proBNP values above the upper limit of 125 pg/ml, there were significant correlations between plasma levels and V{sub 3Gy}(%) (p = 0.001), the ratios D{sub 15cm{sup 3}}(Gy)/D{sub mean}(Gy) (p = 0.01), the ratios D{sub 15cm}{sup 3}/D{sub 50%} (Gy) (p = 0.008) for the heart and correlations between plasma levels and V{sub 2Gy} (%) (p = 0.002), the ratios D{sub 1cm{sup 3}}(Gy)/D{sub mean}(Gy) (p = 0.03), and the ratios D{sub 0.5cm{sup 3}}(Gy)/D{sub 50%}(Gy) (p = 0.05) for the ventricle. Conclusions: Patients with left-sided breast cancer show higher values of NT-pro BNP after RT when compared with non-RT-treated matched patients, increasing in correlation with high doses in small volumes of heart and ventricle. The findings of this study show that the most important parameters are not the mean doses but instead the small

  1. Usefulness of Serum B-Type Natriuretic Peptide Levels in Comatose Patients Resuscitated from Out-of-Hospital Cardiac Arrest to Predict Outcome

    DEFF Research Database (Denmark)

    Frydland, Martin; Kjaergaard, Jesper; Erlinge, David;

    2016-01-01

    of spontaneous circulation (ROSC). Neurological outcome was evaluated by the Cerebral Performance Category (CPC) score and modified Rankin Scale (mRS) at 6 months. Six hundred thirty-eight patients (99%) had serum NT-proBNP levels ≥125 pg/ml. Patients with TTM at 33°C had significantly lower NT-proBNP serum...

  2. H-FABP、NT-proBNP、CRP、cTnT在 ACS 患者预后中的评估价值%Prognostic value of H-FABP,NT-proBNP,CRP and cTnT in patients with ACS

    Institute of Scientific and Technical Information of China (English)

    蔡福金; 田亚平

    2014-01-01

    Objective To study the prognostic value of H-FABP,NT-proBNP,CRP and cTnT in patients with ACS.Methods 96 patients with ACS were divided into the poor prognosis group (35 cases)and control group (61 ca-ses)according to the occurrence of adverse cardiovascular events.Level of H-FABP,NT-proBNP,CRP and cTnT was tested after the admission of the patients.A one-year follow-up was carried out after the discharge and ROC was plotted to determine the accuracy of the four indicators of prognosis of patients with ACS.In the same time,risk factors for ad-verse cardiovascular events were also found out.Results Level of H-FABP,NT-proBNP,CRP and cTnT of poor prog-nosis group was statistically higher than that of the control group (P < 0.05);AUC and cutoff value H-FABP,NT-proBNP,CRP,cTnI detection of adverse cardiovascular events were 0.811,40.95 μg/L,0.749,,1342.98 ng/L,0.788, 9.69 mg/L,0.812,0.78 μg/L;COX analysis showed that COX H-FABP,NT-proBNP,CRP,and elevated cTnT levels in patients with ACS is a risk factor for cardiovascular adverse events(P <0.05).Conclusion H-FABP,NT-proBNP, CRP and cTnT has high prognostic value in patients with ACS,which is worth promoting.%目的:探讨分析 H-FABP、NT-proBNP、CRP、cTnT 在 ACS 患者预后中的评估价值。方法96例 ACS 患者根据随访1年内患者是否发生不良心血管事件将所有患者分为预后不良组(35例)与对照组(61例)。于患者入院后检测 H-FABP、NT-proBNP、CRP、cTnT 四项指标的水平,并于出院后进行为期1年的随访,绘制受试者工作特性曲线来测定上述四项指标对 ACS 患者预后评估的准确性,并找出出院后发生不良心血管事件的危险因素。结果入院时预后不良组 H-FABP、NT-proBNP、CRP、cTnT 水平均明显高于对照组(P <0.05);H-FABP、NT-proBNP、CRP、cTnT 检测对预测心血管不良事件的 ROC 曲线下面积与临界值分别为0.811、40.95μg/L,0.749、1342.98 ng/L,0.788、9

  3. Elevated Plasma IL-38 Concentrations in Patients with Acute ST-Segment Elevation Myocardial Infarction and Their Dynamics after Reperfusion Treatment

    Directory of Open Access Journals (Sweden)

    Yucheng Zhong

    2015-01-01

    Full Text Available Objective. Recent studies suggest that IL-38 is associated with autoimmune diseases. Furthermore, IL-38 is expressed in human atheromatous plaque. However, the plasma levels of IL-38 in patients with ST-segment elevation myocardial infarction (STEMI have not yet to be investigated. Methods. On admission, at 24 h, at 48 h, and at 7 days, plasma IL-38, C-reactive protein (CRP, cardiac troponin I (cTNI, and N-terminal of the prohormone brain natriuretic peptide (NT-proBNP levels were measured and IL-38 gene in peripheral blood mononuclear cells (PBMCs was detected in STEMI patients. Results. The results showed that plasma IL-38 levels and IL-38 gene expression in PBMCs were significantly increased in STEMI patients compared with control group and were time dependent, peaked at 24 h. In addition, plasma IL-38 levels were dramatically reduced in patients with reperfusion treatment compared with control group. Similar results were also demonstrated with CRP, cTNI, and NT-proBNP levels. Furthermore, IL-38 levels were found to be positively correlated with CRP, cTNI, and NT-proBNP and be weakly negatively correlated with left ventricular ejection fraction (LVEF in STEMI patients. Conclusions. The results indicate that circulating IL-38 is a potentially novel biomarker for patients with STEMI and IL-38 might be a new target for MI study.

  4. 妊娠期高血压疾病患者NT-proBNP检测的临床意义%Clinical significance of NT-proBNP detection in patients with hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    黄晓涓

    2016-01-01

    Objective To investigate the relationship between NT-proBNP and severity of disease and cardiac insufficiency in patients with hypertensive disorder complicating pregnancy.Methods 80 cases of hypertensive disorder complicating pregnancy were selected according to the severity of the disease in pregnancy induced hypertension, mild preeclampsia, severe preeclampsia, eclampsia, according to the heart function were divided into cardiac insufficiency group and normal group , determined NT-proBNP concentration. Results NT-proBNP was correlated with the severity of hypertensive disorder complicating pregnancy, and was positively correlated with cardiac insufficiency.Conclusion In patients with hypertensive disorder complicating pregnancy, NT-proBNP is a laboratory biochemical indicator that predicts cardiac insufficiency and is a good indicator of the severity of the disease, as well as guidance for treatment.%目的:探讨妊娠期高血压疾病患者NT-proBNP与病情严重程度、心功能不全相关性。方法选取80例妊娠期高血压疾病患者,主要表现为妊娠期高血压疾病、轻度子痫前期、重度子痫前期、子痫,按心功能不全分为心功能不全异常组和正常组,测定NT-proBNP浓度。结果 NT-proBN与妊娠期高血压疾病严重程度有相关性,与心功能不全呈正相关。结论妊娠期高血压疾病患者中,NT-proBNP是预测心功能不全、反映病情严重程度很好的一项实验室生化指标,同时可以指导治疗。

  5. Clinical value of N-terminal pro-brain natriuretic peptide and troponin I plasma levels in elderly patients with sepsis

    Institute of Scientific and Technical Information of China (English)

    苏琴

    2014-01-01

    Objective To evaluate the clinical significance for assessment and prognosis of elder patients with sepsis by way of detecting plasma NT-proBNP and cTnI levels.Methods It was a prospective trial conducted.A total of145 elderly patients with sepsis were admitted to the emergency observation center and the emergency ward from January 2011 through January 2013.Of them,there were 84 patients with mild sepsis,45 patients with severe sepsis,and 16 patients with septic shock.Plasma levels

  6. Correlation of right ventricular hypertrophy and vitamin D, atrial fibrillation and NT-proBNP in patients with pulmonary heart disease%肺心病患者右室肥厚与维生素D、房颤及NT-proBNP的关系

    Institute of Scientific and Technical Information of China (English)

    陈荣花; 张瑞荣; 王希柱; 宋巧凤; 刘婷婷; 朱艳辉

    2015-01-01

    Objective To investigate correlation of right ventricular hypertrophy and vitamin D , atrial fibrillation and NT-proBNP in patients with pulmonary heart disease.Methods 40 cases of pulmonary heart disease were selected, according to whether the right ventricular hypertrophy or not, and divided into hypertrophy group and non hypertrophy group.Echocardiography, serum 25 hydroxy vitamin D, 24 h dynamic electrocardiogram and NT-proBNP level were detected, and the correlation were detected between the right ventricular hypertrophy and influence factors.ResuIts The right ventricular anterior wall ( RVAW) and right ventricular diastolic diameter ( RVDd) in hypertrophy group were significantly greater than those in non hypertrophy group (P<0.05).The serum 25 hydroxy vitamin D levels in hypertrophy group was lower than that in non hypertrophy group (P<0.05), but there was no significant correlation of right ventricular hypertrophy and 25 hydroxy vitamin D levels(r=-0.189,P=0.424).The thickness of right ventricular anterior wall in atrial fibrillation group was greater than that in non atrial fibrillation group (P<0.05), but there was no significant correlation of right ventricular hypertrophy and atrial fibrillation times(r=0.178,P=0.452).Serum NT-proBNP levels in hypertrophy group was higher than that in non hypertrophy group (P<0.05), but there was no significant correlation of right ventricular hypertrophy and serum NT-proBNP levels(r=-0.105, P=0.660).ConcIusion Patients with right ventricular hypertrophy of pulmonary heart disease who has a lower serum 25 hydroxy vitamin D level and a higher NT-proBNP level.Patients with atrial fibrillation has a thicker RVAW.However, there was no correlation of above influence factors.%目的:探讨肺心病患者右室肥厚与维生素D、房颤及NT-proBNP的关系。方法选取河北唐山市人民医院收治的肺心病患者40例,根据是否伴有右室肥厚分为肥厚组以及非肥厚组。对2组患者进行

  7. Association between plasma brain natriuretic peptide/N-terminal pro-brain natriuretic peptide levels and atrial fibrillation:evidence from a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Liu Yaowu; Xiao Yunyun; Chen Xinguang; Zhang Fengxiang

    2014-01-01

    Background Several small sample-size observational studies evaluated the association of plasma brain natriuretic peptide (BNP) or N-terminal pro-brain natriuretic peptide (NT-proBNP) with atrial fibrillation (AF),but the results were contradictory.We aimed to perform a meta-analysis of relevant studies to evaluate the availability of this association.Methods We performed an extensive literature search on PubMed,Web of Science (WOS) and the Cochrane Library databases.Pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to assess the strength of association using random effects models.We performed sensitivity and subgroup analyses to explore the potential sources of heterogeneity.We also estimated publication biases.Statistical analyses were performed using the STATA 12.0 software.Results A total of 11 studies including 777 cases and 870 controls were finally analyzed.Overall,the brain natriuretic peptide/N-terminal pro-brain natriuretic peptide levels were higher in atrial fibrillation patients than controls without atrial fibrillation.Results showed that the SMD in the natriuretic peptide levels between cases and controls was 2.68 units (95%CI 1.76 to 3.60); test for overall effect z-score=5.7 (P <0.001).There was significant heterogeneity between individual studies (I2=97.8%; P <0.001).Further analysis revealed that differences in the assay of natriuretic peptide possibly account for this heterogeneity.Conclusions Increased BNP/NT-proBNP levels were associated with the presence of atrial fibrillation.This finding indicates that BNP/NT-proBNP may prove to be a biomarker of an underlying predisposition to AF.

  8. 三种快速定量检测NT-proBNP仪器分析性能验证比较%Analysis Performance Verification of Three Kinds of Rapid Quantitative Detection Instrument for NT proBNP

    Institute of Scientific and Technical Information of China (English)

    陈允

    2016-01-01

    Objective To verify the analysis performance of three kinds of rapid quantitative detection instrument for NT-proBNP (POCT), and to verify the comparability with chemiluminescence detection system. Methods With the reference of national clinical test procedures, the precision, accuracy, linearity range, reference range of three kinds of POCT instrumentations for detection of NT-proBNP were verified. Results The total imprecisions of three kinds of POCT instrumentations were less than 15%of the statement CV value. The linear correlation analysis showed that the correlation coefficient r2 values of concentration and its corresponding evaluation method for the determination of instrument measurements were 0.990, 0.990, 0920. In addition to a value beyond the reference range of vendors, the reference interval validation showed that the NT-proBNP concentrations were in the reference range. Conclusions From the aspects of precision validation, total precisions of three instruments are all less than 15%manufacturer statement CV value. From the aspects of linear validation,②regression analysis has the highest correlation coefficient r2, which has comparability with the corresponding evaluation method RocheCobas, clinically acceptable. Reference range validation shows that the three kinds have similar instrument test results in different age.%目的:对三种快速定量检测NT-proBNP (POCT)仪器进行分析性能的验证,同时与化学发光法进行检测系统之间的可比性验证。方法参考全国临床检验操作规程,对三台检测NT-proBNP的POCT仪器进行精密度、正确度和线性范围、参考区间验证,确定其是否适用于本实验室。结果三种检测NT-proBNP的仪器总不精密度小于厂家声明的CV 值的15%;三台仪器测定的浓度与其对应的评价方法测定值,经线性相关分析得到相关系数r2值为0.990、0.992、0920;三种仪器参考区间验证中NT-proBNP浓度除了一个检测值

  9. Soluble suppression of tumorigenicity 2 (sST2), but not galactin-3, adds to prognostication in patients with systemic AL amyloidosis independent of NT-proBNP and troponin T.

    Science.gov (United States)

    Dispenzieri, Angela; Gertz, Morie A; Saenger, Amy; Kumar, Shaji K; Lacy, Martha Q; Buadi, Francis K; Dingli, David; Leung, Nelson; Zeldenrust, Steven; Hayman, Suzanne R; Kapoor, Prashant; Grogan, Martha; Hwa, Lisa; Russell, Stephen J; Go, Ronald S; Rajkumar, S Vincent; Kyle, Robert A; Jaffe, Allan

    2015-06-01

    The use of soluble cardiac biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin has revolutionized prognostication for patients with AL amyloidosis. Soluble ST2 (sST2) and galectin-3 have also been reported to have prognostic value in other cardiac patient populations. We identified 502 patients with AL amyloidosis, who provided a research sample and consent to review their medical records between 1/1/2006-12/31/2010 within 90 days of their diagnosis. Samples were assayed for sST2 and galectin-3. Within this AL amyloidosis population, overall survival (OS) was 25.5 months (95% CI 18, 35.7 months). Receiver operating curve analyses were done to detect the best cut-points for sST2 and galectin-3 to predict both 1- and 5-year OS. The respective cut points for sST2 were 30 and 29.7 ng/mL, while the median sST2 for the entire population was 31 ng/mL (IQR 19.8, 53.6). The respective cut points for galectin-3 were 11 and 10.4 ng/mL while the median for the entire population was 16.6 ng/mL (IQR 11.5, 24.0). Although on univariate analysis, both sST2 and galectin-3 were prognostic, upon multivariate analysis, only sST2 was independent of troponin, NT-proBNP, serum immunoglobulin free light chain, and blood pressure. Not only did sST2 add to previously reported prognostication systems, but a novel prognostication 5-point system including sST2 was possible. The addition of sST2 - but not galectin-3 - to existing prognostication systems for patients with AL amyloidosis strengthens the ability to predict for death.

  10. Changes of plasma brain natriuretic peptide and amino-terminal pro-brain natriuretic peptide in children of congenital heart disease complicated with different degrees of pulmonary hypertension%先天性心脏病伴不同程度肺动脉高压患儿血浆脑钠肽及氨基末端脑钠肽前体的变化

    Institute of Scientific and Technical Information of China (English)

    郭俊晓; 张玉龙; 刘志平; 赵龙

    2015-01-01

    Objective To explore the changes of plasma brain natriuretic peptide (BNP) and aminoterminal pro-brain natriuretic peptide (NT-proBNP) in children with congenital heart disease (CHD) complicated with different degrees of pulmonary arterial hypertension (PAH).Methods Totally 60 children of left-right shunt congenital heart disease from December 2012 to December 2013 were enrolled.The pulnonary arterial systolic pressure was measured by echocardiography;the BNP and NT-proBNP level were measured and compared among patients with different degree of PAH.Results The plasma BNP and NT-proBNP were increased in non PAH, mild PAH, moderate PAH and severe PAH patients [(30 ± 26), (134 ± 22), (307 ± 86), (661 ± 67) ng/L;(94 ±35), (153 ± 25), (487 ± 213), (2 430 ± 1 278) ng/L].There were significant differences regarding plasma BNP among non PAH, mild PAH, moderate PAH and severe PAH patients (all P < 0.05);NT-proBNP showed statistical differences in severe PAH patients compared with that in non-PAH patients (P < 0.05) and no differences were observed among other patients (all P > 0.05).Conclusion In left to right shunt congenital heart disease children complicated with PAH, the plasma BNP and NT-proBNP levels increased with increasing of PAH degree, and can be used as an index to evaluate the degrees of PAH.%目的 分析先天性心脏病伴不同程度肺动脉高压(PAH)患儿血浆脑钠肽(BNP)及氨基末端脑钠肽前体(NT-proBNP)水平的变化情况.方法 纳入2012年12月至2013年12月内蒙古医科大学附属医院经超声心动图确诊的左向右分流先天性心脏病患儿60例.采用超声心动图评估肺动脉收缩压,比较不同程度PAH患儿血浆BNP及NT-proBNP水平差异.结果 无PAH患儿16例、轻度PAH患儿16例、中度PAH患儿14例、重度PAH患儿14例.血浆BNP及NT-proBNP水平在无PAH、轻度PAH、中度PAH和重度PAH患儿中依次升高[BNP: (30 ±26)、(134 ±22)、(307±86)、(661±67) ng/L;NT-proBNP:(94

  11. The effects of physical exercise on plasma levels of relaxin, NTproANP, and NTproBNP in patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Heringlake M

    2009-03-01

    Full Text Available Abstract The insulin-like and vasodilatatory polypeptide relaxin (RLX, formerly known as a pregnancy hormone, has gained interest as a potential humoral mediator in human heart failure. Controversy exists about the relation between plasma levels of RLX and the severity of heart failure. The present study was designed to determine the course of RLX, atrial, and brain natriuretic peptide (NT-proANP and NT-proBNP during physical exercise in patients with ischemic heart disease (IHD and to relate hormone levels to peak cardiac power output (CPO as a measure of cardiopulmonary function with prognostic relevance. 40 patients with IHD were studied during right-heart-catheterization at rest and during supine bicycle ergometry. RLX, NTproBNP, and NTproANP were determined before, during exercise, and after recovery. NT-proANP and NT-proBNP levels increased during maximal charge, and recovery while RLX levels decreased. Cardiac power output at maximal charge correlated inversely with NTproANP and NTproBNP but positively with RLX. Patients with high degree heart failure (CPO

  12. Effects of different doses of fluvastatin on serum hs -CRP,NT -proBNP in patients with coronary heart disease and chronic heart failure and its clinical efficacy%不同剂量氟伐他汀对冠心病合并慢性充血性心力衰竭患者血脂指标、血清N末端B型钠尿肽原、高敏C反应蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    王江; 袁丽艳

    2015-01-01

    性心力衰竭患者的炎性反应,降低 NT-proBNP 水平而改善心功能,有效发挥调脂功效,且安全性较好,值得临床推荐。%Objective To explore effects of different doses of fluvastatin on serum hs -CRP,NT -proBNP in patients with coronary heart disease (CHD)and chronic heart failure (CHF)and its clinical efficacy.Methods 120 CHD patients with CHF were randomly divided into three groups,each group included 50 cases.Each group received the therapy of 20mg/d(20mg group),40mg/d(40mg group),and 80mg/d(80mg group),respectively,three groups were treated for 12 weeks.The related indicators were compared among the three groups before and after treat-ment,and the incidence of major cardiovascular events (MACE )and adverse reactions were recorded.Results There was no statistically significant difference between groups before treatment (P >0.05).The serum hs -CRP and BNP of three groups were significantly different after treatment(F =185.956,16.824,all P 0.05).The incidence of MACE in 80mg group was lower than that in 20mg group and 40mg group.However,the incidence of three groups had no significant difference after treatment (P >0.05 ). Conclusion The treatment of high -dose fluvastatin can significantly decrease inflammatory of CHD patients with CHF,and also decreases the NT -proBNP level,effectively control lipid levels,the treatment is safe and worthy of clinical recommendations.

  13. Inflammation but not obesity or insulin resistance is associated with increased plasma fibroblast growth factor 23 concentration in the elderly.

    Science.gov (United States)

    Holecki, Michał; Chudek, Jerzy; Owczarek, Aleksander; Olszanecka-Glinianowicz, Magdalena; Bożentowicz-Wikarek, Maria; Duława, Jan; Mossakowska, Małgorzata; Zdrojewski, Tomasz; Skalska, Anna; Więcek, Andrzej

    2015-06-01

    Fibroblast growth factor 23 (FGF23) is a hormone involved in calcium-phosphate homoeostasis. The data of recently published studies suggest that FGF-23 may also play a role in some metabolic processes beyond mineral metabolism, such as insulin resistance or energy homoeostasis. The aim of the study was to attempt the relationships between plasma cFGF-23 (C-terminal) and iFGF-23 (intact) concentrations and the occurrence of obesity, insulin resistance and inflammation in elderly population. The analysis included 3115 elderly subjects (1485 women). During three visits, a questionnaire survey, comprehensive geriatric assessment and anthropometric measurements were performed as well as blood and urine samples were collected by trained nurses. Serum phosphorus, calcium, intact parathormone (iPTH), 25(OH)D3 , iFGF-23 and cFGF-23, insulin, glucose, albumin (also in urine), creatinine, hs-CRP, interleukin-6 and NT-proBNP concentrations were assessed. HOMA-IR was calculated according to the standard formula. Both forms of FGF23, iPTH and 25-OH-D3 levels were not related to the occurrence of obesity and insulin resistance. Increase in phosphorus, iPTH and NT-proBNP concentrations is associated with rise in plasma iFGF23 and cFGF23 levels. Additionally, increase in hs-CRP explained the elevated plasma iFGF23 levels. In multiple regression models, circulating iFGF23 and cFGF23 level's variability in elderly population were explained by changes in serum phosphorus, iPTH, eGFR, hs-CRP and NT-proBNP levels but not by BMI and HOMA-IR values. In conclusion, our study shows that increased levels of both circulating Fibroblast growth factor 23 forms in elderly subjects are associated with inflammation but not obesity or insulin resistance per se. © 2015 John Wiley & Sons Ltd.

  14. Is the association of serum sodium with mortality in patients with type 2 diabetes explained by copeptin or NT-proBNP? (ZODIAC-46)

    NARCIS (Netherlands)

    Riphagen, Ineke J.; Logtenberg, Susan J. J.; Groenier, Klaas H.; van Hateren, Kornelis J. J.; Landman, Gijs W. D.; Struck, Joachim; Navis, Gerjan; Kootstra-Ros, Jenny E.; Kema, Ido P.; Bilo, Henk J. G.; Kleefstra, Nanne; Bakker, Stephan J. L.

    2015-01-01

    Background and aims: Hyponatremia has been associated with an increased mortality risk in the general population. Diabetes is a condition predisposing for elevated levels of arginine vasopressin (AVP) and heart failure, both common causes of hyponatremia. These factors, however, are also associated

  15. Is the association of serum sodium with mortality in patients with type 2 diabetes explained by copeptin or NT-proBNP? (ZODIAC-46)

    NARCIS (Netherlands)

    Riphagen, Ineke J.; Logtenberg, Susan J. J.; Groenier, Klaas H.; van Hateren, Kornelis J. J.; Landman, Gijs W. D.; Struck, Joachim; Navis, Gerjan; Kootstra-Ros, Jenny E.; Kema, Ido P.; Bilo, Henk J. G.; Kleefstra, Nanne; Bakker, Stephan J. L.

    Background and aims: Hyponatremia has been associated with an increased mortality risk in the general population. Diabetes is a condition predisposing for elevated levels of arginine vasopressin (AVP) and heart failure, both common causes of hyponatremia. These factors, however, are also associated

  16. Effects of Sacubitril/Valsartan (LCZ696) on Natriuresis, Diuresis, Blood Pressures, and NT-proBNP in Salt-Sensitive Hypertension.

    Science.gov (United States)

    Wang, Tzung-Dau; Tan, Ru-San; Lee, Hae-Young; Ihm, Sang-Hyun; Rhee, Moo-Yong; Tomlinson, Brian; Pal, Parasar; Yang, Fan; Hirschhorn, Elizabeth; Prescott, Margaret F; Hinder, Markus; Langenickel, Thomas H

    2017-01-01

    Salt-sensitive hypertension (SSH) is characterized by impaired sodium excretion and subnormal vasodilatory response to salt loading. Sacubitril/valsartan (LCZ696) was hypothesized to increase natriuresis and diuresis and result in superior blood pressure control compared with valsartan in Asian patients with SSH. In this randomized, double-blind, crossover study, 72 patients with SSH received sacubitril/valsartan 400 mg and valsartan 320 mg once daily for 4 weeks each. SSH was diagnosed if the mean arterial pressure increased by ≥10% when patients switched from low (50 mmol/d) to high (320 mmol/d) sodium diet. The primary outcome was cumulative 6- and 24-hour sodium excretion after first dose administration. Compared with valsartan, sacubitril/valsartan was associated with a significant increase in natriuresis (adjusted treatment difference: 24.5 mmol/6 hours, 50.3 mmol/24 hours, both Pdiuresis (adjusted treatment difference: 291.2 mL/6 hours, Pnatriuresis and diuresis, superior office and ambulatory blood pressure control, and significantly reduced N-terminal pro B-type natriuretic peptide levels in Asian patients with SSH.

  17. Effect of Shenmai injection combined with L-carnitine on chronic pulmonary heart failure and serum Copeptin, NT-proBNP, hs-cTnT%参脉注射液联合左卡尼汀对老年肺心病心力衰竭期心功能及血清 Copeptin、NT-proBNP、hs-cTnT 的影响

    Institute of Scientific and Technical Information of China (English)

    杨继雷; 姚秀叶; 谷伟; 李彦明; 董利平; 袁桂莉

    2016-01-01

    目的:探讨参麦注射液联合左卡尼汀对慢性肺源性心脏病( CPHD)心力衰竭期心功能及血清和肽素(Copeptin)、N末端脑利钠肽前体(NT-proBNP)、高敏心肌肌钙蛋白T(hs-cTnT)水平的影响及其机制。方法选取2013年1月—2014年10月河北北方学院附属第一医院老年科收治的 CPHD心力衰竭期患者110例,按随机数字表法分为观察组和对照组各55例,2组均给予吸氧、祛痰平喘、强心、利尿剂、扩血管等常规治疗,对照组加用左卡尼汀3 g,1次/d,连续治疗3周,观察组在对照组基础上加用参麦注射液100 ml静脉滴注,1次/d,连续治疗3周。观察2组治疗前后心功能、血清Copeptin、NT-proBNP、hs-cTnT水平的变化。结果观察组总有效率为94摀.55%(52/55),高于对照组的83.64%(46/55)( P <0.05)。2组在治疗前各项观察指标比较差异无统计学意义( P >0.05),治疗3周后E峰、Ve、E/A、Ve/Va明显升高,A峰、Va明显降低,但观察组变化更显著( P均<0.05);治疗后2组PaO2、PaCO2均改善,血清Copeptin、NT-proBNP、hs-cTnT较治疗前明显下降,且观察组下降更明显( P均<0.05)。结论参麦注射液联合左卡尼汀能明显改善CPHD心力衰竭期患者心功能,降低血清Copeptin、NT-proBNP、hs-cTnT水平,且用药安全。%Objective To discuss the effect of Shenmai injection combined with L-carnitine on chronic pulmonary heart disease (CPHD) of heart failure and cardiac function and serum peptide hormone (Copeptin), N-terminal brain natri-uretic peptide precursor ( NT-proBNP ) , high-sensitivity cardiac muscle troponin T ( hs-cTnT ) levels and its mechanism. Methods Select from January 2013 to October 2014, 110 patients of CPHD with heart failure in the First Affiliated Hospital of Hebei North University, they were randomly divided into observation group and control group with 55 cases

  18. Identification of chronic heart failure patients with a high 12-month mortality risk using biomarkers including plasma C-terminal pro-endothelin-1.

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    Ewa A Jankowska

    Full Text Available OBJECTIVES: We hypothesised that assessment of plasma C-terminal pro-endothelin-1 (CT-proET-1, a stable endothelin-1 precursor fragment, is of prognostic value in patients with chronic heart failure (CHF, beyond other prognosticators, including N-terminal pro-B-type natriuretic peptide (NT-proBNP. METHODS: We examined 491 patients with systolic CHF (age: 63±11 years, 91% men, New York Heart Association [NYHA] class [I/II/III/IV]: 9%/45%/38%/8%, 69% ischemic etiology. Plasma CT-proET-1 was detected using a chemiluminescence immunoassay. RESULTS: Increasing CT-proET-1 was a predictor of increased cardiovascular mortality at 12-months of follow-up (standardized hazard ratio 1.42, 95% confidence interval [CI] 1.04-1.95, p = 0.03 after adjusting for NT-proBNP, left ventricular ejection fraction (LVEF, age, creatinine, NYHA class. In receiver operating characteristic curve analysis, areas under curve for 12-month follow-up were similar for CT-proET-1 and NT-proBNP (p = 0.40. Both NT-proBNP and CT-proET-1 added prognostic value to a base model that included LVEF, age, creatinine, and NYHA class. Adding CT-proET-1 to the base model had stronger prognostic power (p<0.01 than adding NT-proBNP (p<0.01. Adding CT-proET-1 to NT-proBNP in this model yielded further prognostic information (p = 0.02. CONCLUSIONS: Plasma CT-proET-1 constitutes a novel predictor of increased 12-month cardiovascular mortality in patients with CHF. High CT-proET-1 together with high NT-proBNP enable to identify patients with CHF and particularly unfavourable outcomes.

  19. Degree and distribution of left ventricular hypertrophy as a determining factor for elevated natriuretic peptide levels in patients with hypertrophic cardiomyopathy: insights from cardiac magnetic resonance imaging.

    Science.gov (United States)

    Park, Jeong Rang; Choi, Jin-Oh; Han, Hye Jin; Chang, Sung-A; Park, Sung-Ji; Lee, Sang-Chol; Choe, Yeon Hyeon; Park, Seung Woo; Oh, Jae K

    2012-04-01

    Whether the left ventricular (LV) mass index (LVMI) and LV volumetric parameters are associated independently with natriuretic peptide levels is unclear in hypertrophic cardiomyopathy (HCM). Therefore, we investigated which parameters have an independent relationship with N-terminal pro-B type natriuretic peptide (NT-proBNP) levels in HCM patients using echocardiography and cardiac magnetic resonance imaging (CMR). A total of 103 patients with HCM (82 men, age 53 ± 12 years) were evaluated. Echocardiographic evaluations included left atrial volume index (LAVI) and early diastolic mitral inflow E velocity to early annular Ea velocity ratio (E/Ea). LVMI, maximal wall thickness and LV volumetric parameters were measured using CMR. The median value of NT-proBNP level was 387.0 pg/ml. The mean NT-proBNP level in patients with non-apical HCM (n = 69; 36 patients with asymmetric septal hypertrophy, 11 with diffuse, and 22 with mixed type) was significantly higher than in those with apical HCM (n = 34, P < 0.001). NT-proBNP level was negatively correlated with LV end-diastolic volume (LVEDV) (r = -0.263, P = 0.007) and positively with LVMI (r = 0.225, P = 0.022) and maximal wall thickness (r = 0.495, P < 0.001). Among the echocardiographic variables, LAVI (r = 0.492, P < 0.001) and E/Ea (r = 0.432, P < 0.001) were correlated with NT-proBNP. On multivariable analysis, non-apical HCM, increased maximal wall thickness and LAVI were independently related with NT-proBNP. Severity of LV hypertrophy and diastolic parameters might be important in the elevation of NT-proBNP level in HCM. Therefore, further evaluation of these parameters in HCM might be warranted.

  20. Plasma asymmetric dimethylarginine and cardiovascular events in patients with acute decompensated heart failure.

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    Dückelmann, Christina; Mittermayer, Friedrich; Haider, Dominik G; Altenberger, Johann; Wolzt, Michael

    2008-07-01

    This prospective study investigated whether plasma asymmetric dimethylarginine (ADMA) concentrations are related to cardiovascular events in patients with acute heart failure. It has been reported that increased plasma ADMA concentrations are associated with adverse cardiovascular outcome in chronic heart failure. In 118 patients with acute decompensated heart failure and impaired left ventricular function, ADMA and N-terminal pro-brain natriuretic peptide (NT-proBNP) were assessed by high-performance liquid chromatography and by an enzyme-linked immunosorbent assay, respectively. Venous blood was collected at admission and after 1 week, and clinical events were observed during follow-up. All patients (median age 73 years, 96 males) were followed up for a median of 10.7 months. A clinical endpoint (cardiac decompensation, major adverse cardiovascular event, or all-cause mortality) occurred in 66 patients. In 81 patients, changes (Delta) in ADMA or NT-proBNP between admission and a median of 7 days were available. ADMA, NT-proBNP at admission, and DeltaADMA or DeltaNT-proBNP were comparable in patients with and without a clinical endpoint. In contrast to ADMA, NT-proBNP concentrations above the median were associated with higher adjusted hazard ratio for occurrence of an endpoint (HR 2.1; 95% confidence interval 1.2-3.9; P = 0.013). An inverse relationship was observed between DeltaNT-proBNP and endpoints before (P = 0.010) and after (P = 0.015) adjustment for confounders. In patients with acute heart failure, ADMA did not detect patients at future cardiovascular risk.

  1. Changes in Plasma Copeptin Levels during Hemodialysis: Are the Physiological Stimuli Active in Hemodialysis Patients?

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    Esmée M Ettema

    Full Text Available Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP, are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli for copeptin release, i.e. plasma osmolality, blood volume and mean arterial pressure (MAP, are operational in hemodialysis patients.One hundred and eight prevalent, stable hemodialysis patients on a thrice-weekly dialysis schedule were studied during hemodialysis with constant ultrafiltration rate and dialysate conductivity in this observational study. Plasma levels of copeptin, sodium, MAP, and blood volume were measured before, during and after hemodialysis. Multivariate analysis was used to determine the association between copeptin (dependent variable and the physiological stimuli plasma sodium, MAP, excess weight as well as NT-pro-BNP immediately prior to dialysis and between copeptin and changes of plasma sodium, MAP and blood volume with correction for age, sex and diabetes during dialysis treatment.Patients were 63 ± 15.6 years old and 65% were male. Median dialysis vintage was 1.6 years (IQR 0.7-4.0. Twenty-three percent of the patients had diabetes and 82% had hypertension. Median predialysis copeptin levels were 141.5 pmol/L (IQR 91.0-244.8 pmol/L. Neither predialysis plasma sodium levels, nor NT-proBNP levels, nor MAP were associated with predialysis copeptin levels. During hemodialysis, copeptin levels rose significantly (p<0.01 to 163.0 pmol/L (96.0-296.0 pmol/L. Decreases in blood volume and MAP were associated with increases in copeptin levels during dialysis, whereas there was no significant association between the change in plasma sodium levels and the change in copeptin levels.Plasma copeptin levels are elevated predialysis and increase further during hemodialysis. Volume stimuli, i.e. decreases in MAP and blood volume, rather than osmotic

  2. 氨基末端 B 型脑利钠肽前体与急性脑梗死患者左心室舒张功能的相关性分析%Correlation between NT-proBNP and Left Ventricular Diastolic Function of Patients with Acute Cerebral Infarction

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    李建刚; 张建军; 张会平; 麦兴盛; 左鹏飞; 李亚峰

    2016-01-01

    Objective To analyze the correlation between NT-proBNP and left ventricular diastolic function of patients with acute cerebral infarction. Methods A total of 273 patients with acute cerebral infarction were selected as control group in the Central Hospital of Baoji from March 2013 to March 2016,and they were divided into subgroups A1( with diameter of infarction focus over 5 cm,n = 54),A2(with diameter of infarction focus within 3 to 5 cm,n = 118)and A3(with diameter of infarction focus less than 3 cm,n = 101)according to the diameter of infarction focus,into subgroups B1(with large - artery atherosclerosis,n = 91),B2(with cardiac embolism,n = 57),B3(with small artery occlusion,n = 80),B4(with other specific etiology,n = 17)and B5(with unknown etiology,n = 28)according to the TOAST type for ischemic stroke;a total of 232 healthy people admitted to this hospital for physical examination were selected as control group at the same time. NT-proBNP, isovolumic relaxation time(IVRT),peak value of left atrioventricular valve ring movement speed at early filling stage and peak value of left atrioventricular valve ring movement speed at late filling stage( Ea/ Aa ratio),and tissue motion velocity of left atrioventricular valve ring at left atrial systolic stage(A' value)were detected,Pearson correlation analysis was used to analyze the correlations between NT-proBNP and IVRT,Ea/ Aa. Results NT-proBNP of observation group was statistically significantly higher than that of control group,IVRT of observation group was statistically significantly longer than that of control group,while Ea/ Aa ratio of observation group was statistically significantly lower than that of control group( P ﹤ 0. 05);no statistically significant differences of A' value was found between observation group and control group( P ﹥ 0. 05). Pearson correlation analysis showed that,NT-proBNP was positively correlated with IVRT of observation group( r = 0. 33,P = 0. 02 ),was negatively correlated with

  3. Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure.

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    Huai-Ren Chang

    Full Text Available BACKGROUND: Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF. METHODS: Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA classification system (I-IV was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation. RESULTS: Forty-nine patients (52.7% had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297, plasma triglyceride (β = -0.286 and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346. Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index was positively associated with plasma Nt-proBNP levels (β = 0.491, and was the independent predictor of plasma Nt-proBNP levels in CHF patients. CONCLUSIONS: Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.

  4. NT-brain natriuretic peptide levels in pleural fluid distinguish between pleural transudates and exudates.

    Science.gov (United States)

    Tomcsányi, János; Nagy, Erzsébet; Somlói, Miklós; Moldvay, Judit; Bezzegh, Attila; Bózsik, Béla; Strausz, János

    2004-10-01

    Pleural effusion is not pathognomic and distinguishing between transudates and exudates often presents a diagnostic dilemma. The purpose of our study was to examine whether the inclusion of pleural fluid brain natriuretic peptide (BNP) measurement into the analysis improves the diagnostic accuracy of pleural effusion. The pleural effusion of 14 patients with CHF (group A) and 14 subjects with different pleural pathology (group B) were analyzed. Samples of pleural fluid and serum were obtained from all patients on admission and biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear and culture and cytology were performed on the pleural fluid. In vitro quantitative determination of N-terminal pro-Brain natriuretic peptide (NT-proBNP) in serum and pleural fluid were performed by electrochemiluminescence immunoassay proBNP method on an Elecsys 2010 (Roche) analyzer. The median NT-proBNP levels in groups A and B were 6295 pg/ml and 276 pg/ml, respectively: (P=0.0001). There was no overlap between the two groups. While the Light's criteria had a sensitivity of 93% and specificity of 43% for transudates, the pleural fluid NT-proBNP level accurately differentiated between the two groups. The pleural NT-proBNP levels were elevated in all patients who had transudate. Therefore if the NT-proBNP levels of pleural effusion are within the normal range, transudate resulting from congestive heart failure can be ruled out. Our results suggest that the inclusion of pleural fluid NT-proBNP measurement in the routine diagnostic panel would enhance discrimination among the different causes of pleural effusions.

  5. Changes of plasma norepinephrine and serum N-terminal pro-brain natriuretic peptide after exercise training predict survival in patients with heart failure.

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    Rengo, Giuseppe; Pagano, Gennaro; Parisi, Valentina; Femminella, Grazia Daniela; de Lucia, Claudio; Liccardo, Daniela; Cannavo, Alessandro; Zincarelli, Carmela; Komici, Klara; Paolillo, Stefania; Fusco, Flavia; Koch, Walter J; Perrone Filardi, Pasquale; Ferrara, Nicola; Leosco, Dario

    2014-02-15

    Short-term changes of neurohormones can give important prognostic information in heart failure (HF) patients. In this study, we evaluate whether changes in plasma Norepinephrine (NE) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) after exercise training predict cardiac mortality in HF patients. We enrolled 221 HF patients (mean age 72.5 ± 10.2 year) followed-up for a mean period of 27.64 ± 10.7 months. All pts underwent a 3-month exercise training. Before training, clinical examination, echocardiography, peak VO2 determination, and blood draw for NT-proBNP and NE measurements were performed. Primary end-point was cardiac related mortality. Eighty-six-nine percent of patients were in NYHA class III, mean left ventricular ejection fraction (LVEF) was 32.5 ± 10.4%, and mean peak VO2 was 12.36 ± 1.45 ml/kg/min. At baseline, mean NT-proBNP was 2111.4 ± 1145.6 pg/ml and mean NE was 641.8 ± 215.3 pg/ml. One hundred-one subjects died for cardiac causes. Training was associated with a significant increase of peak VO2 and LVEF, whereas NE, NT-proBNP, and heart rate decreased. Multiple Cox proportional hazards regression analysis was performed using delta% values (post vs pre-training) of LVEF, heart rate, NE, and NT-proBNP along with baseline covariates, revealing delta value of NE as the strongest predictor of cardiac mortality. Noteworthy, training reduced NT-proBNP in both survivor and non-survivor patients, while a lack of reduction of NE was observed in non survivors. In our HF population, short-term changes of NE after exercise training independently predicted long-term cardiac mortality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Right ventricular function and N-terminal pro-brain natriuretic peptide levels in adult patients with simple dextro-transposition of the great arteries.

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    Martínez-Quintana, Efrén; Marrero-Negrín, Natalia; Gopar-Gopar, Silvia; Rodríguez-González, Fayna

    2017-06-01

    Dextro-transposition of the great arteries (d-TGA) patients is at high risk of developing right ventricular dysfunction and tricuspid regurgitation in adulthood. Determining the relation between echocardiographic parameters, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels and the New York Heart Association (NYHA) functional class may help determining the best time to operate them. Patients with simple d-TGA operated in infancy with an atrial switch procedure (Mustard or Senning operation) were followed up in our Adult Congenital Heart Disease Unit. Analytical, echocardiographic, and clinical parameters were determined to evaluate the correlation between right echocardiographic ventricular function, NT-pro-BNP levels, and NYHA functional class. Twenty-four patients with d-TGA were operated in infancy of whom 17 alive patients had simple d-TGA. Nine patients had NT-pro-BNP levels lower than 200 pg/mL and eight patients were above 200 pg/mL. Patients with lower hemoglobin concentration, higher right ventricular diameter or under diuretic treatment showed significant higher NT-pro-BNP levels (above 200 pg/dL). The Spearman test showed a positive correlation between basal right ventricular diameter and tricuspid regurgitation with pro NT BNP levels (correlation coefficient of .624; P=.017 and .490; P=.046, respectively) and a negative correlation with the right ventricle fractional area change (-.508, P=.045). No correlation was seen between NT-pro-BNP levels and the rest of echocardiographic parameters or the NYHA functional class. NT-pro-BNP levels showed a positive correlation with basal right ventricular diameter and tricuspid regurgitation but not with NYHA association functional class in d-TGA patients. © 2017, Wiley Periodicals, Inc.

  7. RELATIONSHIPS BETWEEN PLASMA NT-PROBNP LEVEL AND SHORT-TERM PROGNOSIS OF UNSTABLE ANGINA PECTORIS%血浆NT-proBNP水平与不稳定型心绞痛近期预后的关系

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    王伟; 任国成; 高志广; 张晓莉; 宝凤梅

    2014-01-01

    目的:探讨血浆N末端-脑钠肽前体(NT-proBNP)水平与不稳定型心绞痛(UAP)患者近期预后的关系。方法:因胸痛住院并经冠状动脉造影检查确诊为UAP的患者52例,分别检测症状发作后18h和症状缓解96h血浆NT-proBNP水平,并计算差值比。对UAP患者随访30天,记录患者主要心血管事件(MACE)的发生情况,并应用受试者工作曲线(ROC)分析差值比对UAP患者发生近期心血管事件的预测价值。结果:发生心血管事件患者的NT-proBNP差值比高于未发生者,差异具有统计学意义(P<0.05)。ROC结果显示,NT-proBNP差值比为0.99时,其预测UAP患者近期发生心血管事件的灵敏度和特异度分别为64.3%和81.8%。结论:NT-proBNP差值比可用来预测UAP患者近期心血管事件的发生情况,可作为筛选高危病例的一个指标。%Objective:To explore the relationships between N-terminal pro-brain natriuretic peptide (NT-proBNP) level and short-term prognosis of unstable angina pectoris (UAP). Methods:52 UAP patients were hospitalized because of chest pain and confirmed by coronary angiography. The plasma NT-proBNP level of 52 patients was respectively detected 18hafter attacksofsymptoms andremissionofsymptoms for96h, and then calculated the D-value ratio.All the patients were followed up for 30 days and recorded the occurrence of main adverse cardiovascular event (MACE). ROC curve of D-value ratio was used to analyze the predictive value of D-value ratio for MACE.Results:The D-value ratio of patients with MACE was obviously higher than that of the patients no MACE (P<0.05).According to the ROC curve, the predictive sensitivity of MACE was 64.3%and specificity was 81.8%when D-value ratio was 0.99. Conclusions:The D-value ratio of NT-proBNPcanbe usedtopredictMACEinUAP,and can be used as a markerforscreening high-risk patients.

  8. Precision performance evaluation of BNP and NT-proBNP using CLSI EP15-A2 document%应用CLSI EP15-A2文件评价BNP和NT-proBNP测定的精密度性能

    Institute of Scientific and Technical Information of China (English)

    欧阳能良; 王伟佳; 李飞; 阚丽娟; 索明环; 严海忠; 温冬梅; 张秀明

    2011-01-01

    Objective To evaluate the precision performance of Siemens ADVIA Centaur Automated B-Type Natriuretic Peptide ( BNP) Assay and Roche N-terminal pro B-type Natriuretic Peptide( NT-proBNP) Assay. Methods Using document EP15-A2 published in 2004 by American Clinical and Laboratory Standards Institution (CLSI) ,choose 5 BNP and NT-proBNP samples with different concentration,each sample was tested 4 times intraassay every day and last for 5 days, calculate the intraassay and total CV (% ) and compared with that announced by manufactures. Results The intraassay and total CV ( % ) are 2. 3% , 1. 7 % , 1. 8 % , 1.3% ,1. 1% and 3. 5% ,3. 2% ,2. 7% ,2. 6% ,2. 3%for BNP samples( with concentration 30. 6 , 70. 3,452. 2,1069. 4 ,1736. 8pg/ml) ,which were all lower than that announced by manufacture ; The intraassay and total CV(%) are 2. 2 % ,1. 3 % ,1. 9 % ,1. 2 % ,1. 1 % and 2. 9% ,1. 9% , 2. 3 % , 1. 8% , 1. 5 % for NT-proBNP( with concentration 72. 9, 123. 9 , 466. 8, 2123. 9, 4322. O pg/ml) , except there shows no difference to the check value by calculation for the 72. 9pg/ml sample,others are also much lower than that announced by manufacture. Conclusion The precision performance of BNP and NT-proBNP assay are both well,which meet the clinical needs. The application of document EP15-A2 to verify the precision announced by the manufacture is economical and works easily.%目的 评价西门子ADVIA Centaur化学发光免疫系统检测B型利钠肽(BNP)和罗氏Cobas E601检测N末端B型利钠肽原(NT-proBNP)的精密度性能.方法 使用美国临床与实验室标准化协会(CLSI)EP15-A2文件,选用5个不同浓度的BNP和NT-proBNP样本,每个样本每天批内重复测定4次,持续5天,计算批内不精密度(批内CV)和总不精密度(总CV),并与厂商声明的不精密度进行比较.结果 BNP浓度为30.6、70.3、452.2、1 069.4、1 736.8 pg/mL时批内CV分别为2.3%、1.7%、1.8%、1.3%、1.1%,

  9. Does Serum N-Terminal pro-Brain Natriuretic Peptide Level Predict the Severity of Angiographic Lesions in Patients with Acute Coronary Syndrome?

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    Afsaneh Rajabiani

    2015-10-01

    Full Text Available Background: Serum N-terminal pro-brain natriuretic peptide (NT-proBNP, a polypeptide secreted by ventricular myocytes in response to stretch, was suggested as a predictor of adverse prognosis of the acute coronary syndrome (ACS. We examined the association between NT-proBNP level and angiographic findings in ACS patients to determine whether it could be used as a predictor of the severity of angiographic lesions.Methods: This cross-sectional study was performed on 126 patients with chest pain or other ischemic heart symptoms suggestive  of ACS.  Venous  blood  samples  were  drawn  to  measure  serum  levels  of  NT-proBNP. Afterward,  coronary angiography was performed and the patients were categorized into four groups according to the number of coronary vessels with significant stenosis. The severity of angiographic lesions was assessed with the Gensini scoring system.Results: According to angiographic diagnosis, 11 (8.7% patients had normal coronary arteries (no coronary artery disease [CAD] and 115 (91.3% had CAD, of whom 108 (85.7% had obstructive CAD and 7 (5.6% had minimal CAD. The serum NT-proBNP concentration was higher in the CAD group than in the non-CAD group (p value <0.01. A progressive significant increase in the NT-proBNP concentration according to the Gensini score and the number of involved vessels was reported after adjustment for sex and age. Furthermore, the Receiver Operating Characteristic Curve (ROC analysis indicated that an NT-proBNP cut-point of 400 pg/ml could predict obstructive CAD with a sensitivity of 65% and a specificity of 78%.Conclusion: Higher levels of NT-proBNP among our ACS patients were associated with the severity of angiographic lesions in terms of both the Gensini score and the number of involved vessels. This finding underscores the potential role of NT-proBNP in predicting the severity of CAD before performing angiography.

  10. Reference range of plasma N-terminal pro-brain natriuretic peptide levels in early preterm infants%早期早产儿血浆N末端脑钠肽参考值范围

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    张茜; 罗成汉; 时赞扬; 卢洁; 程欣茹; 徐千雅; 郭宏湘; 王丽; 程秀永

    2013-01-01

    .358,t1d与7 d=14.743,t3d与7d =11.105,P均=0.000).出生后1d、3d、7d早产儿血浆NT-proBNP水平分别为(1875 ±686) ng/L、(1615±574) ng/L、(1118 ±380) ng/L;均数95%置信区间分别为530~3220 ng/L、490~2740 ng/L、373~ 1863 ng/L.结论 早产儿血浆NT-proBNP水平出生第1天达高峰,之后随日龄增加而下降,二者呈负相关;血浆NT-proBNP水平不受胎龄、性别、出生体质量、分娩方式及营养方式的影响.%Objective To establish the reference range of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in early preterm infants.Methods 1.Inclusion criteria of the subjects:(1) preterm infants admitted to Neonatal Ward of First Affiliated Hospital of Zhengzhou University between Oct.2009 and Aug.2012 within 24 hours after birth;(2) maternal health during pregnancy; (3) written informed consent obtained from parents;(4) normal laboratory examination results such as blood gas analysis,electrolyte,hepatorenal function,myocardial enzyme,routine blood count and infectious disease screening (hepatitis B,hepatitis C,syphilis and acquired immune deficiency syndrome) within 24 hours after birth.Plasma NT-proBNP levels were measured on day 1,day 3 and day 7 of life.Variable data was analyzed using the Shapiro-Wilk test for normality test.Difference in plasma NT-proBNP levels on different days of life was analyzed using repeated measure analysis of variance.A multiple regression analysis was performed to determine the influencing factors for plasma NT-proBNP level,reference value interval:reference range containing 95 % of the reference population,namely(x-1.96 s)-(x-+ 1.96 s),with inspection level α =0.05.Results 1.A total of 204 preterm infants (104 cases were male and 100 cases were female) were included in the present study,with gestational age ranging from 27 + 1 to 36 +6 weeks(median 33 weeks) and birth weight ranging from 700 to 3050 g (median 1590 g).Of these preterm infants,vaginal delivery were 78

  11. 血浆NT-proBNP检测在COPD合并呼吸衰竭患者中的临床意义%Clinical Significance of Plasma NT-proBNP Testing in COPD Patients with Respiratory Failure

    Institute of Scientific and Technical Information of China (English)

    程利

    2011-01-01

    目的 通过测定COPD合并呼吸衰竭患者血浆NT-proBNP数值水平,探讨其临床价值.方法 采用电化学发光免疫学方法测定COPD呼衰患者和COPD非呼吸衰竭患者治疗前血浆NT-pmBNP水平.结果 COPD呼吸衰竭患者血浆NT-proBNP数值水平高于COPD非呼衰患者.结论 COPD合并呼吸衰竭患者血浆NT-proBNP数值水平明显升高提示存在早期和(或)轻度右心功能不全,应引起临床医生重视.

  12. N-terminal pro-brain natriuretic peptide is related with coronary flow velocity reserve and diastolic dysfunction in patients with asymmetric hypertrophic cardiomyopathy.

    Science.gov (United States)

    Tesic, Milorad; Seferovic, Jelena; Trifunovic, Danijela; Djordjevic-Dikic, Ana; Giga, Vojislav; Jovanovic, Ivana; Petrovic, Olga; Marinkovic, Jelena; Stankovic, Sanja; Stepanovic, Jelena; Ristic, Arsen; Petrovic, Milan; Mujovic, Nebojsa; Vujisic-Tesic, Bosiljka; Beleslin, Branko; Vukcevic, Vladan; Stankovic, Goran; Seferovic, Petar

    2017-10-01

    The relations of elevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac ischemia in hypertrophic cardiomyopathy (HCM) patients is uncertain. Therefore we designed the study with the following aims: (1) to analyze plasma concentrations of NT-pro-BNP in various subsets of HCM patients; (2) to reveal the correlations of NT-pro-BNP, myocardial ischemia, and diastolic dysfunction; (3) to assess predictors of the elevated plasma levels of NT-pro-BNP. In 61 patients (mean age 48.9±16.3 years; 26 male) with asymmetric HCM plasma levels of NT-pro-BNP were obtained. Standard transthoracic examination, tissue Doppler echocardiography with measurement of transthoracic coronary flow velocity reserve (CFVR) in left anterior descending artery (LAD) was done. Mean natural logarithm value of NT-pro-BNP was 7.11±0.95pg/ml [median value 1133 (interquartile range 561-2442)pg/ml]. NT-pro-BNP was significantly higher in patients with higher NYHA class, in obstructive HCM, more severe mitral regurgitation, increased left atrial volume index (LAVI), presence of calcified mitral annulus, elevated left ventricular (LV) filling pressure and in decreased CFVR. Levels of NT-pro-BNP significantly correlated with the ratio of E/e' (r=0.534, ppro-BNP. Plasma levels of NT-pro-BNP were significantly higher in HCM patients with more advanced disease. Elevated NT-pro-BNP not only reflects the diastolic impairment of the LV, but it might also be the result of cardiac ischemia in patients with HCM. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  13. 不同心功能分级慢性心力衰竭患者血浆氮末端脑钠肽前体水平变化%Changes of N terminal pro B natriuretic peptide plasma concentration in chronic heart failure patients with different cardiac functional grading

    Institute of Scientific and Technical Information of China (English)

    毕平; 冉小平; 李伦; 梅光艳

    2012-01-01

    Objective To study the changes and significance of N terminal pro B natriuretic peptide(NT-proBNP) plasma concentration in chronic heart failure(CHF) patients with different New York Heart Association(NYHA) class. Methods Sixty-five patients with CHF were chosen as the treatment group,and twenty-one healthy people were chosen as the control group during the same period. NT-proBNP plasma concentration was detected and compared between two groups. Results The NT-proBNP plasma concentration in observation group was significantly higher than that in control group( P <0.01). The NT-proBNP plasma concentration in patients with CHF showed positive correlation with NYHA class (r = 0.509, P < 0. 01). With the increase of NYHA class,the NT-proBNP plasma concentration heightened. Conclusion NT-proBNP plasma can be as a index to diagnose,determine the severity of CHF and to judge efficacy.%目的 探讨纽约心脏病协会(NYHA)不同分级慢性心力衰竭(CHF)患者血浆氮末端脑钠肽前体(NT-proBNP)浓度的变化及其临床意义.方法 选择65例CHF患者为观察组,21例同期健康体检者为对照组;测定2组血浆NT-proBNP浓度并进行比较.结果 观察组患者血浆NT-proBNP浓度显著高于对照组(P<0.01).CHF患者血浆NT-proBNP浓度与NYHA分级呈显著正相关(r=0.509,P<0.01),随着NYHA分级的增加,患者血浆NT-proBNP浓度升高.结论 血浆NT-proBNP可作为CHF诊断、严重程度评估及疗效判定的一项指标.

  14. Prognostic Value of Plasma Intermedin Level in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.

    Science.gov (United States)

    Li, Pengyang; Shi, Lin; Han, Yalei; Zhao, Yuntao; Qi, Yongfen; Wang, Bin

    2016-04-01

    Intermedin (IMD), an autocrine/paracrine biologically active peptide, plays a critical role in maintaining vascular homeostasis. Recent research has shown that high plasma levels of IMD are associated with poor outcomes for patients with ST-segment elevation acute myocardial infarction. However, the prognostic utility of IMD levels in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) has not yet been investigated. We hypothesized that the level of plasma IMD would have prognostic value in patients with NSTE-ACS. Plasma IMD was determined by radioimmunoassay in 132 NSTE-ACS patients on admission to hospital and 132 sex- and age-matched healthy-control subjects. Major adverse cardiovascular events (MACEs), including death, heart failure, hospitalization, and acute myocardial infarction, were noted during follow-up. In total, 23 patients suffered MACEs during the follow-up period (mean 227 ± 118 days, range 2-421 days). Median IMD levels were higher in NSTE-ACS patients than control [320.0 (250.9/384.6) vs. 227.2 (179.7/286.9) pg/mL, P variables and NT-proBNP showed that the risk of MACEs increased by a factor of 12.96 (95% CI, 3.26-49.42; P <0.001) with high IMD levels (at the cut-off value). IMD has potential as a prognostic biomarker for predicting MACEs in patients with NSTE-ACS.

  15. Serum levels of N-terminal-pro B-type natriuretic peptide as a diagnostic marker for left ventricular dysfunction in children with end-stage renal disease on hemodialysis

    Directory of Open Access Journals (Sweden)

    Amr Mohamed Zoair

    2016-01-01

    Full Text Available The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP as a marker of left ventricular (LV dysfunction in children with end-stage renal disease (ESRD on regular hemodialysis (HD. The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking. Serum levels of NT-pro BNP were measured in venous blood samples before and about 30 min after HD by ELISA. Volume status was assessed by calculating interdialytic weight gain %. There were significant higher serum NT-pro BNP levels before HD (mean: 702.3 ± 274.3 ng/L compared to controls (mean: 365.55 ± 76.5 ng/L (P <0.001 and these levels decreased significantly after the HD session (mean: 625.1 ± 117.69 ng/L (P = 0.031. Echocardiographic studies showed a significant impairment of LV function of the patients compared to controls. Patients with LV dysfunction had significant higher serum concentrations of NT-pro BNP compared to patients without dysfunction both before (P = 0.003 and after dialysis (P <0.001. Receiver operating curve demonstrated better prediction of LV dysfunction by NT-pro BNP levels after HD compared to its levels before HD (area under the curve was 0.9 and 0.73, respectively. Using a cutoff value of 630 ng/L, serum NT-pro BNP levels after dialysis were a diagnostic predictor of LV dysfunction with a sensitivity of 86.6%, specificity of 93.3%, positive predictive value of 92.8%, and negative predictive value of 87.5%. Serum NT-pro BNP levels were strongly correlated with the parameters of LV dysfunction in children with ESRD on regular HD. A postdialysis cutoff value of 630 ng/L could serve as a biochemical marker of LV dysfunction in those children regardless of chronic fluid overload.

  16. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing

    Directory of Open Access Journals (Sweden)

    Cao R

    2014-12-01

    Full Text Available Ruihua Cao, Yongyi Bai, Ruyi Xu, Ping Ye Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear.Objective: This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population.Methods: We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21–96 years from a community-based population in Beijing, People’s Republic of China.Results: In patients with high resting heart rate (≥75 beats/min, NT-proBNP was higher than in those having low resting heart rate (<75 beats/min. In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18–1.51; P=0.011. A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49–2.36; P=0.031; while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old.Conclusions: Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage. Keywords: resting heart rate, N-terminal pro-brain natriuretic peptide, epidemiology, cardiac function, relationship

  17. Alteration of Plasma Brain Natriuretic Peptide Level After Acute Moderate Exercise in Professional Athletes

    Directory of Open Access Journals (Sweden)

    Homa Sheikhani

    2011-12-01

    Full Text Available Background: Cardiac fatigue or myocardial damage following exercise until complete exhaustion can increase blood levels of brain natriuretic peptide (BNP in athletes. Objectives: The aim of the present study was to investigate the effect of resistance and acute moderate aerobic exercise on alterations in BNP levels in professional athletes. Materials and Methods: Forty professional athletes who had at least 3 years of a championship background in track and field (aerobic group or body building (resistance group volunteered to participate in the present study. Track and field athletes (n = 20 were requested to run 8 km at 60% to 70% of maximum heart rate. Body building athletes (n = 20 performed a resistance training session of 5 exercises in 3 sets of 10 repetitions at 75% of 1 RM (bench press, seated row, leg extension, leg curl, and leg press. Before and immediately after the exercise, plasma BNP levels of both groups of athletes were measured by PATHFASTTM NT-proBNP assay, an immunochemiluminescent assay using two polyclonal antibodies in sandwich test format, on a PATHFASTTM automated analyzer. Results: Plasma BNP levels immediately following exercise increased significantly as compared with baseline values. Plasma BNP concentrations in the aerobic group were significantly higher than in the resistance group before and after exercise. Moreover, the increase in mean BNP concentrations in aerobic athletes was 7 times more than in resistance athletes. Conclusions: BNP levels in athlete who performed distance exercises increased significantly compared with resistance training. Possibly exercise program type, intensity of exercise, volume of exercise program, and field sport can be factors of changes in BNP levels

  18. Impact of diuretic treatment and sodium intake on plasma volume in patients with compensated systolic heart failure

    DEFF Research Database (Denmark)

    Bonfils, Peter K; Damgaard, Morten; Taskiran, Mustafa

    2010-01-01

    AIMS: In patients with heart failure (HF), the use of diuretics may be a double-edged sword that can alleviate symptoms of congestion, but also result in over-diuresis and intravascular volume depletion. The purpose of the present study was to examine plasma volume (PV) in HF patients receiving...... from 0 to 160 mg of furosemide and to investigate whether determination of plasma N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) concentrations can predict PV-status. METHODS AND RESULTS: Plasma volume, extracellular volume, glomerular filtration rate, NT-proBNP, and daily renal...... sodium excretion were measured in 18 patients with medically treated, compensated HF and in 27 healthy volunteers. Cardiac function was examined by non-invasive cardiac output determination and echocardiography. Exercise capacity was evaluated by 6 min walk test. There was a borderline significant...

  19. Low grade inflammation as measured by levels of YKL-40

    DEFF Research Database (Denmark)

    Rathcke, Camilla Noelle; Raymond, Ilan; Kistorp, Caroline

    2010-01-01

    factors and markers including lipids, high sensitive C-reactive protein (hsCRP), N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) and urinary albumin/creatinine-ratio (UACR). Median follow-up period was 5.0 (0.17-5.28) years. RESULTS: In subjects without diabetes and CVD at baseline......, increasing YKL-40 levels independently predicted overall and CV mortality rate with hazard ratios of 1.58 (95% confidence interval (CI), 1.12-2.23, p=0.009) and 1.57 (95% CI, 1.00-2.46, p=0.049) after adjustment for age, sex, smoking, total cholesterol, hsCRP, NT-proBNP and UACR. In combined Kaplan...

  20. The association between plasma N-terminal pro-B-type natriuretic peptide and extravascular lung water index in patients with septic shock%感染性休克患者血浆N末端B型钠尿肽前体与血管外肺水指数的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王锁柱; 李丽娟; 赵磊; 盛博; 古旭云; 陈炜

    2014-01-01

    截断值下敏感度为69.8%,特异度为66.7%。GEF预测感染性休克患者结局的AUC最大值0.794,截断值为0.175,在此截断值下敏感度为76.2%,特异度为81.4%。多因素分析显示,CI和NT-proBNP水平是预后的独立预测因素〔CI:P=0.001,优势比(OR)=9.183,95%CI为2.362~35.694;NT-proBNP:P=0.024,OR=1.000,95%CI为0.999~1.000〕。结论血浆NT-proBNP水平可评价感染性休克患者病情的严重程度,其与EVLWI有明显的相关性,且可预测感染性休克患者的预后。%Objective To study the dynamic change in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and its correlation with extravascular lung water index (EVLWI) in patients with septic shock. Methods Sixty-two patients with septic shock admitted to Department of Critical Care Medicine of Beijing Shijitan Hospital were enrolled. The patients were divided into survival group(39 cases)and non-survivors group (23 cases)according to 28-day prognosis. Venous blood was collected after intensive care unit(ICU)admission. The changes in plasma NT-proBNP and hemodynamics indexes levels were analyzed to evaluate their predictive value for clinical outcomes. Results Acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score(23.2±2.5 vs. 28.1±2.6),sequential organ failure assessment(SOFA score:7.74±2.80 vs. 12.43±3.00)and hemodynamics indexes including EVLWI〔ml/kg:7.0(6.0,8.0)vs. 9.0(7.0,12.0)〕,blood lactate(mmol/L):3.60±2.30 vs. 10.40±2.70)and NT-proBNP〔ng/L:945.0(228.0,1 246.0)vs. 5 471.0(3 308.0,11 174.0)〕in survivors were significantly lower than those in non-survivors,and cardiac index〔CI(L�min-1�m-2):4.23±0.85 vs. 3.31±0.74〕, global ejection fraction(GEF:0.205±0.054 vs. 0.149±0.054)were significantly higher than those in non-survivors (P<0.05 or P<0.01). Correlation analysis showed a positive correlation was found between NT-proBNP and EVLWI (r=0.277,P=0.010),and negative correlations were found

  1. N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Anna Sellmer

    Full Text Available Bronchopulmonary dysplasia (BPD is a serious complication of preterm birth. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP has been suggested as a marker that may predict BPD within a few days after birth.To investigate the association between NT-proBNP day three and bronchopulmonary dysplasia (BPD or death and further to assess the impact of patent ductus arteriosus (PDA on this association in neonates born before 32 gestational weeks.A cohort study of 183 neonates born before 32 gestational weeks consecutively admitted to the Neonatal Intensive Care Unit, Aarhus University Hospital, Denmark. On day three plasma samples were collected and echocardiography carried out. NT-proBNP was measured by routine immunoassays. The combined outcome BPD or death was assessed at 36 weeks of postmenstrual age. Receiver operator characteristic (ROC analysis was performed to determine the discrimination ability of NT-proBNP by the natural log continuous measure to recognize BPD or death. The association of BPD or death was assessed in relation to natural log NT-proBNP levels day three.The risk of BPD or death increased 1.7-fold with one unit increase of natural log NT-proBNP day three when adjusted for gestational age at birth (OR = 1.7, 95% CI 1.3; 2.3. The association was found both in neonates with and without a PDA. Adjusting for GA, PDA diameter, LA:Ao-ratio, or early onset sepsis did not change the estimate.We found NT-proBNP to be associated with BPD or death in very preterm neonates. This association was not only explained by the PDA. We speculate that NT-proBNP may help the identification of neonates at risk of BPD as early as postnatal day three.

  2. Prognostic value of circulating catestatin levels for in-hospital heart failure in patients with acute myocardial infarction%儿茶酚抑素对ST段抬高型心肌梗死患者住院期间发生心力衰竭的预测价值

    Institute of Scientific and Technical Information of China (English)

    冀磊; 裴志强; 马登峰; 张静; 苏晋生; 高向东; 薛伟珍; 陈小平; 王卫淑

    2012-01-01

    ,being diuretic users,and to have a lower ejection fraction (all P <0.05).Higher CST levels were also associated with increased risk of heart failure (P < 0.05).In proportion with the deterioration of the cardiac function,CST,NE,NT-proBNP concentration gradually increased (all P <0.05).Spearman rank correlation analysis showed that the CST was negatively correlated with LVEF (rs =-0.923,P < 0.001) and positivey correlated with NT-proBNP (rs =0.884,P < 0.001).After multivariate adjustment,CST remained to be an independent risk factor for the development of in-hospital heart failure(OR =1.125,95% CI:1.056-1.198 ; P < 0.001).The area under the ROC curve of CST and NT-proBNP was 0.777 and 0.874.Using CST =77.29 ng/L as a cut-off value,the sensitivity was 92.8% and specificity was 70.6% for predicting the development of in-hospital heart failure.Conclusion The plasma CST level is an independent predictor for the development of in-hospital heart failure in patients with STEMI.

  3. Detection and Significance of Brain Natriuretic Peptide Level in Normal Late Pregnant Women with Twin Pregnancy%正常双胎晚期妊娠孕妇氨基末端脑钠肽前体水平的检测及意义∗

    Institute of Scientific and Technical Information of China (English)

    游一平; 李晨辉; 唐雅兵; 王诗章

    2014-01-01

    目的探讨正常双胎晚期妊娠孕妇氨基末端脑钠肽前体(NT-proBNP)水平的正常值范围,为临床应用提供指导。方法用免疫电化学发光法测定本院758例正常双胎晚期妊娠孕妇血清 NT-proBNP水平,并根据孕周不同进一步将758例正常双胎晚期妊娠孕妇分为3个亚组,即 A组(孕28~31+6周)、B组(32~35+6周)、C组(≥孕36周),并比较三组NT-proBNP水平。结果正常双胎晚期妊娠孕妇NT-proBNP水平为(60.44±42.02)pg/mL,A、B、C三组血清NT-proBNP值分别为(29.55±25.49)pg/mL、(86.28±54.25)pg/mL、(66.69±31.44)pg/mL,A组与B、C组比较,A组血清NT-proBNP水平明显低于B组与C组,且差异有显著性(P0.05)。结论本组测得正常双胎晚期妊娠孕妇 NT-proBNP水平,样本量较大,其结果可以初步确立正常双胎晚期妊娠孕妇NT-proBNP参考值的范围。%Obj ective]To explore normal value range of brain natriuretic peptide(amino terminal pro-brain natriuretic peptide,NT-proBNP)level in normal late pregnant women with twin pregnancy so as to provide the guidance for clinical application.[Methods]Serum NT-proBNP level in 758 normal twin pregnant women of our hospital was determined by immune electrochemical luminescence method.According to gestational weeks,758 normal late pregnant women with twin pregnancy were further divided into 3 subgroups including group A(28~31+6 gestational weeks),group B(32~35+6 gestational weeks)and group C(≥36 gestational weeks).The levels of NT-proBNP among 3 groups were compared.[Results]The levels of NT-proBNP in normal late preg-nant women with twin pregnancy were (60.44±42.02)pg/mL,and those in group A,B and C were (29.55± 25.49)pg/mL,(86.28±54.25)pg/mL and (66.69±31.44)p/mL,respectively.The levels of NT-proBNP in group A were obviously lower than those in group B and C,and there was significant difference(P 0.05).[Conclusion]In this group, NT-proBNP level in normal late pregnant women with twin pregnancy is determined

  4. Relationship between N-terminal pro-B type natriuretic peptide and extensive echocardiographic parameters in mild to moderate aortic stenosis

    Directory of Open Access Journals (Sweden)

    Cemri M

    2008-01-01

    Full Text Available Context: The N-terminal pro-B type natriuretic peptide levels (NT pro-BNP are increased in cases of volume or pressure overload. Aims: To examine NT pro-BNP levels and enclose whether any relationship is present between the levels of NT pro-BNP and extensive echocardiographic parameters in asymptomatic patients with mild to moderate aortic stenosis (AS. Settings and Design: A cross-sectional study about the NT pro-BNP levels was conducted in 37 asymptomatic AS patients and compared with 40 controls. Methods: Patients < 70 years old with mild to moderate AS with a peak transaortic gradient> 20 mm Hg in transthoracic echocardiogram were included in our study. Extensive echocardiographic parameters and NT pro-BNP levels were obtained from these patients and these indices were compared with the control population selected from the patients who had similar clinical characteristics with the AS patients. Statistical Analysis: NT-proBNP values were found to be distribution free. Spearman correlation coefficient was used for correlation analysis. Mean values were compared by the Kruskal-Wallis test. Results: The NT pro-BNP levels were increased in patients with AS (median; interquartiles range: 686 [449-855] pg/mL vs. 140 [116-150] pg/mL, P < 0.001. Among patients with AS, when correlation analysis was performed mean transaortic gradient, aortic valve area index, myocardial performance index, E m /A m ratio, left-ventricular mass index (LVMI and E/E m ratio had correlations (r=0.38, P = 0.026; r=-0.46, P =0.008; r=0.19, P =0,049; r=-0.22, P =0.04, r=0.49, P =0.003 and r=0.53, P < 0.001 respectively with plasma NT pro-BNP levels. The LVMI (r = 0.49, P = 0.003 and E/E m ratio (r = 0.53 P < 0.001 have the strongest correlations when compared to other parameters. Conclusion: Plasma NT pro-BNP levels are increased in even asymptomatic patients with AS and correlated with several echocardiographic parameters related to severity of AS and degree of diastolic

  5. Elevated baseline plasma phospholipid protein (PLTP) levels are an independent predictor of long-term all-cause mortality in patients with diabetes mellitus and known or suspected coronary artery disease.

    Science.gov (United States)

    Cavusoglu, Erdal; Marmur, Jonathan D; Chhabra, Sandeep; Hojjati, Mohammad R; Yanamadala, Sunitha; Chopra, Vineet; Eng, Calvin; Jiang, Xian-Cheng

    2015-04-01

    To investigate the long-term prognostic significance of baseline plasma PLTP levels in a group of well-characterized male patients with diabetes mellitus and known or suspected coronary artery disease referred for coronary angiography. PLTP is a plasma protein that mediates the net transfer and exchange of phospholipids between lipoproteins. It has been implicated in the pathogenesis of atherosclerosis and elevated plasma levels have been reported in patients with diabetes mellitus. Baseline plasma PLTP levels were measured in 154 male patients with diabetes mellitus who were referred for coronary angiography and followed prospectively for 5 years for the development of all-cause mortality. After adjustment for a variety of baseline clinical, angiographic and laboratory parameters, plasma PLTP levels (analyzed as a continuous variable) were an independent predictor of all-cause mortality at 5 years (HR, 1.55; 95% CI, 1.22-2.00; P = 0.0009). Furthermore, in 3 additional multivariate models that also included a wide variety of contemporary biomarkers with established prognostic efficacy (i.e., ST2, GDF-15, Cystatin C, Fibrinogen, and NT-proBNP), PLTP remained an independent predictor of all-cause mortality at 5 years. Elevated baseline plasma levels of PLTP are associated with an increased risk of long-term all-cause mortality in patients with diabetes and known or suspected coronary disease. Furthermore, this association is independent of a variety of clinical, angiographic, and laboratory variables, including a whole host of contemporary biomarkers with established prognostic efficacy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Relative Importance of History of Heart Failure Hospitalization and N-Terminal Pro-B-Type Natriuretic Peptide Level as Predictors of Outcomes in Patients With Heart Failure and Preserved Ejection Fraction

    DEFF Research Database (Denmark)

    Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars

    2015-01-01

    about the value of a history of HF hospitalization as a predictor of adverse cardiovascular outcomes in patients with HF and HF-PEF. METHODS: We estimated rates and adjusted hazard ratios (HRs) for the composite endpoint of cardiovascular death or HF hospitalization, according to history of recent HF.......49 (95% CI: 4.04 to 4.99) per 100 person-years, respectively (HR: 2.71; 95% CI: 2.33 to 3.16). For patients with NT-proBNP concentrations >360 pg/ml (n = 1,299), the event rate was 11.51 (95% CI: 10.54 to 12.58) compared to 3.04 (95% CI: 2.63 to 3.52) per 100 person-years in those with a lower level...... of NT-proBNP (n = 1468) (HR: 3.19; 95% CI: 2.68 to 3.80). In patients with no recent HF hospitalization and NT-proBNP ≤360 pg/ml (n = 1,187), the event rate was 2.43 (95% CI: 2.03 to 2.90) compared with 17.79 (95% CI: 15.77 to 20.07) per 100 person-years when both risk predictors were present (n = 523...

  7. The response of circulating brain natriuretic peptide to academic stress in college students.

    Science.gov (United States)

    Amir, Offer; Sagiv, Moran; Eynon, Nir; Yamin, Chen; Rogowski, Ori; Gerzy, Yishay; Amir, Ruthie E

    2010-01-01

    Brain natriuretic peptide (BNP), a cardiac peptide, has been implicated in the regulation of hypothalamic-pituitary-adrenocortical (HPA) responses to psychological stressors. The influence of academic stress on circulating concentration of the N-terminal fragment of BNP precursor (NT-proBNP), and in relation to the stress hormone (cortisol) response was studied in 170 college students undergoing major examinations. Just prior to the examination, we measured self-estimated stress level, systolic, and diastolic blood pressure (SBP, DBP), heart rate (HR), plasma levels of cortisol, and NT-proBNP. These parameters were compared to the participants' baseline measurements, taken at the same hour of a different 'control day', without a major examination to induce stress. Hemodynamic variables (SBP, DBP, and HR) increased on the examination day compared with baseline values ( p stress was marked by a significant decrease in plasma NT-proBNP concentration (-40%, p stress and the NT-proBNP reduction ( p = 0.02). In response to academic stress, the plasma cortisol elevation was accompanied by a marked reduction in plasma NT-proBNP level. These data may indicate that mental stress entails an interface between the HPA axis and the peripheral natriuretic peptide system, leading to reciprocating changes in circulating levels of the corresponding hormones.

  8. Plasma chromograninx

    DEFF Research Database (Denmark)

    Goetze, Jens P; Hilsted, Linda M; Rehfeld, Jens F

    2014-01-01

    Cardiovascular risk assessment remains difficult in elderly patients. We examined whether chromogranin A (CgA) measurement in plasma may be valuable in assessing risk of death in elderly patients with symptoms of heart failure in a primary care setting. A total of 470 patients (mean age 73 years......) were followed for 10 years. For CgA plasma measurement, we used a two-step method including a screening test and a confirmative test with plasma pre-treatment with trypsin. Cox multivariable proportional regression and receiver-operating curve (ROC) analyses were used to assess mortality risk...... of follow-up showed significant additive value of CgA confirm measurements compared with NT-proBNP and clinical variables. CgA measurement in the plasma of elderly patients with symptoms of heart failure can identify those at increased risk of short- and long-term mortality....

  9. NT-proBNP对评估IABP治疗前后心源性休克患者心功能变化的意义%The value of NT-proBNP in evaluation of cardiac funotion in patients with oardiogenie shook before and after treated with IABP

    Institute of Scientific and Technical Information of China (English)

    许国华; 区彩文; 陈国钦; 宋明才; 李健豪; 林转娣

    2009-01-01

    价心功能,可作为临床诊断心衰的实验室指标之一.%BP can significantly advance the cardiac function and serum N-terminal proBNP level of the patients of cardiogenic shock..NT-proBNPcan objectively evaluate the cardiac function,and it can be used as a marker of clinical diagnosis of heart failure.

  10. Association between left ventricular global longitudinal strain and natriuretic peptides in outpatients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Gaborit, F; Bosselmann, H; Tønder, N;

    2015-01-01

    BACKGROUND: Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Increased levels of NP reflect increased wall stress of the LV. However, little is known about...... ventricular ejection fraction (LVEF) was 33 % and median LV GLS was -11 %. LV GLS was associated with increased plasma concentrations of NT-proBNP and proANP in multivariate logistic regression (NT-proBNP: Odds RatioGLS: 7.25, 95 %-CI: 2.48-21.1, P ....28-8.30, P = 0.013) and linear regression (NT-proBNP: βGLS: 1.19, 95 %-CI: 0.62-1.76, P fibrillation, renal function) and left atrial volume index...

  11. Value of combined IMA,NT-proBNP and TnI-Ultra in the diagnosis of acute coronary syndrome%心肌损伤相关蛋白联合检测对急性冠状动脉综合征的诊断价值

    Institute of Scientific and Technical Information of China (English)

    喻垚; 郭变琴; 罗光丽; 吴立翔

    2016-01-01

    Objective To investigate the diagnosis value of IMA ,NT‐proBNP and TnI‐Ultra in ACS .Methods Thirty healthy people as the control group ,then non‐ischemic chest pain group 46 cases ,unstable angina 57 cases , non‐ST elevation myocardial infarction group 21 cases and ST‐elevation myocardial infarction group 19 cases were se‐lected .Levels of IMA ,NT‐proBNP and TnI‐Ultra were measured ,three indicator levels of each group and within 3 hours group and 3 - 6 hours group in ACS patients were analyzed and compared statistically .The sensitivity ,specific‐ity ,positive predictive value ,negative predictive value and accuracy to the diagnosis of ACS were calculated by separa‐ted detection and combined application .Results The levels of IMA ,NT‐proBNP ,TnI‐Ultra in the NSTEMI group and the STEMI group were higher than the NICP group and the control group .The levels of IMA and NT‐proBNP in ACS groups within 3 hour and between 3 to 6 hour were significantly higher than the control group(P< 0 .05) .The sensitivity ,negative predictive value ,and accuracy of the combination of serum IMA ,NT‐proBNP and TnI‐Ultra to diagnose ACS were higher than any individual indicator .Conclusion The serum IMA can be used as an indicator of ACS in early myocardial ischemia ,serum IMA in combination with NT‐proBNP and TnI‐Ultra may reflect the differ‐ent stages of the onset of ACS and could improve the sensitivity and accuracy ,which have an important clinical value in the early diagnosis and prognosis evaluation .%目的:探讨缺血修饰清蛋白(IMA)、N末端脑钠肽前体(NT‐proBNP)及超敏肌钙蛋白I(TnI‐Ultra)联合检测对急性冠状动脉综合征(ACS)的临床诊断价值。方法收集该院健康对照组30例、非缺血性胸痛组(NICP)46例、不稳定型心绞痛(UA )组57例、非 ST 段抬高心肌梗死(NSTEMI)组21例和 ST 段抬高心肌梗死(STEMI)组19例。检

  12. Effect of Danshen injections on NT-proBNP in patients with hypertension and left ventricular failure%丹参注射液对高血压合并左心室心力衰竭患者B型脑钠肽的影响

    Institute of Scientific and Technical Information of China (English)

    秦继宝; 蒋玲

    2016-01-01

    目的:探讨丹参注射液对高血压合并左室心力衰竭患者的 B 型脑钠肽的影响,为临床治疗提供实验室依据。方法选取2015年2月至2016年2月该院80例高血压合并左室心力衰竭患者,随机分为2组,40例患者采用常规治疗(对照组),40例患者在常规治疗的基础上增加丹参注射液(实验组)。比较2组患者治疗前后 B 型脑钠肽水平、炎性因子水平、临床疗效。结果治疗前,2组患者的 B 型脑钠肽、超敏 C 反应蛋白(hs‐CRP)、N 末端前脑利钠肽(NT‐proBNP)水平差异无统计学意义(P>0.05);治疗后,实验组患者 B 型脑钠肽明显低于对照组(P <0.05);左心室射血分数、左心室质量指数比对照组明显升高(P<0.05);左心室容积指数比对照组显著降低(P<0.05)。实验组患者治疗后显效和总有效率明显高于对照组(P<0.05);无效率比对照组明显降低(P<0.05)。结论丹参注射液对高血压合并左心室心力衰竭患者疗效显著,明显改善患者 B 型脑钠肽水平,具有临床价值。%Objective To study the effect of Danshen injection on brain peptide type B (NT‐proBNP) in patients with hyperten‐sion and left ventricular failure ,provide an effective basis for clinical treatment .Methods Totally 80 patients of hypertension with left heart failure from February 2015 to February 2016 were randomly divided into two groups :40 patients were treated with con‐ventional therapy (control group ) ,40 patients in the conventional treatment combined with Danshen injection (experimental group) .We compared NT‐proBNP ,inflammatory factors and clinical efficacy between two groups .Results Before treatment ,the expression of NT‐proBNP and hs‐CRP ,NT‐proBNP level was basically the same in two groups (P> 0 .05) .After treatment ,the ex‐perimental group of patients with NT‐proBNP was significantly lower than the

  13. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Køber, Lars;

    2005-01-01

    BACKGROUND: The level of the inactive N-terminal fragment of pro-brain (B-type) natriuretic peptide (BNP) is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic marker in patients with chronic coronary heart disease as well. We assessed...... the relationship between N-terminal pro-BNP (NT-pro-BNP) levels and long-term mortality from all causes in a large cohort of patients with stable coronary heart disease. METHODS: NT-pro-BNP was measured in baseline serum samples from 1034 patients referred for angiography because of symptoms or signs of coronary...... of myocardial infarction, angina, hypertension, diabetes, or chronic heart failure; creatinine clearance rate; body-mass index; smoking status; plasma lipid levels; LVEF; and the presence or absence of clinically significant coronary artery disease on angiography. CONCLUSIONS: NT-pro-BNP is a marker of long...

  14. NT-proBNP as a predictor of intradialytichypotension among maintaining hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    余金波

    2012-01-01

    Objective To assess the risk factors of intradialytichypotension (IDH) among maintaining hemodialysis (MHD) patients and to explore the relation between NTproBNP and IDH,thus to provide clinical evidence for the prevention and treatment of IDH. Methods A total of 202 MHD patients during March

  15. Diagnostic and therapic evaluations of N-terminal pro B-type natriuretic peptide and C-reactive protein in geriatric diastolic heart failure ( ≥80 Years of Age)%高龄老年舒张性心力衰竭患者N末端脑利钠肽原和C反应蛋白的变化及其意义

    Institute of Scientific and Technical Information of China (English)

    卓胜青; 陈勇驰; 曾平; 杨辉剑; 连环

    2011-01-01

    目的 测定高龄老年人(≥80岁)舒张性心力衰竭(DHF)患者治疗前、后血N末端脑利钠肽原(NT-ProBNP)和C反应蛋白(CRP)的水平,探讨高龄老年DHF患者NT-ProBNP和CRP的变化及其意义.方法 经临床治疗后心力衰竭明显改善的高龄老年DHF患者42例作为研究对象,并选取心功能正常的高龄老年人38例作为对照组.监测DHF患者治疗前、后的血NT-ProBNP和CRP水平.结果 高龄老年DHF患者的NT-ProBNP和CRP值明显高于对照组(P<0.01);高龄老年DHF患者治疗后NT-ProBNP和CRP均显著下降(P<0.01).结论 血浆NT-ProBNP和CRP在高龄老年DHF患者中明显升高,NT-ProBNP和CRP的变化对高龄老年DHF患者疗效观察和病情转归有一定的临床价值.%Objective To analyze the change and significance of plasma N-terminal pro B-type natriuretic peptide (NT-ProBNP) and serum C-reactive protein (CRP) in geriatric diastolic heart failure (DHF) and further illustrate clinical value measuring plasma NT-ProBNP and serum CRP at the same time. Methods Collected 42 geriatric DHF patients as research target which heart function was obviously improved by clinical treatment. 38 patients of normal cardiac function as control group. Plasma NT-ProBNP and serum CRP levels were measured before and after treatment in geriatric DHF groups. Results The level of plasma NT-ProBNP and serum CRP in geriatric DHF were significantly higher than that in control group (P < 0.01). Plasma NT-ProBNP and serum CRP in geriatric DHF patients were significantly decreased by clinical treatment (P < 0.01). Conclusion The levels of plasma NT-ProBNP and serum CPR in geriatric DHF were significantly higher than those in control group. The levels of plasma NT-ProBNP and serum CPR coincided with the levels of geriatric DHF.

  16. 重组人生长激素对老年心力衰竭合并贫血患者肾功能及氨基末端B型利钠肽前体的影响%Effects of Recombinant human growth hormone on renal function and level of N-terminal pro-B-type natriuretic peptide in elderly patients with chronic heart failure and anemia

    Institute of Scientific and Technical Information of China (English)

    陈佳娟; 祝河忠; 党书毅

    2013-01-01

    目的 观察重组人生长激素(rhGH)对老年慢性心力衰竭(CHF)合并贫血患者心功能、肾功能、血红蛋白的影响.方法 将87例心功能Ⅱ~Ⅳ级(NYHA)的慢性心力衰竭患者随机分为治疗组(44 例)及对照组(43例).在慢性心力衰竭常规治疗基础上,对照组给予口服铁剂,治疗组给予口服铁剂加皮下注射重组人生长激素.治疗4周后,观察两组血红蛋白、血肌酐、肌酐清除率、心功能、氨基末端B型利钠肽前体(NT-proBNP)变化.结果 与治疗前相比,治疗后治疗组血红蛋白明显升高[(111.2±3.3)g/L比(99.3±4.3)g/L,P<0.05],血清肌酐水平明显降低[(161.4±39.7)μmol/L比(198.2±41.7)μmol/L,P<0.05],肌酐清除率增加[(43.8±7.1)ml/min比(39.0±8.8)ml/L,P<0.05],心功能分级明显改善[(3.1±0.7)比(2.3±0.5)],血浆NT-proBNP显著下降[(11236.1±430.7)ng/L比(2215.3±950.2)ng/L,P<0.05].对照组上述参数均有所改善,但差异无统计学意义.结论 老年慢性心力衰竭合并贫血患者应用rhGH和口服铁剂治疗,在改善心功能的基础上,可进一步纠正贫血,改善肾功能,降低血浆NT-proBNP水平.%Objective To investigate the effects of Recombinant human growth hormone (rhGH) on hemoglobin, cardiac and renal function of elderly patients with congestive heart failure ( CHF) and anemia. Methods Eighty-seven patients CHF (NYHAⅡ-Ⅳ) and anemia were randomized into treatment group (n=44) and control group (n=43). All patients accepted the standard treatment of heart failure. Patients in treatment group re- ceived rhGH and oral iron preparation daily. The patients in control group were given only oral iron preparation. After four-week treatment, the levels of Hb. serum creatinine, creatinine clearance, plasma NT-proBNP and cardiac function were examined. Results In treatment group, there was significant increase oi Hb[ ( 111.2±3.3 )g/L vs (99.3±4.3)g/T, P<0.05], significant deduction of scrum creatinine [( 161.4

  17. Magnetic Resonance Imaging-Detected Myocardial Inflammation and Fibrosis in Rheumatoid Arthritis: Associations With Disease Characteristics and N-Terminal Pro-Brain Natriuretic Peptide Levels.

    Science.gov (United States)

    Kobayashi, Hitomi; Kobayashi, Yasuyuki; Yokoe, Isamu; Akashi, Yosikatsu; Takei, Masami; Giles, Jon T

    2017-09-01

    Myocardial dysfunction and heart failure (HF) are increased in rheumatoid arthritis (RA), yet there are few studies of the myocardium in RA. RA patients with no known heart disease or risk factors underwent gadolinium-enhanced cardiac magnetic resonance imaging (MRI). Images were assessed for left-ventricular (LV) structural and functional parameters and for myocardial late gadolinium enhancement (LGE; an indicator of myocardial fibrosis) and T2-weighted imaging (an indicator of active inflammation). We modeled the associations between RA characteristics and N-terminal pro-brain natriuretic protein (NT-proBNP) levels with LGE and T2-weighted imaging. We also assessed whether LGE and/or T2-weighted imaging were associated with abnormal LV structure or dysfunction. A total of 60 RA patients were studied. LGE was present in 19 (32%) and T2-weighted imaging in 7 (12%), 5 of whom also had LGE. After adjustment for relevant confounders, higher odds of LGE with each swollen joint (odds ratio [OR] 1.87, P = 0.008), each log unit higher C-reactive protein level (OR 3.36, P = 0.047), and each log unit higher NT-proBNP (OR 20.61, P = 0.009) were found. NT-proBNP was also significantly higher (135%) among those with T2-weighted imaging than in those without T2-weighted imaging or LGE. Higher LV mass index and LV mass:end diastolic volume ratio were observed in those with T2-weighted imaging than in those with no myocardial abnormalities and in those with LGE without T2-weighted imaging; however, ejection fraction was not reduced in those with either LGE or T2-weighted imaging. These data suggest that cardiac MRI findings indicating myocardial inflammation/fibrosis are correlated with RA disease activity and alterations in myocardial structure known to precede clinical HF. © 2016, American College of Rheumatology.

  18. Assessment of blood N-terminal pro-brain natriuretic peptide levels in patients with heart failure with preserved ejection fraction%射血分数正常的心力衰竭患者全血N-末端脑钠肽前体浓度变化

    Institute of Scientific and Technical Information of China (English)

    陈广胜; 徐崇利; 张郁青; 林涛

    2012-01-01

    Objectives To assess ihe changes of blood N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels in patients with heart failure with preserved ejection fraction (HFPEF). Methods Totally 78 patients with cardiovascular diseases were classified into three groups: 22 cases with normal heart function, 33 cases with HFPEF and 23 cases with heart failure with reduced ejection fraction (HFREF). Blood NT-pro-BNP levels were measured and echoeardiograms were performed in all patients. Results Blood NT-pro-BNP levels in patients with HFPEF were significantly higher than those in patients with normal heart function [(1 424+996 )pg/mL vs. (167+ 117 )pg/mL,P<0.01 ] and significantly lower than those in patients with HFREF [(1 424±996)mg/L vs. (5 910±2828)mg/L,P<0.01 ]. For heart failure patients, blood NT-pro-BNP levels were negatively correlated with ejection fraction (r=—0.72,P<0.01 ), positively correlated with left atrial diameter (r=0.34,-P<0.05), left end-diastolic ventricular diameter (r=0.61 ,P<0.05) , left end-systolic ventricular diameter (r=0.62,P<0.05) and E/A ratio (r=0.40, P<0.05). Conclusions Compared with that of HFREF, HFPEF is associated with a less elevated level of NT-pro-BNP.%目的 评估射血分数正常的心力衰竭(心衰)患者全血N-末端脑钠肽前休(N-terminal pro-brain natriureticpeptide,NT-pro-BNP)浓度的变化.方法 入选78例心脏病患者分为3组:心功能正常组22例,射血分数正常心衰(heart failure with preserved ejection fretion,HFPEF)组33例,射血分数减低心衰(heart failure with reduced ejection fraction,HFREF)组23例.测定患者的全血NT-pro-BNP浓度并进行超声心动图检查.结果 HFPEF组患者全血NT-proBNP浓度高于心功能正常组[(1 424±996)pg/mL vs.(167±117) pg/mL,P<0.01],低于HFREF组[(1 424±996)mg/L vs.(5 910±2 828)mg/L,P<0.01],差异有统计学意义.心衰患者全血NT-proBNP浓度与射血分数呈负相关(r=-0.72,P<0.01),与左心房内径(r=0.34,P<0.05)

  19. Effect of physical training on exercise capacity, gas exchange and N-terminal pro-brain natriuretic peptide levels in patients with chronic heart failure.

    Science.gov (United States)

    Maria Sarullo, Filippo; Gristina, Tommaso; Brusca, Ignazio; Milia, Salvatore; Raimondi, Raffaella; Sajeva, Massimo; Maria La Chiusa, Stella; Serio, Gesualdo; Paterna, Salvatore; Di Pasquale, Pietro; Castello, Antonio

    2006-10-01

    Decreased exercise capacity is the main factor restricting the daily life of patients with chronic heart failure. N-terminal pro-brain natriuretic peptide (NT pro-BNP) is strongly related to the severity of and is an independent predictor of outcome in chronic heart failure. The study aimed to evaluate the effect of exercise training on functional capacity and on changes in NT pro-BNP levels and to assess the effect of exercise training on quality of life. Sixty patients (45 men/15 women, mean age 52.7 years; +/-5.3 SD), with stable heart failure (45 ischaemic/hypertensive and 15 idiopathic patients), in New York Heart Association (NYHA) functional class II (n=35) to III (n=25), with an ejection fraction less than 40%, were randomly assigned to a training (n=30) and a control group (n=30). The training group (30 patients) performed 3 months of supervised physical training programme using a bicycle ergometer for 30 min three times a week at a load corresponding to 60-70% of their oxygen consumption (VO2) peak. The control group did not change their previous physical activity. A graded maximal exercise test with respiratory gas analysis and an endurance test with constant workload corresponding to 85% of the peak oxygen load at the baseline and after 3 months were performed, and at the same times NT pro-BNP levels were measured. The exercise capacity increased from 15.8 (+/-2.3 SD) to 29.9 (+/-2.1 SD) min (P<0.0001) and the peak VO2 tended to improve from 14.5 (+/-1.4 SD) to 17.7 (+/-2.6 SD) ml/kg per min (P<0.0001) during the supervised training period. VO2 at the anaerobic threshold increased from 12.9 (+/-1.0 SD) to 15.5 (+/-1.7 SD) ml/kg per min (P<0.0001). NT pro-BNP levels decreased from 3376 (+/-3133 SD) to 1434 (+/-1673 SD) pg/ml (P=0.043). The positive training effects were associated with an improvement in the NYHA functional class. Physical training of moderate intensity significantly improves the exercise capacity and neurohormonal modulation in patients

  20. Role of Right Ventricular Dysfunction and Diabetes Mellitus in N-terminal pro-B-type Natriuretic Peptide Response of Patients With Severe Mitral Regurgitation and Heart Failure After MitraClip.

    Science.gov (United States)

    Kaneko, Hidehiro; Neuss, Michael; Weissenborn, Jens; Butter, Christian

    2017-04-06

    MitraClip (MC) is an alternative therapeutic option for patients with severe mitral regurgitation (MR) who are at high surgical risk. Most candidates for MC have severe heart failure (HF) with increased N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels. We sought to clarify the response of NT-pro BNP after MC and to identify the determinants of NT-pro BNP nonresponders. Among 136 consecutive patients successfully treated with MC, we excluded 20 patients due to low baseline NT-pro BNP levels and therefore examined 116 patients. NT-pro BNP responders were defined as patients whose NT-pro BNP levels decreased by > 30% at 6 months after MC. Mean NT-pro BNP levels significantly decreased from 6,117 pg/mL at baseline to 4,143 pg/mL at 6 months after MC (P 5,000 pg/mL (OR, 0.204; P = 0.001) were independent determinants of nonresponders. All-cause death tended to be less common in responders to NT-pro BNP (20% versus 31%; P = 0.163). In conclusion, NT-pro BNP levels significantly decreased after MC. DM and RVSD were determinants of NT-pro BNP nonresponse after the MC procedure.

  1. Acute exercise in elite rugby players increases the circulating level of the cardiovascular biomarker GDF-15.

    Science.gov (United States)

    Galliera, Emanuela; Lombardi, Giovanni; Marazzi, Monica G; Grasso, Dalila; Vianello, Elena; Pozzoni, Roberto; Banfi, Giuseppe; Corsi Romanelli, Massimiliano M

    2014-09-01

    Intense training can lead to a pathophysiological change in serum concentration of a variety of biomarkers. Traditional biomarkers of cardiac injury are very useful in monitoring CVD patients, but in healthy subjects or athletes they cannot be informative enough about the cardiovascular risk, because in these cases their serum levels do not increase over the pathological limit. Therefore novel cardiovascular biomarkers are required in order to allow a better monitoring of sport performance, prediction of overtraining and diagnosis of sport-related cardiac injuries. Growth differentiation factor-15 (GDF-15) is emerging as a powerful cardiovascular injury risk indicator. In this study we investigate the effect of intense physical training of on the circulating levels of GDF-15 in rugby professional players. Serum GDF-15, Erythropoietin, IL-6, the cardiovascular parameter ST-2, NT-proBNP and routine hematological parameters were measured in a group of 30 rugby players before and after a session of intense training. While ST-2, IL-6 and hsCRP displayed no significant changes after intense training, NT-proBNP and GDF-15 showed a significant increase, even without reaching the pathological level. The measure of GDF-15 in professional rugby players could be a useful tool to monitoring their cardiovascular status during training and competition session in order to prevent the onset of collateral cardiovascular adverse event due to the intense training and, in the case of cardiac injury, it could possibly allow a very early diagnosis at the beginning of the pathogenic process.

  2. N-Terminal Pro-Brain Natriuretic Peptide Is Associated with a Future Diagnosis of Cancer in Patients with Coronary Artery Disease.

    Directory of Open Access Journals (Sweden)

    José Tuñón

    Full Text Available Several papers have reported elevated plasma levels of natriuretic peptides in patients with a previous diagnosis of cancer. We have explored whether N-terminal pro-brain natriuretic peptide (NT-proBNP plasma levels predict a future diagnosis of cancer in patients with coronary artery disease (CAD.We studied 699 patients with CAD free of cancer. At baseline, NT-proBNP, galectin-3, monocyte chemoattractant protein-1, soluble tumor necrosis factor-like weak inducer of apoptosis, high-sensitivity C-reactive protein, and high-sensitivity cardiac troponin I plasma levels were assessed. The primary outcome was new cancer diagnosis. The secondary outcome was cancer diagnosis, heart failure requiring hospitalization, or death.After 2.15±0.98 years of follow-up, 24 patients developed cancer. They were older (68.5 [61.5, 75.8] vs 60.0 [52.0, 72.0] years; p=0.011, had higher NT-proBNP (302.0 [134.8, 919.8] vs 165.5 [87.4, 407.5] pg/ml; p=0.040 and high-sensitivity C-reactive protein (3.27 [1.33, 5.94] vs 1.92 [0.83, 4.00] mg/L; p=0.030, and lower triglyceride (92.5 [70.5, 132.8] vs 112.0 [82.0, 157.0] mg/dl; p=0.044 plasma levels than those without cancer. NT-proBNP (Hazard Ratio [HR]=1.030; 95% Confidence Interval [CI]=1.008-1.053; p=0.007 and triglyceride levels (HR=0.987; 95%CI=0.975-0.998; p=0.024 were independent predictors of a new cancer diagnosis (multivariate Cox regression analysis. When patients in whom the suspicion of cancer appeared in the first one-hundred days after blood extraction were excluded, NT-proBNP was the only predictor of cancer (HR=1.061; 95%CI=1.034-1.088; p<0.001. NT-proBNP was an independent predictor of cancer, heart failure, or death (HR=1.038; 95%CI=1.023-1.052; p<0.001 along with age, and use of insulin and acenocumarol.NT-proBNP is an independent predictor of malignancies in patients with CAD. New studies in large populations are needed to confirm these findings.

  3. Correlation between arterial wall stiffness, N-terminal prohormone of brain natriuretic peptide, functional and structural myocardial abnormalities in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Viktoriya Aleksandrovna Serhiyenko

    2013-12-01

    Full Text Available Aim. To assess arterial wall stiffness, plasma levels of of N-terminal prohormone of brain natriuretic peptide (NT-proBNP, as well as functional state and structure of the myocardium in patients with type 2 diabetes mellitus (T2DM and cardiac autonomic neuropathy (CAN.Materials and Methods. The study involved a total of 65 patients with T2DM. 12 had no evidence of cardiovascular disease (CVD or CAN, 14 were diagnosed with subclinical stage of CAN, 18 – with functional stage, and 21 – with organic stage. We measured aortic pulse wave velocity (PWV, aortic augmentation index (AIx, brachial artery AIx, ambulatory arterial stiffness index (AASI and plasma levels of NT-proBNP. Clinical examination included ECG, Holter monitoring, ambulatory BP measurement and echocardiography.Results. Patients with isolated T2DM showed a trend for increased vascular wall stiffness. PWV was increased in patients with subclinical stage of CAN. Aortic and brachial AIx, PWV and AASI were elevated in patients with functional stage of CAN, PWV being significantly higher vs. subclinical CAN subgroup. Organic stage was characterized by pathologically increased values of all primary parameters; PWV and AASI were significantly higher compared with other groups. Development and progression of CAN was accompanied by an increase in NT-proBNP plasma levels. Concentration of NT-proBNP was in direct correlation with left ventricular mass (LVM and PWV. PWV and LVM values also directly correlated between themselves.Conclusion. Development and progression of CAN in patients with T2DM is accompanied by an increase in vascular wall stiffness. The elevation of plasma NT-proBNP in patients with T2DM correlates with the development of CAN and is significantly and independently associated with an increase in LVM and PWV. Our data suggests the pathophysiological interconnection between metabolic, functional and structural myocardial abnormalities in patients with T2DM and CAN.

  4. Serial measurements of N-terminal pro-brain natriuretic peptide after acute ischemic stroke

    DEFF Research Database (Denmark)

    Jensen, J K; Mickley, H; Bak, S;

    2006-01-01

    consecutive patients with acute ischemic stroke. RESULTS: NT-proBNP peaked the day after onset of symptoms (p = 0.007) followed by a decrease until day 5 (p = 0.001, ANOVA). At 6-month follow-up the difference in the level of NT-proBNP was unchanged compared to day 5 (p = 0.42). NT-proBNP levels > or =615 pg...

  5. Left ventricular diastolic dysfunction and N-terminal probrain sodium-uretic peptid level in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Dzyak G.V.

    2013-06-01

    Full Text Available In our study 100 consecutive non-valvular permanent atrial fibrillation patients with NYHA I – III heart failure, 43 - 86 years old (65 men and 35 women were examined. Control group consisted of 30 patients with arterial hypertension and coronary artery disease matched by age, sex with basic group. Relationship of NT-proBNP with echocardiographic parameters of left heart were studied. Transthoracic echocardiography with tissue doppler measurements were performed on echocardiograph “SONOS 7500”. For left ventricular filling pressure assessment ratio Em/Ea was used due to its diagnostic value in atrial fibrillation (regardless of left ventricular ejection fraction. Mean left ventricular filling pressure was increased in patients with heart failure: in atrial fibrillation group and controls as well. In comparison with controls atrial fibrillation group was more likely to have higher both systolic and diastolic left atrial square and volume. According to Em/Ea in 95% of patients with non-valvular atrial fibrillation high left ventricular filling pressure was observed, this testifies to diastolic dysfunction. This parameter correlated well with left atrial square and volume during systole and diastole. Correlation between NT pro-BNP level and NYHA class of heart failure, left ventricular filling pressure was determined in patients with atrial fibrillation. Tissue doppler echocardiography makes it possible to diagnose left ventricular diastolic dysfunction in atrial fibrillation patients.

  6. Usefulness of serum bilirubin levels as a biomarker for long-term clinical outcomes after percutaneous coronary intervention.

    Science.gov (United States)

    Kim, Hyun-Wook; Choi, Dong-Hyun; Lim, Leejin; Lee, Young-Min; Kang, Joon Tae; Chae, Seung Seok; Ki, Young-Jae; Song, Heesang; Koh, Young-Youp

    2015-11-01

    The aim of this study was to evaluate the prognostic value of serum total bilirubin on the development of adverse outcomes after percutaneous coronary intervention (PCI) besides high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT-proBNP). Serum total bilirubin, hs-cTnT, and NT-proBNP were analyzed in 372 patients who underwent PCI. The primary endpoint was cardiac death. There were 21 events of cardiac death during a mean of 25.8 months of follow-up. When the serum total bilirubin cut-off level (median value) was set to 0.58 mg/dL using the receiver operating characteristic curve, the sensitivity was 95.2 % and the specificity was 51.0 % for differentiating between the group with cardiac death and the group without cardiac death. Kaplan-Meier analysis revealed that the lower serum total bilirubin group (bilirubin group (≥0.58 mg/dL) (10.4 vs. 0.6 %, log-rank: P = 0.0001). In conclusion, low serum total bilirubin is a predictive marker for cardiac death after PCI.

  7. Reference Intervals for N-Terminal Pro-B-Type Natriuretic Peptide in Amniotic Fluid between 10 and 34 Weeks of Gestation

    OpenAIRE

    Merz, Waltraut M.; Christina Leufgen; Rolf Fimmers; Birgit Stoffel-Wagner; Ulrich Gembruch

    2014-01-01

    BACKGROUND: In adult and pediatric cardiology, n-terminal pro-B-type natriuretic peptide (nt-proBNP) serves as biomarker in the diagnosis and management of cardiovascular dysfunction. Elevated levels of circulating nt-proBNP are present in fetal conditions associated with myocardial pressure or volume load. Compared to fetal blood sampling, amniocentesis is technically easier and can be performed from early pregnancy onwards. We aimed to investigate amniotic fluid (AF) nt-proBNP concentration...

  8. Natriuretic peptides for the detection of paroxysmal atrial fibrillation in patients with cerebral ischemia--the Find-AF study.

    Directory of Open Access Journals (Sweden)

    Rolf Wachter

    Full Text Available BACKGROUND AND PURPOSE: Diagnosis of paroxysmal atrial fibrillation (AF can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF. METHODS: Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP, brain-type natriuretic peptide (BNP and N-terminal pro atrial-type natriuretic peptide (NT-proANP plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPmedian (239 pg/ml, 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNP<239 pg/ml (p = 0.025. The ratio of early (0 h to late (24 h plasma levels of NT-proBNP showed no difference between both groups. For the detection of paroxysmal atrial fibrillation, BNP, NT-proBNP and NT-proANP at admission had an area under the curve in ROC analysis of 0.747 (0.663-0.831, 0.638 (0.531-0.744 and 0.663 (0.566-0.761, respectively. In multivariate analysis, BNP was the only biomarker to be independently predictive for paroxysmal atrial fibrillation. CONCLUSIONS: BNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring.

  9. Research of Plasma Concentration of N-terminal pro B-type Natriuretic Peptide Changes in The Relationship with Condition of Patients Suffering from Acute Cerebro- vascular Accident and Prognosis%N末端B型钠尿肽前体浓度的变化与急性脑血管意外患者病情及预后关系的研究

    Institute of Scientific and Technical Information of China (English)

    王宝林

    2014-01-01

    目的:探讨B型钠尿肽前体浓度的变化与急性脑血管意外患者病情及预后的关系及其对脑血管疾病的诊疗价值。方法纳入我科自2010年1月至2014年1月期间收治的急性脑血管意外患者106例,NIHSS评分在5~25分,同期98例来自我院查体中心的健康人群作为对照组。检测所有对照组和发病24小时内、1周、2周、4周患者的B型钠尿肽前体浓度,所有入选病例于发病24 h内行NIHSS评分,分析B型钠尿肽前体水平于发病时间及病情转归之间的相关关系。结果急性脑血管意外组24 h内检测的B型钠尿肽前体的浓度均较正常对照组显著增高,NIHSS评分的分值与B型钠尿肽前体浓度呈正相关,发病后第1、2周B型钠尿肽前体浓度开始下降,较对照组仍有统计学意义,4周的检测结果虽较对照组高,但无统计学意义。结论急性脑血管意外可引起血浆B型钠尿肽前体浓度增高,于病情的严重程度及病情转归有关,具有重要的临床意义。%ObjectiveTo investigate the plasma concentration of N-terminal pro B-type natriuretic peptide changes in the relationship with condition of patients suffering from acute cerebrovascular accident and prognosis and clinical significance of changes.Methods We selected 106 patients suffering from acute cerebrovascular accident in our department from January 2010 to January 2014.Thier NIHSS were between 5 score and 25 score, 98 healthy people, who came for body-check, as control. All the people received blood test for NT-proBNP in 24 hours.All patients received blood test for NT-proBNP in 24 hours and 1 week and 2 weeks and 4 weeks. All patients received NIHSS in 24 hours.Results The plasma concentration of NT-proBNP in acute cerebrovascular accident group were higher than in control in 2 weeks, but there were not statistical significance after 4 weeks, and there were positive linear correlation relationship between the plasma

  10. Prognostisk vaerdi af N-terminal pro B-type natriuretisk peptid hos patienter med stabil iskaemisk hjertesygdom--sekundaerpublikation

    DEFF Research Database (Denmark)

    Kragelund, Charlotte B; Grønning, Bjørn Aaris; Køber, Lars

    2006-01-01

    We assessed the relationship between NT-proBNP levels and all-cause mortality in patients with stable coronary heart disease. NT-proBNP was measured in 1,034 patients referred for elective coronary angiography. In a multivariable Cox regression analysis, the hazard ratio for death from any cause...... for patients with NT-proBNP levels in the fourth quartile as compared with those in the first quartile was 2.4 (95% CI 1.5-4.0). NT-proBNP provides prognostic information on all-cause mortality independent of conventional cardiovascular risk factors and left ventricular dysfunction. Udgivelsesdato: 2006-Feb-13...

  11. Circulating cardiac biomarkers and postoperative atrial fibrillation in the OPERA trial.

    Science.gov (United States)

    Masson, Serge; Wu, Jason H Y; Simon, Caterina; Barlera, Simona; Marchioli, Roberto; Mariani, Javier; Macchia, Alejandro; Lombardi, Federico; Vago, Tarcisio; Aleksova, Aneta; Dreas, Lorella; Favaloro, Roberto R; Hershson, Alejandro R; Puskas, John D; Dozza, Luca; Silletta, Maria G; Tognoni, Gianni; Mozaffarian, Dariush; Latini, Roberto

    2015-02-01

    Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery and predicts increased morbidity and mortality. Identification of patients at high risk of POAF with the help of circulating biomarkers may enable early preventive treatment but data are limited, especially in contemporary surgical patients. Plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) were measured at enrollment, on the morning of cardiac surgery, at end surgery, and 2 days postsurgery in 562 patients undergoing cardiac surgery, randomized to perioperative supplementation with oral fish oil or placebo in the Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation trial (OPERA). The primary endpoint was incident POAF lasting ≥ 30 s, centrally adjudicated and confirmed electrocardiographically. Higher levels of NT-proBNP and hs-cTnT before surgery were associated with older age, renal or cardiac dysfunction and EuroSCORE. NT-proBNP peaked on postoperative day 2 (2172 [1238-3758] ng/L, median [Q1-Q3]), while hs-cTnT peaked at the end of surgery (373 [188-660] ng/L). Fish oil supplementation did not alter the time course of the cardiac biomarkers (P > 0.05). Concentrations of NT-proBNP or hs-cTnT, on the morning of surgery, or changes in their level between morning of surgery and postsurgery, were not significantly associated with POAF after adjustment for clinical and surgical characteristics. Among patients undergoing cardiac surgery, NT-proBNP and hs-cTnT are related to clinical and surgical characteristics, have different perioperative time courses but are not independently associated with risk of POAF. © 2014 Stichting European Society for Clinical Investigation Journal Foundation.

  12. Clinical Significance of the Plasma Apelin in Essential Hypertension Patients with LVH and Heart Failure%高血压伴 LVH 心力衰竭的 Apelin 测定分析

    Institute of Scientific and Technical Information of China (English)

    韩超; 王蔚浩; 何耀武; 姜明花; 邓文彬

    2015-01-01

    Objective:To study plasma Apelin level before and after the treatment of primary hypertension patients with LVH and heart failure ;to discuss the relationship between plasma Apelin with essential hypertension ,LVH,early heart failure. Methods:Selected 66 essential hypertension patients with LVH without heart failure , 65 essential hypertension patients with LVH and early heart failure ( NYHA Cardiac function classification Ⅰ -Ⅱ) , and 30 healthy people as the normal control group . Measured patients ’ plasma Apelin level and the content of Plasma N -terminal pro-brain natriuretic peptide ( NT-proBNP) with the double antibody sandwich method ,and measured the left ventricle ejection fraction ( LVEF) with ultrasound.Results:There were statistically significant difference between the control group and the group without heart failure ,the group with heart failureon EF, NT-proBNP(P0.05 ) .The fall of blood pressure and the improvement of heart function were related to the plasma Apelin level , but in different groups , the antihypertensive methods had no significant influence to the plasma Apelin level . Conclusion:Patients’ plasma Apelin level becomes lower following hypertension with LVH ,and becomes higher following early heart failure .Monitoring Apelin levels can predict the occurrence of heart failure ,and Apelin can be used as an auxiliary index to bserve the condition and prognosis of heart function .%目的:研究原发性高血压伴LVH心力衰竭患者治疗前后血浆Apelin的水平,探讨原发性高血压伴LVH早期心衰与血浆Apelin的关系。方法:选取原发性高血压伴LVH无心衰患者66例(无心衰组),原发性高血压伴LVH早期心衰( NYHA心功能分级Ⅰ~Ⅱ级)患者65例(早期心衰组),选取经体检筛查身体健康的中老年体检者30例作为正常组(对照组)。用双抗体夹心法分别测定3组患者血浆Apelin水平和血浆N末端脑钠肽原(NT-proBNP)含量,用

  13. Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients.

    Directory of Open Access Journals (Sweden)

    Jiann-Horng Yeh

    Full Text Available Several studies on diagnostic accuracy of pleural N-terminal pro-B-type natriuretic peptide (NT-pro-BNP for effusions from congestive heart failure (CHF conclude that pleural NT-pro-BNP is a useful biomarker with high diagnostic accuracy for distinguishing CHF effusions. However, its applicability in critical care settings remains uncertain and requires further investigations.NT-proBNP was measured in pleural fluid samples of a prospective cohort of intensive care unit patients with pleural effusions. Receiver operating characteristic curve analysis was performed to determine diagnostic accuracy of pleural NT-proBNP for prediction of CHF effusions.One hundred forty-seven critically ill patients were evaluated, 38 (26% with CHF effusions and 109 (74% with non-CHF effusions of various causes. Pleural NT-proBNP levels were significantly elevated in patients with CHF effusions. Pleural NT-pro-BNP demonstrated the area under the curve of 0.87 for diagnosing effusions due to CHF. With a cutoff of 2200 pg/mL, pleural NT-proBNP displayed high sensitivity (89% but moderate specificity (73%. Notably, 29 (27% of 109 patients with non-CHF effusions had pleural NT-proBNP levels >2200 pg/mL and these patients were more likely to experience septic shock (18/29 vs. 10/80, P<0.001 or acute kidney injury (19/29 vs. 9/80, P<0.001.Among critically ill patients, pleural NT-proBNP measurements remain a useful diagnostic aid in evaluation of pleural effusions. However, patients with non-CHF effusions may exhibit high pleural NT-proBNP concentrations if they suffer from septic shock or acute kidney injury. Accordingly, it is suggested that clinical context should be taken into account when interpreting pleural NT-proBNP values in critical care settings.

  14. Prognosis assessment value of N-terminal pro-B-type natriure tic peptide for noncardiac severe patients in intensive care unit%N-末端B-型钠尿肽前体在ICU非心源性重症患者预后判断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李宝亮; 苏华; 陈琛

    2015-01-01

    目的:探讨氨基末端B型钠尿肽前体( NT-pro-BNP)是否是ICU非心源性重症患者预后判断的独立危险因素。方法采用前瞻性研究方法,选择综合ICU非心源性患者152例,进入ICU后完善患者基本资料,记录患者年龄、性别、APACHEⅡ评分等。于收治1、2、5 d进行NT-proBNP检测,记录患者28 d的终点事件。结果152例入选患者28 d死亡率40§.13%(61/152)。死亡组血浆NT-pro-BNP第1天浓度和APACHE Ⅱ评分明显高于存活组( P <0.05),NT-pro-BNP与APACHE Ⅱ有相关性,且均为影响患者28 d死亡率的独立危险因素,二者的敏感性、特异性ROC曲线比较,NT-pro-BNP ROC曲线下面积为0.731,APACHEⅡ评分ROC曲线下面积为0.716,在评估患者预后比较中 NT-pro-BNP 优于 APACHE Ⅱ,但差异无统计学意义( P >0.05)。血浆 NT-pro-BNP 最佳临界值为5003.39 pg/ml,NTp-ro-BNP<5003 pg/ml组生存率高于NT-pro-BNP >5003 pg/ml组(χ2=32.1, P <0.01)。结论ICU非心源性重症患者NT-pro-BNP>5003 pg/ml是判断预后的独立危险因素。%Objective To investigate whether plasma N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is an independent risk factor for noncardiac severe patients in intensive care unit ( ICU ) .Methods A prospective observational study was performed in which 152 noncardiac severe patients in ICU were enrolled .The patients ’ age, sex, basic data, APACHEⅡscores were collected,the patients’ NT-pro-BNP levels were detected at day 1,2,5 after admission to ICU and 28-day mortality was recorded.Results The 28-day mortality of the patients was 39.8%(61/152).The plasma NT-pro-BNP levels (pg/ml) and APACHE Ⅱscore in death group were significantly higher than those in survival group ( P 0.05).The optimized critical value of plasma NT-pro-BNP was 5 003.39pg/ml,furthermore,the survival rate in NT-pro-BNP5 003pg/ml group (χ2=32.1, P5 003pg/ml of

  15. Low blood pressure predicts increased mortality in very old age even without heart failure: the Leiden 85-plus Study

    NARCIS (Netherlands)

    Poortvliet, R.K.; Blom, J.W.; Craen, A.J. de; Mooijaart, S.P.; Westendorp, R.G.J.; Assendelft, W.J.J.; Gussekloo, J.; Ruijter, W. de

    2013-01-01

    AIMS: To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects without heart failure, defined by low levels of NT-proBNP, as well as in 90-year-old subjects with high levels of NT-proBNP. METHODS AND RESULTS: This study was embedded in the

  16. Low blood pressure predicts increased mortality in very old age even without heart failure: the Leiden 85-plus Study

    NARCIS (Netherlands)

    Poortvliet, R.K.; Blom, J.W.; Craen, A.J. de; Mooijaart, S.P.; Westendorp, R.G.J.; Assendelft, W.J.J.; Gussekloo, J.; Ruijter, W. de

    2013-01-01

    AIMS: To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects without heart failure, defined by low levels of NT-proBNP, as well as in 90-year-old subjects with high levels of NT-proBNP. METHODS AND RESULTS: This study was embedded in the

  17. N-terminal Prohormone B-type Natriuretic Peptide and Cardiovascular Function in Africans and Caucasians: The SAfrEIC Study

    DEFF Research Database (Denmark)

    Kruger, Ruan; Schutte, Rudolph; Huisman, Hugo W;

    2011-01-01

    BACKGROUND: This study compared NT-proBNP levels and the association with cardiovascular markers between Africans and Caucasians from South Africa. METHODS: This cross-sectional study involved 201 Africans and 255 Caucasians from the North West province, South Africa. Serum NT-proBNP concentratio...

  18. The value of use of amino-terminal brain naturitic peptide as marker in cases of pleural effusion of different etiologies

    Directory of Open Access Journals (Sweden)

    Laila A. Banawan

    2013-10-01

    Conclusion: The results support the feasibility of using the pleural fluid amino terminal proBNP measurement in thoracentesis that would enhance discrimination among the different causes of pleural effusion especially for heart failure patients. Serum and pleural fluid levels of NT-pro BNP were closely correlated and measurement of NT-pro BNP in serum showed equally good diagnostic properties.

  19. Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population

    Institute of Scientific and Technical Information of China (English)

    Xu Ruyi; Ye Ping; Luo Leiming; Sheng Li; Wu Hongmei; Xiao Wenkai; Zheng Jin

    2014-01-01

    Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable (<0.003 ng/ml),intermediate (0.003-0.014 ng/ml),and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r=0.175,P <0.001),a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β=-0.206,P <0.001; β=-0.118,P <0.001,respectively).In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β=0.341,P <0.001; β=0.143,P <0.001,respectively),and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β=0.399,P <0.01).Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

  20. Reference intervals for N-terminal pro-B-type natriuretic peptide in amniotic fluid between 10 and 34 weeks of gestation.

    Directory of Open Access Journals (Sweden)

    Waltraut M Merz

    Full Text Available BACKGROUND: In adult and pediatric cardiology, n-terminal pro-B-type natriuretic peptide (nt-proBNP serves as biomarker in the diagnosis and management of cardiovascular dysfunction. Elevated levels of circulating nt-proBNP are present in fetal conditions associated with myocardial pressure or volume load. Compared to fetal blood sampling, amniocentesis is technically easier and can be performed from early pregnancy onwards. We aimed to investigate amniotic fluid (AF nt-proBNP concentrations in normal pregnancies between 10 and 34 weeks of gestation. METHODS: Nt-proBNP and total protein (TP was measured in AF by chemiluminescence assay (photometry, respectively. To adjust for a potential dilutional effect, the AF-nt-proBNP/AF-TP ratio was analyzed. Reference intervals were constructed by regression modeling across gestational age. RESULTS: 132 samples were analyzed. A negative correlation between AF-nt-proBNP/AF-TP ratio and gestational age was observed. Curves for the mean and the 5% and 95% reference interval between 10 and 34 weeks of gestation were established. CONCLUSION: In normal pregnancy, nt-proBNP is present in AF and decreases during gestation. Our data provide the basis for research on AF-nt-proBNP as biomarker in fetal medicine.

  1. 慢性心力衰竭患者血红蛋白水平与心肾功能的相关性%Relationship among hemoglobin level and cardiac function, renal function in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    张艳

    2013-01-01

    目的:探讨慢性心力衰竭(CHF)患者血红蛋白(Hb)水平与其心功能、肾功能的关系.方法:150例CHF男性患者按照心功能分为三组:NYHA Ⅱ级组44例、Ⅲ级组49例,Ⅳ级组57例,并随机抽选30例健康体检患者为健康对照组,分析各组心功能指标[左室舒张末期内径(LVEDd),左室射血分数(LVEF),N末端脑利钠肽前体(NT-proBNP)],肾功能指标[血清肌酐(SCr),肾小球率过滤(GFR)],血液学指标[Hb,红细胞(RBC),血红细胞比容(HCT)];根据CHF患者贫血情况分为贫血组(61例)和非贫血组(89例),并对两组上述指标进行比较.结果:CHF各组贫血发生率均明显高于健康对照组,且随着心衰等级的增加而明显升高(P<0.05);与健康对照组比较,CHF各组心功能各项指标(LVEDd,LVEF,NT-proBNP),肾功能指标(SCr,GFR),血液学指标(Hb,RBC,HCT)均有明显恶化,且随着心衰等级增加而明显加重(P均<0.05);与CHF非贫血组比较,CHF贫血组SCr[(89.78±44.79) mmol/L比(78.79±45.02) mmol/L]、GFR[(86.13±25.42)ml· min-1(1.73m)-1比(67.99±32.12) ml· min-1(1.73m)-1]、LVEF[(55.79±11.34)%比(45.65±12.03)%]水平明显降低,LVEDd[(49.89±8.93) mm比(56.45±11.23) mm]明显增大,NT-proBNP[(945.27±1249.76) pg/ml比(3884.23±2790.42) pg/ml]水平明显升高(P<0.05);线性相关分析显示Hb与LVEDd、NT-proBNP呈负相关(r=-0.346,-0.547,P均<0.05),与LVEF、GFR呈正相关(r=0.453,0.338;P均<0.05).结论:慢性心力衰竭患者血红蛋白下降会显著降低心、肾功能.%Objective:To explore the relationship among hemoglobin (Hb) level and cardiac function,renal function in patients with chronic heart failure (CHF).Methods:According to NYHA cardiac function class,a total of 150 male CHF patients were divided into NYHA class Ⅱ group (n =44),NYHA class Ⅲ group (n =49) and NYHA class Ⅳ group (n =57).Another 30 healthy subjects were randomly selected as healthy control group.Indexes of cardiac function [left

  2. Osteoprotegerin and mortality in type 2 diabetic patients

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Lajer, Maria Stenkil; Gall, Mari-Anne;

    2010-01-01

    OBJECTIVE Plasma osteoprotegerin (OPG) is an emerging strong and independent predictor of cardiovascular disease (CVD) in high-risk populations. OPG is a bone-related glycopeptide produced by vascular smooth muscle cells, and increased plasma OPG levels may reflect arterial vascular damage. We...... filtration rate, and conventional risk factors); hazard ratio (HR) 1.81 [95% CI 1.21-2.69]. The all-cause predictive effect of OPG was independent of NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP) and was also useful within groups divided according to level of UAER. In total, 103 (73%) patients...... predictor of all-cause mortality in type 2 diabetic patients. The effect of OPG on all-cause mortality was independent of conventional cardiovascular risk factors, UAER, and NT-proBNP levels....

  3. Predictive Values of N-Terminal Pro-B-Type Natriuretic Peptide and Cardiac Troponin I for Myocardial Fibrosis in Hypertrophic Obstructive Cardiomyopathy.

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    Changlin Zhang

    Full Text Available Both high-sensitivity cardiac troponin T and B-type natriuretic peptide are useful in detecting myocardial fibrosis, as determined by late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR, in patients with non-obstructive hypertrophic cardiomyopathy. However, their values to predict myocardial fibrosis in hypertrophic obstructive cardiomyopathy (HOCM remain unclear. We investigated the role of N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP and cardiac troponin I (cTnI to identify LGE-CMR in patients with HOCM.Peripheral concentrations of NT-proBNP and cTnI were determined in patients with HOCM (n = 163; age = 47.2 ± 10.8 years; 38.7% females. Contrast-enhanced CMR was performed to identify and quantify myocardial fibrosis.LGE was detected in 120 of 163 patients (73.6%. Patients with LGE had significantly higher levels of NT-proBNP and cTnI than those without LGE (1386.2 [904.6-2340.8] vs. 866.6 [707.2-1875.2] pmol/L, P = 0.003; 0.024 [0.010-0.049] vs. 0.010 [0.005-0.021] ng/ml, P <0.001, respectively. The extent of LGE was positively correlated with log cTnI (r = 0.371, P <0.001 and log NT-proBNP (r = 0.211, P = 0.007. On multivariable analysis, both log cTnI and maximum wall thickness (MWT were independent predictors of the presence of LGE (OR = 3.193, P = 0.033; OR = 1.410, P < 0.001, respectively, whereas log NT-proBNP was not. According to the ROC curve analysis, combined measurements of MWT ≥21 mm and/or cTnI ≥0.025 ng/ml indicated good diagnostic performance for the presence of LGE, with specificity of 95% or sensitivity of 88%.Serum cTnI is an independent predictor useful for identifying myocardial fibrosis, while plasma NT-proBNP is only associated with myocardial fibrosis on univariate analysis. Combined measurements of serum cTnI with MWT further improve its value in detecting myocardial fibrosis in patients with HOCM.

  4. Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nilsson, Jens C; Groenning, Bjoern A; Nielsen, Gitte;

    2002-01-01

    BACKGROUND: Left ventricular (LV) remodeling after myocardial infarction (MI) has received much attention because of its severe impact on morbidity and mortality rates. However, the incidence and extent of LV remodeling in a modern infarct population who were offered antiremodeling treatment in c......, approximately 30% had significant increments develop in LVEDVI and LVESVI, and LV ejection fraction remained unchanged. Patients in whom LV dilatation developed could be identified early after the MI with elevated plasma levels of NT-proBNP...

  5. REMODELING OF THE RIGHT HEART AND THE LEVEL OF BRAIN NATRIURETIC PEPTIDE IN PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION: A COMPARATIVE CROSS-SECTIONAL OBSERVATIONAL STUDY

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    A. A. Klimenko

    2015-09-01

    Full Text Available Aim. To study the right heart remodeling and level of N-terminal brain natriuretic peptide (Nt-proBNP in patients with chronic thromboembolic pulmonary hypertension (CTEPH. Material and methods. Patients (n=79 after pulmonary embolism were included into the study. The main group consisted of patients (n=43 with an increase in systolic pulmonary artery pressure (SPAP >30 mm Hg: 30 (37.9%  patients had pulmonary hypertension (PH degree I, and 13 (16.5%  — PH degree II–III. Group of comparison con- sisted of 36 patients expired pulmonary embolism and having SPAP <30 mm Hg. The control group consisted of 20 people. 6-minute walk test (6-MWT and Doppler echocardiography were performed in all patients. Besides myocardial tissue Doppler echocardiography and assessment of Nt-proBNP level were performed in 38 and 71 patients, respectively. Results. Dyspnea occurred in 90.7% of patients with various degrees of PH and 80.5% of patients with normal SPAP. Patients without PH and with PH I complained of palpitations, weakness, fatigue, and dizziness with similar frequency. Patients with PH I were comparable with ones of comparison group in 6-MWT distance that dramatically decreased in patients with PH II–III. Enlargement of the right atrium (RA and/or right ventricular (RV was observed in 76.7% of patients with PH I and 100% of patients with PH II–III. RV diastolic function abnormalities (E/A<1 and E/A>2 were detected in 19.4%, 16.7% and 61.5% of patients of comparison group, PH I and PH II–III patients, respectively. According to myocardial tissue Doppler echocardiography Em/Am<1 was observed in 8 (72.7% patients of the comparison group and in 13 (76.4% patients with PH. Nt-proB-NP level was 17.3 [2.3, 33.9] fmol/ml in PH I patients and 142.1 [62.1, 171.8] fmol/ml in PH II–III patients. Nt-proBNP level was 6.5 [3.1, 18.3] fmol/mL in patients of the comparison group, and it was higher than this in patients of the control group (3.5 [1.8, 7

  6. Hemodynamic Determinants of the Biologic Variation of N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Stable Systolic Chronic Heart Failure.

    Science.gov (United States)

    Täger, Tobias; Wiedergruen, Ann-Kathrin; Fröhlich, Hanna; Cebola, Rita; Corletto, Anna; Horsch, Andrea; Hess, Georg; Slottje, Karen; Zdunek, Dietmar; Katus, Hugo A; Wians, Frank H; Frankenstein, Lutz

    2017-07-27

    Biologic variation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in chronic heart failure (CHF) may affect blood levels and risk stratification. The sources of NT-proBNP variation are unknown. We performed NT-proBNP measurements and clinical and hemodynamic assessments in 50 patients with heart failure with reduced ejection fraction (HFrEF) who met criteria for clinical stability over 2 time intervals. Hemodynamic variables were measured with the use of inert gas rebreathing and impedance cardiography. Heart rhythm was monitored with the use of external electrocardiographic event recorders throughout the study. Determinants of NT-proBNP-levels and both absolute (ΔNT-proBNPabs) and relative (ΔNT-proBNP%) changes at 1-week and 2-week intervals were identified with the use of univariable and multivariable linear mixed-effects models and linear regression analyses, respectively. Clinical and hemodynamic variables did not significantly change between study visits. The individual variation of NT-proBNP at 2 weeks was 9.2% (range 3.9%-18.6%). Weight and glomerular filtration rate were independently associated with baseline NT-proBNP concentrations (P = .01 and P = .005, respectively). There was no relationship between absolute and relative changes of NT-proBNP at 1-week intervals and changes in clinical and hemodynamic variables. Absolute change of NT-proBNP at 2-week intervals was associated with absolute change in left cardiac work index (P = .008), and relative change in NT-proBNP at 2-week intervals was determined by relative change of thoracic fluid content index (P = .008) and diastolic blood pressure (P = .01). The coefficients of determination (R(2)) for the multivariable models with Δ1wkNT-proBNPabs, Δ2-weeksNT-proBNPabs, Δ1wkNT-proBNP%, and Δ2wksNT-proBNP% as dependent variables were 0.21, 0.19, 0.10, and 0.32, respectively. In patients with stable HFrEF, changes in clinical and hemodynamic variables only marginally

  7. Is there a relationship between obesity, heart rate variability and inflammatory parameters in heart failure?

    Science.gov (United States)

    Taçoy, Gülten; Açikgöz, Kadri; Kocaman, Sinan Altan; Ozdemir, Murat; Cengel, Atiye

    2010-02-01

    To investigate the effect of body mass index (BMI) on heart rate variability (HRV) and inflammatory parameters in patients with heart failure. We analyzed 55 consecutive patients (mean age, 63.5 +/- 12.8 years; male/female, 39/16) with symptomatic left ventricular systolic (ejection fraction or= 30 kg/m2). The cause of heart failure was mainly ischemic heart disease (75%) with mean ejection fraction 30 +/- 7%. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein levels were measured, and time-domain HRV indices were determined on Holter electrocardiogram. The relationship between HRV indices and laboratory, inflammatory and echocardiographic parameters was investigated with correlation analysis. Age, sex, clinical characteristics (hypertension, diabetes mellitus, dyslipidemia, family history, smoking) were similar between groups. BMI was inversely correlated with NT-pro BNP levels (P = 0.001). HRV indices did not differ between groups. Correlation analysis demonstrated the relationship between HRV indices and fasting blood glucose (SDNN, SDANN, SDNNI, root mean square successive differences, VTI), C-reactive protein (SDANN, SDNNI, VTI), pulmonary artery pressure (SDNN, SDANN, VTI) levels. In systolic heart failure patients a higher BMI is associated with decreased NT-proBNP levels. Although HRV indices were not different between groups, inflammatory parameters, fasting blood glucose and pulmonary artery pressure were correlated with them.

  8. Echocardiographic Assessment of Left Ventricular Function in Type 1 Gaucher's Disease

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    Mirta Koželj

    2010-01-01

    Full Text Available There is predominate opinion among physicians managing type 1 Gauchers' disease (GD that cardiac involvement is not an issue in these patients. In order to follow this hypothesis, we prospectively investigated 15 adult imiglucerase-treated type 1 GD patients by echocardiography, Doppler, and tissue Doppler echocardiography. This was a case-controlled study with 18 matched healthy volunteers. The obtained data was correlated with the levels of NT-proBNP (brain natriuretic peptide. None of the GD patients had clinical signs of heart disease. In 3 of the 15 patients, we observed echocardiographic signs of aortic and mitral valve calcification. The left ventricular systolic function was within normal limits. Compared to the control group, there was no statistically significant difference observed in the most sensitive indices of left ventricular diastolic function, parameter Em (P=.095, and E/Em ratio (P=.097, as demonstrated by tissue Doppler echocardiography. However, there was a positive correlation between the E/Em ratio and NT-proBNP plasma levels (P=.009. In conclusion, the prospective echocardiographic study of type 1 GD patients did not validate any left ventricular dysfunction. But, the E/Em ratio showed a strong statistical correlation with the most sensitive indicators of heart failure, NT-proBNP. Research on larger groups of patients and the usage of even more sensitive methods as strain-rate imaging will be necessary to confirm eventual myocardial involvement in GD patients.

  9. Serial measurements of cardiac biomarkers in patients after allogeneic hematopoietic stem cell transplantation

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    Roziakova Lubica

    2012-02-01

    Full Text Available Abstract Background Previous therapy with anthracyclines (ANT and conditioning regimen followed by hematopoietic stem cell transplantation (HSCT represents a high risk for development of cardiotoxicity. The aim of this study was to assess subclinical myocardial damage after HSCT using echocardiography and cardiac biomarkers - high sensitive cardiac troponin T (hs-cTnT and N-terminal pro-B-type natriuretic peptide (NT-proBNP and to identify patients at risk of developing clinical cardiotoxicity. Patients and methods Thirty-seven patients who were treated with allogeneic HSCT for hematologic diseases at median age of 28 years at time of HSCT were studied. Conditioning regimen included either chemotherapy without total body irradiation (TBI or combination of chemotherapy with TBI. Twenty-nine (78,3% patients were pretreated with ANT therapy. Cardiac biomarkers were serially measured before conditioning regimen and at days 1, 14 and 30 after HSCT. Cardiac systolic and diastolic functions were assessed before conditioning regimen and 1 month after HSCT by echocardiography. Results The changes in plasma NT-proBNP and hs-cTnT levels during the 30 days following the HSCT were statistically significant (P P Conclusions Elevations in both cardiac biomarkers were found before clinical signs of cardiotoxicity developed. Persistent elevations in NT-pro-BNP and hs-cTnT concentrations simultaneously for a period exceeding 14 days might be used for identification of patients at risk of developing cardiotoxicity and requiring further cardiological follow up.

  10. Level of urinary liver-type fatty acid-binding protein is associated with cardiac markers and electrocardiographic abnormalities in type-2 diabetes with chronic kidney disease stage G1 and G2.

    Science.gov (United States)

    Maeda, Yoshiteru; Suzuki, Atsushi; Ishii, Junnichi; Sekiguchi-Ueda, Sahoko; Shibata, Megumi; Yoshino, Yasumasa; Asano, Shogo; Hayakawa, Nobuki; Nakamura, Kazuhiro; Akiyama, Yasukazu; Kitagawa, Fumihiko; Sakuishi, Toshiaki; Fujita, Takashi; Hashimoto, Shuji; Ozaki, Yukio; Itoh, Mitsuyasu

    2015-05-01

    Urinary liver-type fatty acid-binding protein (L-FABP) reflects the degree of stress in proximal tubules of the kidney. We examined the level of L-FABP in type-2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) stage G1 and G2, and its relationship with cardiac markers and electrocardiographic (ECG) abnormalities. T2DM patients whose estimated glomerular filtration rate (eGFR) was ≥60 mL/min/1.73 m(2) were recruited [n = 276 (165 males), mean age 64 years]. The median level of urinary L-FABP was 6.6 μg/gCr. Urinary L-FABP showed significant correlation with urinary albumin-to-creatinine ratio (ACR) (r = 0.51, p L-FABP ≤8.4 μg/gCr and ACR ≤30 mg/gCr; group 2, L-FABP ≤8.4 μg/gCr and ACR >30 mg/gCr; group 3, L-FABP >8.4 μg/gCr and ACR ≤30 mg/gCr; group 4, L-FABP >8.4 μg/gCr and ACR >30 mg/gCr). Compared with group 1, group 4 was significantly higher in systolic blood pressure, and eGFR using standardized serum cystatin C, high-sensitivity troponin T, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Group 4 had significantly higher level of NT-proBNP than group 3. Groups 2, 3 and 4 showed more ECG abnormalities than group 1. These findings suggest that simultaneous measurement of urinary L-FABP and ACR should be useful to assess cardiovascular damage reflecting on the elevation of cardiac markers and ECG abnormalities in T2DM with CKD G1 and G2.

  11. Low blood pressure predicts increased mortality in very old age even without heart failure: the Leiden 85-plus Study.

    Science.gov (United States)

    Poortvliet, Rosalinde K E; Blom, Jeanet W; de Craen, Anton J M; Mooijaart, Simon P; Westendorp, Rudi G J; Assendelft, Willem J J; Gussekloo, Jacobijn; de Ruijter, Wouter

    2013-05-01

    To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects without heart failure, defined by low levels of NT-proBNP, as well as in 90-year-old subjects with high levels of NT-proBNP. This study was embedded in the Leiden 85-plus Study, an observational population-based prospective study. All 90-year-old participants (n = 267) were included between 2002 and 2004 and followed up for mortality for at least 5 years. Differences in mortality risks were compared between participants with low systolic blood pressure (≤150 mmHg) and high systolic blood pressure (>150 mmHg) within strata of low NT-proBNP (low NT-proBNP, low systolic blood pressure gave a two-fold increased risk (hazard ratio 2.0, 95% confidence interval 1.1-3.4) compared with participants with high systolic blood pressure. For participants with high NT-proBNP, low systolic blood pressure provided a 1.7 increased mortality risk (95% confidence interval 1.2-2.3) compared with high systolic blood pressure. Low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects, irrespective of the NT-proBNP level. Therefore, the absence or presence of heart failure as determined by NT-proBNP does not influence the prognostic value of low systolic blood pressure with regard to mortality in the oldest old.

  12. Chemotherapeutics-induced Cardiomyopathy in Acute Leukemia Patients and It′s Detection Methods%急性白血病患者化疗相关心脏毒性及检测方法分析

    Institute of Scientific and Technical Information of China (English)

    孙长勇; 杨淑莲; 李泳浩; 侯伟; 王茂生; 王永胜

    2012-01-01

    Objective To research cardiomyopathy induced by chemotherapeutics ( DNR and Arsenious acid ) in patients with acute leukemia and its detection methods. Methods Eighty - eight acute leukemia patients, admitted from June 2010 to April 2011, were given conventional chemotherapy. 12 - lead electrocardiogram ( EGG ), myocardial enzymes and changes of plasma NT - proBNP level were observed before, after chemotherapy. Results EGG changed obviously and plasma NT -proBNP elevated in 8 patients after chemotherapy ( P 0. 05 ). Plasma NT - proBNP elevated in most patients ( P 0. 05 ). Conclusion EGG is a conventional detection method for chemotherapy - induced cardiomyopathy, NT - proBNP can be used as a simple and practical monitoring tools.%目的 研究急性白血病常用化疗药物(柔红霉素和亚砷酸)引起相关心脏毒性及监测方法.方法 对2010年6月-2011年4月在河北省廊坊市中医医院收治的88例初治急性白血病患者进行常规药物化疗,并监测化疗前后12导联心电图(ECG)、心肌酶谱及血浆N末端脑钠肽前体(NT-proBNP)水平变化.结果 共8例患者出现明显ECG改变,且化疗后血浆NT-proBNP均升高,差异有统计学意义(P<0.05);而心肌酶谱变化差异无统计学意义(P>0.05).88例患者中大部分患者化疗后血浆NT-proBNP升高,差异有统计学意义(P<0.05);心肌酶谱变化差异无统计学意义(P>0.05).结论 对于急性白血病患者应用柔红霉素及亚砷酸常规药物治疗可能引起相关的心脏毒性,ECG是常规检测手段,NT-proBNP亦可作为简便实用的监测手段.

  13. The predictive capacity and additional prognostic power of N-terminal pro-B-type natriuretic peptide in Chinese elderly with chronic heart failure

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    Fu S

    2015-01-01

    Full Text Available Shihui Fu,1,2,* Leixing Xie,2,* Dongyun Li,1,2 Ping Ye,1 Leiming Luo11Department of Geriatric Cardiology, 2Department of Cardiology and Hainan Branch, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China*These authors are joint first authorsObjective: This study was conducted to research the prognostic utility of N-terminal pro-B-type natriuretic peptide (NT-proBNP, compare the utility of the Seattle Heart Failure Score (SHFS with NT-proBNP, develop a risk-evaluation model based on NT-proBNP, assess the associations of NT-proBNP with patient characteristics, and screen for decisive factors of NT-proBNP in Chinese elderly with chronic heart failure (CHF.Patients and methods: There were 306 patients (≥60 years with CHF chosen as study subjects. Each one received an assessment of NT-proBNP on serum. The end point was all-cause mortality during a mean follow-up period of 471 days.Results: Subjects had a median age of 85 (60–100 years, a median NT-proBNP of 1,743.4 pg/mL, and a median SHFS of 1.87. During the follow-up period, 104 deaths occurred. NT-proBNP was significantly related to mortality (odds ratio 1.603, 95% confidence interval 1.407–1.826; P<0.001 and the significance persisted after full adjustment (odds ratio 1.282, 95% confidence interval 1.103–1.489; P=0.001. Age, New York Heart Association class IV CHF, plasma albumin, and neutrophils/lymphocytes were also independent predictors for mortality (P<0.05 for all. NT-proBNP and the SHFS showed similar predictive capacities (0.736 versus 0.796, P=0.105. The addition of NT-proBNP to the SHFS (0.818 versus 0.796, P=0.168 generated marginal growth in the c-statistic. The model based on NT-proBNP consisting of all selected predictors in this study, including age, New York Heart Association class IV CHF, plasma albumin, neutrophils/lymphocytes, and NT-proBNP, had a moderately higher c-statistic compared with the SHFS (0.846 versus 0.796, P=0.066. NT-proBNP

  14. Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

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    Reneta Yovcheva Koycheva

    2015-12-01

    Full Text Available BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT, precursor of B-natriuretic peptide (NT-proBNP and high sensitivity C-reactive protein (hs CRP and their relation to the presence of left ventricular hypertrophy (LVH in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure. MATERIAL AND METHODS: Were studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH, and gr B - 8 patients (without LVH. RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05 after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47 and weaker with hs CRP (r = 0.163. Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966, for NT-proBNP (r = 0.918 and for hs CRP (r = 0.859. It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng /mL, p < 0.05 and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg /mL, p < 0.05. Not find a significant difference in hs CRP in both groups. CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

  15. Heart Failure Protein May Signal Early Brain Damage

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162447.html Heart Failure Protein May Signal Early Brain Damage Higher levels ... stress. Blood levels of NT-proBNP rise when heart failure worsens and fall when it gets better. Previous ...

  16. NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

    DEFF Research Database (Denmark)

    Rathcke, C.N.; Kjøller, Erik; Fogh-Andersen, N.

    2010-01-01

    Background: Myocardial perfusion imaging (MPI) can detect myocardial perfusion abnormalities but many examinations are without pathological findings. This study examines whether circulating biomarkers can be used as screening modality prior to MPI. Methodology/Principal Findings: 243 patients wit...

  17. Effect of beta-blockade and ACE inhibition on B-type natriuretic peptides in stable patients with systolic heart failure

    DEFF Research Database (Denmark)

    Rosenberg, J.; Gustafsson, F.; Remme, W.J.;

    2008-01-01

    treatment allocation: Carvedilol, enalapril or carvedilol+enalapril. Changes in BNP and NT-proBNP from baseline to 6 months maintenance visit were evaluated in each treatment arm. Furthermore, the prognostic value of BNP and NT-proBNP during monotherapy with carvedilol was assessed with univariate Cox...... (1.005-1.032), BNP 1.171 (1.088-1.260)). Conclusion Treatment of HF patients with carvedilol alone does not reduce levels of natriuretic peptides, but treatment with enalapril does. Both BNP and NT-proBNP predict death and hospitalisation in HF patients treated with carvedilol for six months....... The clinical implication of our results is that NT-proBNP and BNP can be used as risk markers of death and cardiovascular hospitalisations in systolic HF patients receiving carvedilol without ACE inhibition Udgivelsesdato: 2008/8...

  18. Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients

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    Thomas Schachner

    2010-01-01

    Full Text Available BACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass grafting (CABG. METHODS: In 819 patients undergoing isolated CABG surgery preoperative serum NT-proBNP levels were measured. NT-proBNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5-44 months. Risk factors of mortality were identified using χ2, Mann-Whitney test, and Cox regression. RESULTS: NT-proBNP levels >430 ng/ml and >502 ng/ml predicted hospital and overall mortality (p502 ng/ml (p=0.001. Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, low left ventricular ejection fraction and BNP levels >502 ng/ml were isolated as risk factors for overall mortality. Multivariate Cox regression analysis, including the known factors influencing NT-proBNP levels, identified NT-proBNP as an independent risk factor for mortality (OR = 3.079 (CI = 1.149-8.247, p = 0.025. Preoperative NT-proBNP levels >502 ng/ml were associated with increased ventilation time (p=0.005, longer intensive care unit stay (p=0.001, higher incidence of postoperative hemofiltration (p=0.001, use of intra-aortic balloon pump (p502 ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications.

  19. Prognostic impact of plasma N-terminal pro-brain natriuretic peptide in severe chronic congestive heart failure: a substudy of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial.

    Science.gov (United States)

    Hartmann, Franz; Packer, Milton; Coats, Andrew J S; Fowler, Michael B; Krum, Henry; Mohacsi, Paul; Rouleau, Jean L; Tendera, Michal; Castaigne, Alain; Anker, Stefan D; Amann-Zalan, Ildiko; Hoersch, Silke; Katus, Hugo A

    2004-09-28

    The utility of N-terminal proBNP (NT-proBNP) to predict the occurrence of death and hospitalization was prospectively evaluated in the COPERNICUS study, which enrolled patients with an ejection fraction COPERNICUS study and were randomized to placebo (n=506) or carvedilol (n=505). Values of NT-proBNP were markedly increased despite the requirement that patients be euvolemic before the start of treatment (mean+/-SD, 3235+/-4392 pg/mL; median, 1767 pg/mL). By univariate Cox regression analysis, NT-proBNP was found to be a powerful predictor of subsequent all-cause mortality (relative risk [RR], 2.7; 95% CI, 1.7 to 4.3; P=0.0001 for above versus below median) and all-cause mortality or hospitalization for heart failure (RR, 2.4; 95% CI, 1.8 to 3.4; P=0.0001 for above versus below median). The predictive value of NT-proBNP was similar when both placebo and carvedilol patients were analyzed separately. No significant interaction was found between NT-proBNP and treatment group (P=0.93 for above- versus below-median NT-proBNP). NT-proBNP was consistently associated with increased risk for all-cause mortality and for all-cause mortality or hospitalization for heart failure in patients with severe congestive heart failure, even in those who were clinically euvolemic. This marker therefore may be a useful tool in risk stratification of patients with severe congestive heart failure.

  20. Elevated N-terminal pro-brain natriuretic peptide is associated with mortality in tobacco smokers independent of airflow obstruction.

    Directory of Open Access Journals (Sweden)

    Jason A Stamm

    Full Text Available BACKGROUND: Tobacco use is associated with an increased prevalence of cardiovascular disease. N-terminal pro-brain natiuretic peptide (NT-proBNP, a widely available biomarker that is associated with cardiovascular outcomes in other conditions, has not been investigated as a predictor of mortality in tobacco smokers. We hypothesized that NT-proBNP would be an independent prognostic marker in a cohort of well-characterized tobacco smokers without known cardiovascular disease. METHODS: Clinical data from 796 subjects enrolled in two prospective tobacco exposed cohorts was assessed to determine factors associated with elevated NT-proBNP and the relationship of these factors and NT-proBNP with mortality. RESULTS: Subjects were followed for a median of 562 (IQR 252-826 days. Characteristics associated with a NT-proBNP above the median (≥49 pg/mL were increased age, female gender, and decreased body mass index. By time-to-event analysis, an NT-proBNP above the median (≥49 pg/mL was a significant predictor of mortality (log rank p = 0.02. By proportional hazard analysis controlling for age, gender, cohort, and severity of airflow obstruction, an elevated NT-proBNP level (≥49 pg/mL remained an independent predictor of mortality (HR = 2.19, 95% CI 1.07-4.46, p = 0.031. CONCLUSIONS: Elevated NT-proBNP is an independent predictor of mortality in tobacco smokers without known cardiovascular disease, conferring a 2.2 fold increased risk of death. Future studies should assess the ability of this biomarker to guide further diagnostic testing and to direct specific cardiovascular risk reduction inventions that may positively impact quality of life and survival.

  1. Nitric Oxide Bioavailability and Adiponectin Production in Chronic Systolic Heart Failure: Relation to Severity of Cardiac Dysfunction

    Science.gov (United States)

    Tang, W.H. Wilson; Shrestha, Kevin; Tong, Wilson; Wang, Zeneng; Troughton, Richard W.; Borowski, Allen G.; Klein, Allan L.; Hazen, Stanley L.

    2013-01-01

    Adiponectin is an anti-inflammatory, anti-atherogenic adipokine elevated in heart failure (HF) that may protect against endothelial dysfunction by influencing underlying nitric oxide bioavailablity. In this study, we examine the relationship between plasma adiponectin levels and measures of nitric oxide bioavailability and myocardial performance in patients with chronic systolic HF. In 139 ambulatory patients with stable, chronic systolic HF (left ventricular [LV] ejection fraction ≤40%, New York Heart Association [NYHA] class I to IV), we measured plasma levels of adiponectin, asymmetric dimethylarginine (ADMA) and global arginine bioavailability (GABR), and performed comprehensive echocardiography with assessment of cardiac structure and performance. Adverse events (all-cause mortality or cardiac transplantation) were prospectively tracked for a median of 39 months. Plasma adiponectin levels directly correlated with plasma ADMA levels (Spearman’s r=0.41, p<0.001) and NT-proBNP levels (r=0.55, p<0.001), inversely correlated with GABR (r= −0.39, p<0.001), and were not associated with hsCRP (p=0.81) or MPO (p=0.07). Interestingly, increased plasma adiponectin levels remained positively correlated with plasma ADMA levels only in patients with elevated NT-proBNP levels (r= 0.33, p=0.009). Higher plasma adiponectin levels were associated with worse LV diastolic dysfunction (rank sums p=0.002), RV systolic dysfunction (rank sums p=0.002), and RV diastolic dysfunction (rank sums p=0.011), but not after adjustment for plasma ADMA and NT-proBNP levels. Plasma adiponectin levels predicted increased risk of adverse clinical events (HR [95% CI]: 1.45 [1.02–2.07], p=0.038) but not after adjustment for plasma ADMA and NT-proBNP levels, or echocardiographic indices of diastolic or RV systolic dysfunction. In patients with chronic systolic HF, adiponectin production is more closely linked with nitric oxide bioavailability than inflammation, and appears to be more robust

  2. Prognostic value of circulating microRNA-210 levels in patients with moderate to severe aortic stenosis.

    Directory of Open Access Journals (Sweden)

    Helge Røsjø

    Full Text Available Circulating micro-RNAs have been proposed as a novel class of cardiovascular (CV biomarkers, but whether they meet analytical requirements and provide additional information to establish risk indices have not been established. miR-210 levels are increased in subjects with low VO2 max, which is a recognized risk factor in patients with aortic stenosis (AS, and we hypothesized that circulating miR-210 levels may be increased in patients with AS and associated with a poor prognosis.We measured circulating miR-210 levels by real-time PCR in 57 patients with moderate to severe AS and in 10 age- and gender-matched healthy controls. The merit of miR-210 as a biomarker was assessed according to established criteria, including by comparing miR-210 levels with NT-proBNP and miR-22 levels, which is another miRNA biomarker candidate.All patients and control subjects had miR-210 levels within the range of detection (Cq<35 and the analytical variability was low. Circulating miR-210 levels were 2.0±0.2 [mean±SEM] fold increased in AS patients compared to controls (p = 0.002, whereas miR-22 levels were not differently expressed in the AS patients (0.12±0.06 fold increase, p = 0.45. The increase in miR-210 levels in AS patients was comparable to the increment in NT-proBNP levels: [AUC] 0.82 (95% CI 0.70-0.90 vs. 0.85 (0.75-0.93, respectively, p = 0.71. During a median follow-up of 1287 days, 15 patients (26% died. There was a significant association between higher circulating levels of miR-210 and increased mortality during follow-up: hazard ratio [supra- vs. inframedian levels] 3.3 (95% CI 1.1-10.5, p = 0.039. Adjusting for other risk indices in multivariate analysis did not attenuate the prognostic merit of circulating miR-210 levels.Circulating miR-210 levels are increased in patients with AS and provide independent prognostic information to established risk indices. Analytical characteristics were also excellent supporting the potential of

  3. Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations

    DEFF Research Database (Denmark)

    Grønning, Bjørn Aaris; Nilsson, Jens C.; Søndergaard, Lars

    2002-01-01

    BACKGROUND: Brain- and N-terminal pro brain natriuretic peptide (NT-proBNP) have been identified as promising markers for heart failure. However, previous studies have revealed that they may hold insufficient diagnostic power for implementation into clinical practice because of a significant...... to investigate the diagnostic potential of NT-proBNP with magnetic resonance imaging as the reference method for the cardiac measurements. METHODS: Forty-eight patients with stable symptomatic heart failure in New York Heart Association functional classifications II to IV were examined once with blood samples...... and magnetic resonance imaging along with 20 age-matched and gender-matched healthy control subjects. RESULTS: NT-proBNP was associated with LV end-diastolic (r = 0.69; P

  4. Relation of N-Terminal Pro-B-Type Natriuretic Peptide and Left Ventricular Diastolic Function to Exercise Tolerance in Patients With Significant Valvular Heart Disease and Normal Left Ventricular Systolic Function.

    Science.gov (United States)

    Hwang, Ji-Won; Park, Sung-Ji; Cho, Eun Jeong; Kim, Eun Kyoung; Lee, Ga Yeon; Chang, Sung-A; Choi, Jin-Oh; Lee, Sang-Chol; Park, Seung Woo

    2017-03-16

    An association between N-terminal prohormone brain natriuretic peptide (NT-proBNP) and exercise tolerance in patients with valvular heart disease (VHD) has been suggested; however, there are few data available regarding this relation. The aim of this study is to evaluate the correlation between exercise tolerance and NT-proBNP in patients with asymptomatic or mildly symptomatic significant VHD and normal left ventricular ejection fraction (LV EF). A total of 96 patients with asymptomatic or mildly symptomatic VHD and normal LV EF (≥50%) underwent cardiopulmonary exercise echocardiography. NT-proBNP levels were determined at baseline and after exercise in 3 hours. Patients were divided in 2 groups based on lower (<26 ml/kg/min, n = 47) or higher (≥26 ml/kg/min, n = 49) peak oxygen consumption (VO2) as a representation of exercise tolerance. In the 2 groups, after adjusting for age and gender, the NT-proBNP level after exercise in 3 hours, left atrial volume index before exercise, right ventricular systolic pressure before exercise, E velocity after exercise, and E/e' ratio after exercise varied significantly. In addition, peak VO2 was inversely related to NT-proBNP before (r = -0.352, p <0.001) and after exercise (r = -0.351, p <0.001). The NT-proBNP level before exercise was directly related to the left atrial volume index, E/e' ratio, and right ventricular systolic pressure before and after exercise. NT-proBNP after exercise was also directly related to the same parameters. NT-proBNP levels both before and after exercise were higher in the group with lower exercise tolerance. In conclusion, through the correlation among exercise tolerance, NT-proBNP, and parameters of diastolic dysfunction, we demonstrated that diastolic dysfunction and NT-proBNP could predict exercise tolerance in patients with significant VHD and normal LV EF.

  5. 心脏移植术前血N端B型利钠肽原水平与术后早期受者存活率的关系%Relationship between preoperative N-terminal-pro-brain natriuretic levels and early survival of HT recipients

    Institute of Scientific and Technical Information of China (English)

    黄燕; 黄洁; 胡盛寿; 宋云虎; 王巍; 廖中凯; 朱俊

    2013-01-01

    目的 探讨心脏移植术前血N端B型利尿钠肽原(NT-proBNP)水平与术后早期受者存活率的关系.方法 采用免疫法测定284例拟接受心脏移植的心力衰竭患者移植前血NT-proBNP水平,按NT-proBNP水平将284例患者分为≤5000 nmol/L组(≤5000组,237例)和>5000 nmol/L组(>5000组,47例),比较两组受者的术前一般情况、不同原发病者的NT-proBNP水平、两组围手术期体外膜肺氧合(ECMO)技术应用率及死亡率.采用Kaplan-Meier法计算两组受者1年存活率.结果 >5000组术前肺毛细血管楔压为(25.1±7.4)mm Hg(1 mm Hg=0.133 kPa),明显高于≤5000组的(21.4±9.2)mm Hg(P<0.05);心脏指数为(1.8±0.5)L·min-1·m-2,明显低于≤5000组的(2.1±0.6)L·min-1·m-2 (P<0.05).>5000组围手术期需用ECMO支持者占14.9%(7/47),ECMO相关死亡率为71.4%(5/7),1年存活率为91.3%;≤5000组围手术期需用ECMO支持者占6.8%(16/237),ECMO相关死亡率为12.5%(2/16),1年存活率为96.9%,2个组ECMO应用率、ECMO相关死亡率以及受者1年存活率的差异均有统计学意义(P<0.05).结论 术前血NT-proBNP水平较高(>5000 nmol/L)者围手术期ECMO应用率和1年死亡率均较高;术前测定血NT-proBNP水平有助于心脏移植时机的把握.%Objective To assess the correlation between pre-operative N-terminal-pro-brain natriuretic levels and early survival rate among heart transplantion (HT) recipients in a single Chinese center.Methods According to the pre-operative NT-proBNP level of 284 HT recipients,the recipients were divided into two distinctive groups,≤5000 nmol/L group (237 cases) and >5000 nmol/L group (47 cases).The baseline characteristics and mortality for recipients with different primary cardiac diseases and on extracorporeal membrane oxygenation (ECMO) support were compared.Kaplan Meier method was used to calculate the 1-year survival rate of the two groups.Results The pre-operative NT-proBNP >5000 nmol/L group

  6. Clinical Significance of N-terminal pro-BNP for Patients With Community -acquired Pneumonia of Different PCT Levels%氮末端脑钠肽前体在不同降钙素原水平社区获得性肺炎患者中的临床意义研究

    Institute of Scientific and Technical Information of China (English)

    张帅; 张虹霞; 林蕊艳; 韩芳; 张淑明; 胥振阳

    2015-01-01

    Objective To investigate the clinical significance of N-terminal pro-BNP( NT-proBNP)for patients with community-acquired pneumonia( CAP)of different PCT levels. Methods We enrolled 287 CAP patients who received hospitalized treatment in Beijing Luhe Hospital Affiliated to Captial Medical University from January 2012 to December 2013. According to serum PCT level,the subjects were divided into four groups:group A(PCT0. 50μg/L,n=47). The general clinical data and each laboratory examination indicator were analyzed and compared among the four groups,and the correlation between NT-proBNP and inflammatory markers,TNI and PSI was analyzed. Results (1) The four groups were significantly different(P0. 05)in chronic obstructive pulmonary disease,asthma,hypertension,coronary heart disease, atrial fibrillation and cerebrovascular diseases in complications. (2)The four groups were significantly different(P0. 05)in systolic pressure,diastolic pressure,TNI and PCO2. (3) Group A was significantly different(P0. 25 μg/L as the cutoff point,the Spearman correlation analysis was further conducted,and the results showed that NT-proBNP was positively correlated with PCT in patients with bacterial infection(rs =0. 40,P=0. 00). Conclusion The exacerbation of bacterial infection could lead to the increase of NT-proBNP level in patients, which may be mediated by bacterial endotoxin through inflammatory medium. NT-proBNP can be used as an indicator of disease severity degree and prognosis of CAP patients.%目的:了解氮末端脑钠肽前体( NT-proBNP)在不同降钙素原( PCT)水平社区获得性肺炎( CAP)患者中的临床意义。方法选取2012年1月—2013年12月,在首都医科大学附属北京潞河医院接受住院治疗的CAP患者287例。根据PCT水平,将其分为A(PCT0.50μg/L,n=47)4组。比较并分析4组患者一般临床资料和各项实验室检测指标,分析NT-proBNP与炎性标志物、全血肌钙蛋白I( TNI

  7. Association of menopause age and N-terminal pro brain natriuretic peptide: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Ebong, Imo A; Watson, Karol E; Goff, David C; Bluemke, David A; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G

    2015-05-01

    Menopause age can affect the risk of developing cardiovascular disease (CVD). The purpose of this study was to investigate the associations of early menopause (menopause occurring before age 45 y) and menopause age with N-terminal pro brain natriuretic peptide (NT-proBNP), a potential risk marker of CVD and heart failure. Our cross-sectional study included 2,275 postmenopausal women, aged 45 to 85 years and without clinical CVD (2000-2002), from the Multi-Ethnic Study of Atherosclerosis. Participants were classified as having or not having early menopause. NT-proBNP was log-transformed. Multivariable linear regression was used for analysis. Five hundred sixty-one women had early menopause. The median (25th-75th percentiles) NT-proBNP value was 79.0 (41.1-151.6) pg/mL for all participants, 83.4 (41.4-164.9) pg/mL for women with early menopause, and 78.0 (40.8-148.3) pg/mL for women without early menopause. The mean (SD) age was 65 (10.1) and 65 (8.9) years for women with and without early menopause, respectively. No significant interactions between menopause age and ethnicity were observed. In multivariable analysis, early menopause was associated with a 10.7% increase in NT-proBNP levels, whereas each 1-year increase in menopause age was associated with a 0.7% decrease in NT-proBNP levels. Early menopause is associated with greater NT-proBNP levels, whereas each 1-year increase in menopause age is associated with lower NT-proBNP levels, in postmenopausal women.

  8. Association of Atrial Fibrillation and Amino-terminal Pro-brain Natriuretic Peptide Concentrations in Patients After Off-Pump Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    Junquan Li; Qinghua Zhang; Weichen Tian; Hongyu Liu

    2008-01-01

    Objectives To investigate the possible role of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in the occurrence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG).Methods This study group included 70 consecutive patients scheduled for elective off-pump CABG.The patients with ejection fraction (EF) less than 0.30,history of AF,use of class Ⅰor Ⅲ antiarrhythmic drug,implanted pacemaker,postoperative myocardial infarction or chest reopening for pericardial tamponade were excluded.Preoperative and postoperative serum NT-proBNP levels were measured by radioimmunoassay technique.Results Postoperative AF occurred in 15 patients (21.4%);these patients had significantly higher median NT-proBNP levels when compared with those without AF after the operation (P<0.01).Using multivariate logistic regression analyses,an increase in NT-proBNP level after CABG was found to be independently associated with AF (OR=3.78,95% IC=1.81~4.89,P<0.01 ).Increased age,diabetes mellitus,preoperative use of β-blocker,proximal right coronary artery involvement,and longer operation time were also associated with AF.Conclusions These results indicated that AF was associated with higher NT-proBNP concentrations after off pump CABG;the increase in NT-proBNP after CABG may play an important role in the occurrence of AF after the operation.The further studies are needed to define the reason that lead to higher NT-proBNP concentrations among the patients who present AF after off pump CABG.

  9. Serum pregnancy-associated plasma protein A correlates with inflammation and malnutrition in patients treated with maintenance hemodialysis.

    Science.gov (United States)

    Mazur-Laskowska, Małgorzata; Bała-Błądzińska, Agnieszka; Zegartowska, Paulina; Dumnicka, Paulina; Ząbek-Adamska, Anna; Kapusta, Maria; Maleszka, Aleksandra; Maziarz, Barbara; Kuźniewski, Marek; Kuśnierz-Cabala, Beata

    2015-01-01

    Advanced chronic kidney disease (CKD) leads to complications such as anemia, electrolyte abnormalities, bone and mineral disorder, and malnutrition-inflammation-atherosclerosis (MIA) syndrome, that result in high cardiovascu- lar mortality. One of the biomarkers associated with inflammation and cardiovascular events is pregnancy-associated plasma protein A (PAPP-A). The aim of the study was to measure serum PAPP-A in hemodialyzed CKD patients, and to investigate its correlations with the laboratory markers of the complications. We enrolled 78 consecutive stable adult CKD patients treated with maintenance hemodialysis for median period of 60 months. PAPP-A concentrations were measured with by electrochemiluminescence immunoassay. Average serum PAPP-A in hemodialyzed patients was almost two times higher than the upper reference limit. It positively correlated with N-terminal pro-brain natriuretic peptide (NT-proBNP), serum sodium, and the markers of inflammation and malnutrition. In conclusion, serum PAPP-A seems a useful biomarker associated with cardiovascular dysfunction, inflammatory state and malnutrition in hemodialysis patients.

  10. Incremental value of natriuretic peptide measurement in acute decompensated heart failure (ADHF): a systematic review.

    Science.gov (United States)

    Santaguida, Pasqualina L; Don-Wauchope, Andrew C; Ali, Usman; Oremus, Mark; Brown, Judy A; Bustamam, Amy; Hill, Stephen A; Booth, Ronald A; Sohel, Nazmul; McKelvie, Robert; Balion, Cynthia; Raina, Parminder

    2014-08-01

    The aim of this systematic review was to determine whether B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) independently add incremental value for predicting mortality and morbidity in patients with acute decompensated heart failure (ADHF). Medline(®), Embase™, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL were searched from 1989 to June 2012. We also searched reference lists of included articles, systematic reviews, and the gray literature. Studies were screened for eligibility criteria and assessed for risk of bias. Data were extracted on study design, population demographics, assay cutpoints, prognostic risk prediction model covariates, statistical methods, outcomes, and results. From 183 citations, only seven studies (5 BNP and 2 NT-proBNP) considered incremental value in ADHF subjects admitted to acute care centers. Admission assay levels and length of follow-up varied for BNP studies (31 days to 12 months) and for NT-proBNP studies (25-82 months). All studies presented at least one estimate of incremental value of BNP/NT-proBNP relative to the base prognostic model. Using discrimination or likelihood statistics, these studies consistently showed that BNP or NT-proBNP increased model performance. Three studies used reclassification and model validation computations to establish incremental value; these studies showed less consistency with respect to added value. In conclusion, the literature assessing incremental value of BNP/NT-proBNP in ADHF populations is limited to seven studies evaluating only mortality outcomes and at moderate risk of bias. Although there were differences in the base risk prediction models, assay cutpoints, and lengths of follow-up, there was consistency in BNP/NT-proBNP adding incremental value in prediction models in ADHF patients.

  11. Genetic Variation in the Natriuretic Peptide System, Circulating Natriuretic Peptide Levels, and Blood Pressure

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen L; Nielsen, Søren J; Torp-Pedersen, Christian;

    2012-01-01

    BackgroundIn a large collaborative study (n > 50,000), common variants in the natriuretic peptide (NP) genes were found to be associated with circulating NP levels and also with blood pressure (BP) levels based on office BP measurements (OBPMs). It is unknown if determining an individual's BP by ...... evidence that the NP system plays an important role in BP regulation.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.96.......-h ambulatory BP measurements (ABPMs) will influence the effect of NP gene variations on BP levels.MethodsWe used rs632793 at the NPPB (NP precursor B) locus to investigate the relationship between genetically determined serum N-terminal pro-brain NP (NT-proBNP) concentrations and BP levels......). Office BP decreased across the genotypes from A:A to G:G, but the differences did not reach statistical significance (P = 0.12).ConclusionsThis study suggests that 24-h ABPMs is a better method than OBPMs to detect significant differences in BP levels related to genetic variance and provides further...

  12. Associations of monocyte miRNA levels with different kinds of heart failure

    Institute of Scientific and Technical Information of China (English)

    ZENG FAN-fang; WANG Li-li; LONG Juan; JI Jun; YI Wen-ya; LUO Ying

    2016-01-01

    Background Although miRNAs have been shown to associate with a variety of diseases,whether miRNAs in monocyte associate heart failure (HF) has been not well studied.Methods Eight patients with ischemic HF (IHF),8 patients with non-ischemic HF (NIHF) and 8 healthy volunteers were recruited.Clinical characteristics of all participants were collected.Peripheral blood samples were drawn for analysis of miRNA expression in monocytes.Results All participants were male and the participants in IHF group were older and had higher percentage of smoker and diabetes mellitus than in the other two groups (P < 0.05).Serum levels of creatinine and NT-proBNP were significantly higher in IHF patients compared to the other two groups (P < 0.05).More participants in IHF group were treated with ACEI/ARB,beta-blocker and statins.Participants with NYHA grade Ⅲ accounted for 62.5% in IHF group,while participants with NYHA grade Ⅳ accounted for 87.5% in NIHF group.The levels of 11 miRNAs in monocytes were significantly higher in the IHF group,and the levels of 7 miRNAs were significantly increased in the NIHF group.Other differences in miRNAs levels between IHF and NIHF groups were also observed.Conclusion our present study revealed that there are substantial differences in miRNAs between HF patients and healthy volunteer.

  13. N末端脑钠肽和大内皮素-1对心衰的预后价值%Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide and Big Endothelin-1 in Patients with Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    汪隆海; 陈启松; 夏芳; 张平; 何海军

    2011-01-01

    Objective This study was prospectively desigued to investigate the prognostic factors for chronic heart failure and the prognostic ability of N-terminal pro-brain natriuretic peptide (NT-proBNP) and big endothelin-l (Big ET-1) in patients with chronic heart failure. Methods To study 143 consecutive patients hospitalized for chronic heart failure. Serum concentration of NT-proBNP,cTnI,CKMB and plasma Big ET-1 as well as left ventricular ejection fraction (LVEF) and NYHA class I to IV on admission were measured. Cardiac events were found by patients to discharge after 360~480 days, prospectively. Results During a median follow-up period of 380 days,the endpoint of recurrence for cardiac events was reached in 57 patients with 143 heart failure. Patients with endpoint events were older (82 vs 52,P = 0. 000),in a higher functional class (3 vs l,P=0. 000),had higher levels of NT-proBNP (3 802 pmol/L vs 891 pmol/L,P=0. 000) and Big ET-1 (5.13 pmol/L vs 3. 53 pmol/L,P = 0. 000) compared with those without endpoint events. On a Cox proportional hazards regression models analyses, age NT-proBNP and Big ET-1 were found to be the independent predictors of cardiac events. Risk ratio (RR) were 1.175,3. 987 and 2. 691,respectively. Logistic regression models analyses,NT-proBNP and Big ET-1 were found independent predictors of death. Odd ratio (OR) were 2.515 and 1. 978,respectively. Conclusion Measurement of NT-proBNP and Big ET-1 in patients with chronic heart failure could help to identify patients at higher risk for cardiac events and patients for prognosis.%目的 通过对心衰患者的随访研究,探讨N末端脑钠肽(NT-proBNP)和大内皮素-1(Big ET-1)对心衰患者的预后价值.方法 研究143例心衰住院患者,检测入院时NT-proBNP,Big ET-1,肌钙蛋白I,CK-MB和左室射血分数以及NYHA分级.并随访观察患者出院后360~480 d的心血管事件再发生情况.结果 143例心衰患者的中位随访380 d,发生心脏事件57例.发生与未发生

  14. Inter- Not Intraindividual Differences in sTWEAK Levels Predict Functional Deterioration and Mortality in Patients with Dilated Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Kai-Uwe Jarr

    2014-01-01

    Full Text Available Background. TNF-like weak inducer of apoptosis (TWEAK has been reported to predict mortality in patients with dilated cardiomyopathy. However, whether it can be used as a biomarker for disease monitoring or rather represents a risk factor for disease progression remains unclear. Aim of the Study. To evaluate the potential of sTWEAK as a biomarker in patients with dilated cardiomyopathy. Results. We conducted a serial study of sTWEAK levels in 78 patients with dilated cardiomyopathy. Soluble TWEAK levels predicted not only a combined mortality/heart transplantation endpoint after 4 years (P=0.0001, but also the risk for clinical deterioration (P=0.0001. Compared to NT-proBNP, sTWEAK remained relatively stable in individual patients on follow-up indicating that inter- rather than intraindividual differences in sTWEAK levels predicted outcome. Finally, neither did the scavenger receptor sCD163 correlate with sTWEAK levels nor did its determination add additional information on outcome in patients with dilated cardiomyopathy. Conclusion. Soluble TWEAK levels in patients with dilated cardiomyopathy may not be of value for disease monitoring but may represent a risk factor for disease progression and death. Further research will be necessary to elucidate the exact role of sTWEAK as a potential modulator of immune response in the setting of dilated cardiomyopathy.

  15. INTENSE PHYSICAL EXERCISE RELATED TO THE EMERGENT GENERATION OF CARDIOVASCULAR RISK MARKERS: A REVIEW

    Directory of Open Access Journals (Sweden)

    Caroline Le Goff

    2012-01-01

    Full Text Available Objective: The present review was performed in order to bring together the current knowledge about the impact of intense physical exercise on cardiovascular function, especially on plasma levels of cardiovascular risk markers such as cardiac troponin T (cTnT, myeloperoxidase (MPO, amino-terminal pro-brain natriuretic peptide (NT-proBNP, C-reactive protein (CRP and oxidized low-density lipoprotein (oxLDL. Methods: Data were collected using the PubMed database. The articles were chosen for their relevance and importance in the area of interest. Results: The literature describes numerous examples where physical exercise induces plasma variation for the markers studied. Intense physical effort increases the levels of cTnT, MPO and NT proBNP, whereas CRP and oxLDL levels tend to be decreased with regular sport activities. Conclusions: The present literature investigation confirms the fact that intense physical exercise has an impact on the plasma variations of the five cardiovascular risk markers studied. However, practising regular exercise remains one of the first strategies for the prevention of cardiovascular disorders.

  16. Investigation of the relationship between the fragmented QRS and N-terminal pro-B-type natri-uretic peptide%碎裂QRS波与N末端B型利钠肽原相关性的探讨

    Institute of Scientific and Technical Information of China (English)

    曹木根; 章文杰; 林平; 郑炜平

    2015-01-01

    Objective To investigate the relationship between the fragmented QRS complex (fQRS)and N-terminalpro-B-type natriuretic peptide (NT-proBNP).Methods One hundred and two patients with fQRS were selected,and ninety eight patients with no fQRS and no ventricular block were selected as the control group,to compare the difference in NT-proBNP level between the two groups.Based on the occurrence of fQRS lead,the observation group was divided into three subgroups:1)limb lead,2)chest lead,and 3)chest lead and limb lead.By comparing the differ-ences in NT-proBNP level among the subgroups,Spearman correlation analysis was conducted. Results NT-proBNP levels were significantly higher in the fQRS group,compared to the control group (P patients with fQRS are higher than those normal person and the distribution range of fQRS lead and NT-proBNP level are positively correlated.It has certain clinical value for the diagnosis and progno-sis of patients with chronic heart failure.%目的:探讨碎裂 QRS 波(fragmented QRS,fQRS)与血浆 N 末端 B 型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)之间的关系。方法选取体表心电图有fQRS 患者共102例,同时选取同期无 fQRS、无室内阻滞患者98例作为对照组,比较两组患者NT-proBNP 的差异。根据出现 fQRS 导联将观察组分为肢体导联组、胸导联组和肢体导联+胸导联组三个亚组,比较各个亚组之间的 NT-proBNP 水平差异,并对三个亚组之间的 NT-proBNP 水平进行 Spearman 相关性分析。结果与对照组相比,fQRS 组 NT-proBNP 水平增高(P <0.01);与肢导联组相比,胸导联组、肢导联+胸导联组 NT-proBNP 水平均增高(P <0.01);与胸导联组相比,肢导联+胸导联组 NT-proBNP 水平进一步增高(P <0.01);三组之间的 NT-proBNP 值存在正相关。结论fQRS 患者的 NT-proBNP 水平高于正常人,且 fQRS 导联分布范围和 NT-pro

  17. The role of n terminal - probrain natriuretic peptide in the diagnosis of hemodynamic persistent asrteriosus ductus in premature neonates patient

    Science.gov (United States)

    Dasraf, D.; Djer, M. M.; Advani, N.

    2017-08-01

    Persistent ductus arteriosus is one of the most frequent congenital heart diseases found in infants, mainly in preterms. Echocardiography is the gold standard for the diagnosis of hemodynamically significant patent ductus arteriosus (hs-PDA) in preterm neonates. A few studies have suggested that the use of a simple blood assay to detect N-terminal pro-brain natriuretic peptide (NT-proBNP) may be useful in determining the diagnosis and management of hs-PDA. No such studies have been conducted in Indonesia, although the assay kit and characteristics of the patient (gestational age and chronological age) influence the accuracy of NT-proBNP levels in determining hs-PDA. The aim of this study was to determine the association between the NT-proBNP level and the prevalence of hs-PDA in an Indonesian patient population. A cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital. PDA was determined using echocardiography in 49 preterm neonates (gestational age <37 weeks and birthweight <2000 g). Subsequently, these patients were divided into three groups: non-PDA, non-hsPDA, and hs-PDA. The blood NT-proBNP level was then determined in the non-hsPDA and hs-PDA groups, and between-group differences were compared. Among the 49 neonates, 33 patients had PDA, and 16 of these had hs-PDA. The results revealed a significant association between the NT-proBNP level and hs-PDA (p < 0.001).

  18. Brain-natriuretic peptide and cyclic guanosine monophosphate as biomarkers of myxomatous mitral valve disease in dogs

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Falk, Bo Torkel; Teerlink, Tom

    2011-01-01

    Elevations in the plasma concentrations of natriuretic peptides correlate with increased severity of myxomatous mitral valve disease (MMVD) in dogs. This study correlates the severity of MMVD with the plasma concentrations of the biomarkers N-terminal fragment of the pro-brain-natriuretic peptide...... (NT-proBNP) and its second messenger, cyclic guanosine monophosphate (cGMP). Furthermore, the l-arginine:asymmetric dimethylarginine (ADMA) ratio was measured as an index of nitric oxide availability. The study included 75 dogs sub-divided into five groups based on severity of MMVD as assessed...... by clinical examination and echocardiography. Plasma NT-proBNP and cGMP concentrations increased with increasing valve dysfunction and were significantly elevated in dogs with heart failure. The cGMP:NT-proBNP ratio decreased significantly in dogs with heart failure, suggesting the development of natriuretic...

  19. Markers of Myocardial Ischemia in Patients with Obstructive Sleep Apnea and Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Misa Valo

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by intermittent hypoxia during sleep. We tested the hypothesis that nocturnal myocardial ischemia is detectable by ST segment depression and elevation of high sensitive troponin T (hsTrop T and B-type natriuretic peptide (NT-proBNP in patients with OSA and coexisting coronary artery disease (CAD. Twenty-one patients with OSA and CAD and 20 patients with OSA alone underwent in-hospital polysomnography. Blood samples for hsTrop T and NT-proBNP measurements were drawn before and after sleep. ST segment depression was measured at the time of maximum oxygen desaturation during sleep. The apnea-hypopnea-index (AHI, oxygen saturation nadir, and time in bed with oxygen saturation of ≤80% were similar in both groups. Levels of hsTrop T and NT-proBNP did not differ significantly before and after sleep but NT-proBNP levels were significantly higher in patients suffering from OSA and CAD compared to patients with OSA alone. No significant ST depression was found at the time of oxygen saturation nadir in either group. Despite the fact that patients with untreated OSA and coexisting CAD experienced severe nocturnal hypoxemia, we were unable to detect myocardial ischemia or myocyte necrosis based on significant ST segment depression or elevation of hsTrop T and NT-proBNP, respectively.

  20. 慢性心功能不全患者血浆Chemerin变化及临床意义%Increased Circulating Level of Chemerin in Patients with Chronic Systolic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    杨崇哲; 刘丰; 王妍; 尚丹丹; 谭文亮

    2013-01-01

    Objective:To compare plasma Chemerin levels in patients with chronic heart failure(CHF) and in control subjects,and assesse the association of plasma Chemerin with body composition and metabolic parameters in these subjects.Methods:Serum Chemerin and Tumor Necrosis Factor-α(TNF-α) levels were measured by ELISA in 52 patients with CHF and in 52 age,tender,diabetes-history matched controls with cardiovascular disease but normal heart function, and in 26 healthy volunteers.Furthermore,the association between chemerin and NT-proBNP,TNF-α as well as metabolism markers were studied. Results:Plasma Chemerin levels were found to be markedly increased in patients with CHF as compared with patients without CHF and normal controls(P<0.001). Multiple regression analysis showed that TG(r=0.270,P=0.021),body mass index(r=0.250,P=0.029),HOMA-IR(r=0.319,P=0.005) and TNF-α(r=0.348, P=0.003) were independently related factors influencing plasma Chemerin levels.Conclusion:The present work indicates the potential role of Chemerin in the pathogenesis of chronic heart failure through the immune response.%  目的:探讨慢性心功能不全患者血清脂肪因子Chemerin的变化及其临床意义。方法:52例慢性左心功能不全(射血分数EF<45%)患者,以年龄、性别和有无糖尿病史1∶1匹配选取心功能正常患者作为非心衰对照组,26例健康人群为正常对照组,检测体质指数、NT-proBNP等临床及生化指标,ELISA方法检测血浆Chemerin和肿瘤坏死因子α(TNF-α)水平,进行对比研究。结果:心衰患者血浆Chemerin水平较非心衰患者(P<0.001)及正常对照组(P<0.001)明显升高,且随心衰加重而明显升高,多元回归分析显示甘油三酯(r=0.270,P=0.021)、HOMA-IR(r=0.319,P=0.005)、体质指数(r=0.250,P=0.029)、肿瘤坏死因子-α(r=0.348,P=0.003)是影响Chemerin水平的相关因素。结论:Chemerin不仅参与肥胖和代谢综合征的内分泌调节,亦通过

  1. Sildenafil reduces signs of oxidative stress in pulmonary arterial hypertension: Evaluation by fatty acid composition, level of hydroxynonenal and heart rate variability

    Directory of Open Access Journals (Sweden)

    Khrystyna Semen

    2016-04-01

    Full Text Available Pulmonary arterial hypertension (PAH is a rare multifactorial disease with an unfavorable prognosis. Sildenafil therapy can improve functional capacity and pulmonary hemodynamics in PAH patients. Nowadays, it is increasingly recognized that the effects of sildenafil are pleiotropic and may also involve changes of the pro-/antioxidant balance, lipid peroxidation and autonomic control. In present study we aimed to assess the effects of sildenafil on the fatty acids (FAs status, level of hydroxynonenal (HNE and heart rate variability (HRV in PAH patients. Patients with PAH were characterized by an increase in HNE and changes in the FAs composition with elevation of linoleic, oleic, docosahexanoic acids in phospholipids as well as reduced HRV with sympathetic predominance. Sildenafil therapy improved exercise capacity and pulmonary hemodynamics and reduced NT-proBNP level in PAH. Antioxidant and anti-inflammatory effects of sildenafil were noted from the significant lowering of HNE level and reduction of the phopholipid derived oleic, linoleic, docosahexanoic, docosapentanoic FAs. That was also associated with some improvement of HRV on account of the activation of the neurohumoral regulatory component. Incomplete recovery of the functional metabolic disorders in PAH patients may be assumed from the persistent increase in free FAs, reduced HRV with the sympathetic predominance in the spectral structure after treatment comparing to control group. The possibilities to improve PAH treatment efficacy through mild stimulation of free radical reactions and formation of hormetic reaction in the context of improved NO signaling are discussed.

  2. The association of a panel of biomarkers with the presence and severity of carcinoid heart disease: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Rebecca Dobson

    Full Text Available PURPOSE: Metastatic neuroendocrine tumors secrete serotonin and other vasoactive substances that are responsible for carcinoid syndrome and carcinoid heart disease. We sought to evaluate the discriminatory utility of diagnostic biomarkers in determining the presence and severity of carcinoid heart disease in patients with metastatic neuroendocrine tumors. PATIENTS AND METHODS: A cross-sectional study of patients with neuroendocrine tumors with documented liver metastases and/or carcinoid syndrome between April 2009-October 2012 in 5 tertiary referral centers. Serum was analyzed for Chromogranin A, Chromogranin B and N-terminal pro Brain Natriuretic Peptide (NT-proBNP. Plasma was analyzed for Neurokinin A and 5-Hydroxyindoleacetic acid (5HIAA. Echocardiography was used to determine the presence and severity of carcinoid heart disease. Non-parametric receiver operating characteristic curves were constructed for biomarkers, and the area under the curve determined. The severity of cardiac involvement was correlated with the concentration of each biomarker. RESULTS: A total of 187 patients were identified of whom 37 (20% had carcinoid heart disease. Significantly higher median values of all biomarkers were found in the patients with cardiac involvement. NT-proBNP and plasma 5HIAA had the highest areas under the curve for the prediction of carcinoid heart disease [NT-proBNP 0.82 (95% confidence interval 0.74-0.90, p<0.0001 and 5HIAA 0.85 (95% confidence interval 0.78-0.92, p<0.0001]. NT-proBNP was moderately correlated (r = 0.48, p<0.001 whereas plasma 5HIAA was only weakly correlated (r = 0.34, p<0.001 with the echocardiographic severity score. CONCLUSION: NT-proBNP and plasma 5HIAA are both sensitive and specific biomarkers for the presence of carcinoid heart disease whereas only NT-proBNP is moderately correlated with disease severity.

  3. Novel biomarkers in acute heart failure: MR-pro-adrenomedullin.

    Science.gov (United States)

    Peacock, W Frank

    2014-10-01

    First isolated from human pheochromocytoma cells, adrenomedullin (ADM) is a peptide hormone with natriuretic, vasodilatory, and hypotensive effects mediated by cyclic adenosine monophosphate (cAMP), nitric oxide, and renal prostaglandin systems. ADM expression occurs in many tissues and organ systems, including cardiovascular, renal, pulmonary, cerebrovascular, gastrointestinal, and endocrine tissues where it acts as a circulating hormone and a local autocrine and paracrine hormone. ADM plasma concentrations are increased in hypertension, chronic renal disease, and heart failure. As ADM is unstable in vitro, it is necessary to measure its mid-regional pro-hormone fragment, the levels of which correspond to ADM concentration (MR-proADM). The prognostic potential of MR-proADM was recently demonstrated in the Biomarkers in Acute Heart Failure (BACH) trial. In this trial of 568 acute heart failure patients, MR-proADM was superior to both brain natriuretic peptide (BNP) and NT-proBNP in predicting mortality within 14 days. MR-proADM also provided significant additive incremental predictive value for 90-day mortality when added to BNP and NT-proBNP.

  4. Effect of eplerenone on parathyroid hormone levels in patients with primary hyperparathyroidism: a randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Tomaschitz Andreas

    2012-09-01

    Full Text Available Abstract Background Increasing evidence suggests the bidirectional interplay between parathyroid hormone and aldosterone as an important mechanism behind the increased risk of cardiovascular damage and bone disease observed in primary hyperparathyroidism. Our primary object is to assess the efficacy of the mineralocorticoid receptor-blocker eplerenone to reduce parathyroid hormone secretion in patients with parathyroid hormone excess. Methods/design Overall, 110 adult male and female patients with primary hyperparathyroidism will be randomly assigned to eplerenone (25 mg once daily for 4 weeks and 4 weeks with 50 mg once daily after dose titration] or placebo, over eight weeks. Each participant will undergo detailed clinical assessment, including anthropometric evaluation, 24-h ambulatory arterial blood pressure monitoring, echocardiography, kidney function and detailed laboratory determination of biomarkers of bone metabolism and cardiovascular disease. The study comprises the following exploratory endpoints: mean change from baseline to week eight in (1 parathyroid hormone(1–84 as the primary endpoint and (2 24-h systolic and diastolic ambulatory blood pressure levels, NT-pro-BNP, biomarkers of bone metabolism, 24-h urinary protein/albumin excretion and echocardiographic parameters reflecting systolic and diastolic function as well as cardiac dimensions, as secondary endpoints. Discussion In view of the reciprocal interaction between aldosterone and parathyroid hormone and the potentially ensuing target organ damage, the EPATH trial is designed to determine whether eplerenone, compared to placebo, will effectively impact on parathyroid hormone secretion and improve cardiovascular, renal and bone health in patients with primary hyperparathyroidism. Trial registration ISRCTN33941607

  5. Energy expenditure in myocardium of patients with myocardial infarction at different periods and its significance%心肌梗死不同时期患者心肌能量消耗变化及意义

    Institute of Scientific and Technical Information of China (English)

    梁健球; 白书昌; 李琛; 许顶立

    2013-01-01

    目的 探讨多普勒超声指标心肌能量消耗(MEE)在心肌梗死不同时期患者中的变化及临床意义.方法 选取确诊为心肌梗死、且无心力衰竭的患者51例,按诊断分为急性心肌梗死(AMI)组28例,陈旧性心肌梗死(OMI)组23例;选取同期行冠状动脉造影正常的30例作为正常对照(NOR)组.采用多普勒超声技术检测,计算左心室收缩末周向室壁应力(cESS)及MEE;检测血浆N末端前体B型钠尿肽(NT-proBNP);并行相关性分析.结果 与NOR组比较,AMI组和OMI组的cESS、MEE及lgNT proBNP明显升高,且AMI组较OMI组升高更明显(P<0.05).MEE与lgNT-proBNP呈正相关(r=0.605,P=0.0001),与左心室缩短分数和LVEF呈负相关(r=-0.393,-0.376,P=0.0001).结论 MEE能有效地评估不同时期心肌梗患者的心功能状态.%Objective To study the energy expenditure in myocardium of patients with myocardial infarction at different periods and its clinical significance.Methods Fifty-five patients with myocardial infarction but without heart failure were divided into acute myocardial infarction (AMI)group (n=28) and old myocardial infarction (OMI) group (n=23).Thirty patients with normal coronary angiography served as a normal control group.Their circumferential end-systolic wall stress (cESS) and energy expenditure in myocardium were detected by Doppler ultrasonography and their plasma NT-proBNP level was measured.Correlation of cESS and energy expenditure in myocardium with plasma NT-proBNP level was analyzed.Results The cESS,energy expenditure in myocardium and plasma NT-proBNP level were significantly higher in AMI group and OMI group than in normal control group and in AMI group than in OMI group (P<0.05).The energy expenditure in myocardium was positively related with the plasma NT-proBNP level (r=0.605,P=0.0001) and negatively related with the LVFS and LVEF (r=-0.393,-0.376,P =0.000 1).Conclusion Energy expenditure in myocardium can effectively assess the heart function

  6. 老年高血压性肥厚型心肌病和高血压左心室肥厚患者的比较研究%Comparative Study for the Patients of Hypertensive Hypertrophic Cardiomyopathy in Elder age and the Patients of Hypertensive Left Ventricular Hypertrophy

    Institute of Scientific and Technical Information of China (English)

    华潞; 杜海燕; 牛云枫; 王志民; 陶永康; 闫丽荣; 樊朝美; 李一石

    2014-01-01

    Objective: To compare the clinical characteristics and plasma level of N-terminal pro-brain natriuretic peptide (NT-proBNP) between the patients with hypertensive hypertrophic cardiomyopathy in elder age (HHCME) and the patients with hypertensive left ventricular hypertrophy (HTN-LVH). Methods: Our work included 2 groups, HHCME group,n=47 and HTN-LVH group,n=44. Duplex Doppler echocardiography was performed to determine left atrial diameter (LAd), left ventricular end-diastolic dimension (LVEDd), interventricular septal thickness (IVST), left ventricular ejection fraction (LVEF), velocity of early diastolic period (VE) and velocity of end-diastolic period (VA) in mitral valve oriifce. Plasma level of NT-proBNP was measured by ELISA. The above indexes were compared between 2 groups. Results:①Compared with HTN-LVH group, HHCME group presented decreased LVEDd and increased IVST, LVEF, allP0.05.②Plasma level of NT-proBNP was higher in HHCME group,P Conclusion: The plasma NT-proBNP level was higher in HHCME patients than that in HTN-LVH patients which indicated that HHCME patients may have worse prognosis. NT-proBNP might be helpful for differencing HHCME.%目的:比较研究老年高血压性肥厚型心肌病(HHCME)和高血压性左心室肥厚(HTN-LVH)患者的临床特点和血浆N末端B型利钠肽原(NT-proBNP)水平。  方法:入选HHCME患者47例为HHCME组, HTN-LVH患者44例为HTN-LVH组。以二维及多普勒超声心动图分别测定两组患者左心房内径(LAd)、左心室舒张末期内径(LVEDd)、室间隔厚度(IVST),左心室射血分数(LVEF),舒张期二尖瓣口E波流速(VE)及A波流速(VA)等。用酶联免疫吸附法测定患者血浆NT-proBNP浓度。  结果:①HHCME组患者与HTN-LVH组患者比较,左心室舒张末期内径明显缩小(P0.05)。两组患者左心房内径差异无统计学意义(P>0.05);②NT-proBNP水平在HHCME组

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

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens; Kjær, Andreas;

    2010-01-01

    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......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...... 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...

  8. Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nilsson, Jens C; Groenning, Bjoern A; Nielsen, Gitte

    2002-01-01

    in compliance with daily clinical practice is unknown. The purpose of this study was to clarify this issue and to evaluate the predictive value of N-terminal pro brain natriuretic peptide (NT-proBNP). METHODS: Forty-two patients with a first transmural MI were examined after 1 week, 1 month, 3 months, 6 months......), whereas the remaining 18 patients (43%) had stable conditions regarding these LV measures. LV ejection fraction at baseline was significantly reduced in all patient categories but was unchanged over time. Elevated NT-proBNP level at baseline was identified as an independent predictor of increase in LVEDVI...... during follow-up examination (P =.007). A baseline level of NT-proBNP >115 pmol/L identified patients who later had LV dilatation develop with a sensitivity and specificity of 89% and 68% (area under curve = 0.77). CONCLUSION: In this 1-year follow-up study of patients with a first transmural MI...

  9. High-sensitivity cardiac troponin T is associated with cognitive decline in older adults at high cardiovascular risk

    DEFF Research Database (Denmark)

    Wijsman, Liselotte W; de Craen, Anton JM; Trompet, Stella

    2016-01-01

    AIMS: Cardiac troponin T (cTnT), measured with a high-sensitivity (hs) assay, is associated with cognitive decline, but the underlying mechanism is unknown. We investigated the association of hs-cTnT with cognitive function and decline, and studied whether this association was independent....... Participants with pre-existent advanced clinical heart failure were excluded. Hs-cTnT and NT-proBNP obtained after 6 months of follow-up were related with cognitive function, tested repeatedly during a mean follow-up of 3.2 years. Participants with higher hs-cTnT performed worse at baseline on Stroop test...... diseases risk factors or Apolipoprotein E genotype. Further adjusting for NT-proBNP levels revealed the same results. CONCLUSIONS: Higher levels of hs-cTnT associate with worse cognitive function and steeper cognitive decline in older adults independent of cardiovascular diseases, risk factors and NT-proBNP....

  10. The prognostic value of N-terminal proB-type natriuretic peptide in patients with acute respiratory distress syndrome

    Science.gov (United States)

    Lai, Chih-Cheng; Sung, Mei-I.; Ho, Chung-Han; Liu, Hsiao-Hua; Chen, Chin-Ming; Chiang, Shyh-Ren; Chao, Chien-Ming; Liu, Wei-Lun; Hsing, Shu-Chen; Cheng, Kuo-Chen

    2017-01-01

    We investigated whether N-terminal proB-type natriuretic peptide (NT-proBNP) predicts the prognosis of patients with acute respiratory distress syndrome (ARDS). Between December 1, 2012, and May 31, 2015, this observational study recruited patients admitted to our tertiary medical center who met the Berlin criteria for ARDS and who had their NT-proBNP measured. The main outcome was 28-day mortality. We enrolled 61 patients who met the Berlin criteria for ARDS: 7 were classified as mild, 29 as moderate, and 25 as severe. The median APACHE II scores were 23 (interquartile range [IQR], 18–28), and SOFA scores were 11 (IQR, 8–13). The median lung injury score was 3.0 (IQR, 2.50–3.25), and the median level of NT-proBNP was 2011 pg/ml (IQR, 579–7216). Thirty-four patients died during this study, and the 28-day mortality rate was 55.7%. Patients who die were older and had significantly (all p < 0.05) higher APACHE II scores and NT-proBNP levels than did patients who survived. Multivariate analysis identified age (HR: 1.546, 95% CI: 1.174–2.035, p = 0.0019) and NT-proBNP (HR: 1.009, 95% CI: 1.004–1.013, p = 0.0001) as significant risk factors of death. NT-proBNP was associated with poor outcomes for patients with ARDS, and its level predicted mortality. PMID:28322314

  11. Associativity of subclinical thyroid dysfunction with serum NT-pro-brain natriuretic peptide%亚临床甲状腺功能异常与血清NT-pro-BNP水平相关性的研究

    Institute of Scientific and Technical Information of China (English)

    金丹玲; 许艳玲; 刘兆军

    2012-01-01

    目的:研究亚临床甲状腺功能异常患者血浆中NT-pro-BNP浓度的差异.方法:选取2002年至2010年亚临床甲状腺功能异常住院患者122例,年龄23~ 82岁.其中男性54例,女性68例.根据血清TSH水平分为:A组,亚临床甲减1组(TSH4.5~9.9 mU·L-1,n=26);B组,亚临床甲减2组(TSH≥10 mU·L-1,n =30);C组,亚临床甲亢1组(TSH 0.1 ~0.44 mU·L-1,n=24);D组,亚临床甲亢2组(TSH<0.1 mU·L-1,n =21);E组,甲状腺功能正常组(TSH 0.45 ~4.5 mU·L-1,n=21).测定每组患者血清NT-pro-BNP浓度.结果:D组血清NT-pro-BNP浓度较E组增高(95% CI:57.8477~ 168.5159,P<0.05),较C组显著增高(95% CI:11.5080~ 138.5656,P<0.05).A组和B组血清NT-pro-BNP浓度较E组无明显差异(P>0.05).受试者体质量指数、空腹血糖水平、左室质量指数与血浆NT-pro-BNP浓度没有相关性.结论:亚临床甲亢患者TSH <0.1 mU·L-1时,心力衰竭的发生风险明显增加.%Objective: To evaluate the serum NT- pro- brain natriuretic peptide ( NT- pro- BNP) in different subgroup of the subclinical thyroid dysfunction. Methods: 122 patients to be in hospital in the department of endocrinology and cardiology from the year 2002 to 2010, who, on the basis of plasma levels of TSH, were divided into subclinical hypothyroidism 1 group (TSH 4. 5-9. 9 mU·L-1 ,n =26) , subclinical hypothyroidism 2 group (TSH ≥ 10 mU · L-1, n = 30 ) , subclinical hyperthyroidism 1 group ( TSH 2s 0. 1 , < 0. 45 mU · L -1 , n = 24 ) , subclinical hyperthyroidism 2 group ( TSH < 0. 1 mU·L-1,n =21) , control subjects with normal thyroid profile TSH (0.45-4.5 mU·L-1 ,n =21) , to evaluate the serum NT-pro-BNP. Results: Compared to control subjects, subclinical hyperthyroidism were characterized by higher serum NT- pro- BNP, this increase was particularly pronounced in subclinical hyperthyroidism 2 ( TSH < 0. 1 mU · L -1 ) compared to subelinical hyperthyroidism 1 ( TSH ≥ 0. 1 , <0. 45 mU·L-1), serum NT-pro-BNP did not

  12. The REFER (REFer for EchocaRdiogram protocol: a prospective validation of a clinical decision rule, NT-proBNP, or their combination, in the diagnosis of heart failure in primary care. Rationale and design

    Directory of Open Access Journals (Sweden)

    Tait Lynda

    2012-10-01

    Full Text Available Abstract Background Heart failure is a major cause of mortality and morbidity. As mortality rates are high, it is important that patients seen by general practitioners with symptoms suggestive of heart failure are identified quickly and treated appropriately. Identifying patients with heart failure or deciding which patients need further tests is a challenge. All patients with suspected heart failure should be diagnosed using objective tests such as echocardiography, but it is expensive, often delayed, and limited by the significant skill shortage of trained echocardiographers. Alternative approaches for diagnosing heart failure are currently limited. Clinical decision tools that combine clinical signs, symptoms or patient characteristics are designed to be used to support clinical decision-making and validated according to strict methodological procedures. The REFER Study aims to determine the accuracy and cost-effectiveness of our previously derived novel, simple clinical decision rule, a natriuretic peptide assay, or their combination, in the triage for referral for echocardiography of symptomatic adult patients who present in general practice with symptoms suggestive of heart failure. Methods/design This is a prospective, Phase II observational, diagnostic validation study of a clinical decision rule, natriuretic peptides or their combination, for diagnosing heart failure in primary care. Consecutive adult primary care patients 55 years of age or over presenting to their general practitioner with a chief complaint of recent new onset shortness of breath, lethargy or peripheral ankle oedema of over 48 hours duration, with no obvious recurrent, acute or self-limiting cause will be enrolled. Our reference standard is based upon a three step expert specialist consensus using echocardiography and clinical variables and tests. Discussion Our clinical decision rule offers a potential solution to the diagnostic challenge of providing a timely and accurate diagnosis of heart failure in primary care. Study results will provide an evidence-base from which to develop heart failure care pathway recommendations and may be useful in standardising care. If demonstrated to be effective, the clinical decision rule will be of interest to researchers, policy makers and general practitioners worldwide. Trial registration ISRCTN17635379

  13. Utilidad de la determinación perioperatoria de troponina cardiaca, Proteína C Reactiva y de NT-proBNP para la predicción de complicaciones cardiovasculares perioperatorias en cirugía no cardiaca

    OpenAIRE

    Álvarez Zurro, Carlos

    2016-01-01

    Tesis Doctoral leída en la Universidad Rey Juan Carlos de Madrid en 2014. Directores de la Tesis: Dr. Juan Ignacio Gómez-Arnau Díaz-Cañabate y Dr. Antonio Planas Roca Farmacología, Nutrición y Bromatología

  14. CARDIOVASCULAR SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    6.1 Heart failure2003409 The diagnostic value of plasma Nt-proANP and Nt-proBNP in patients with congestive heart failure. HUANG Chenjun(黄陈军), et al. Dept Cardiol, PUMC Hosp, CAMS, Beijing 100730. Chin J Cardiol 2003; 31 (6) :405-407.

  15. The natriuretic peptide time-course in end-stage heart failure patients supported by left ventricular assist device implant: focus on NT-proCNP.

    Science.gov (United States)

    Cabiati, M; Caruso, R; Caselli, C; Frigerio, M; Prescimone, T; Parodi, O; Giannessi, D; Del Ry, S

    2012-08-01

    This study aimed to evaluate left ventricular assist device (LVAD) effects on natriuretic peptide (NP) prohormone plasma levels in end-stage heart failure (HF) patients, especially NT-proCNP, in order to better characterize the NP system during hemodynamic recovery by LVAD. HF patients (n=17, NYHA III-IV) undergoing LVAD were studied: 6 died of multi-organ failure syndrome (NS) and 11 survived (S). Total sequential organ failure assessment (t-SOFA) score and blood samples were obtained at admission (T1) and at 24, 72h and 1, 2, 4 weeks (T2-T6) after LVAD. In S, NT-proANP and NT-proCNP significantly increased at 24h after implantation, reaching a reduction to basal levels at 4 weeks following LVAD [NT-proANP: T1 vs. T2 p=0.017, NT-proCNP: T1 vs. T2 p=0.028, T1 vs. T3 p=0.043]. Elevated NT-proBNP plasma levels were observed at all times. In NS, NP plasma levels sustained higher with respect to S. No statistical variation was observed for NT-proCNP and NT-proANP in S and NS while NT-proBNP reached significant differences at T4 in NS. Considering S+NS, only NT-proCNP strongly correlated with t-SOFA score at T1 (rho=0.554, p=0.04) while subdividing patients NT-proCNP positively correlated in NS with t-SOFA score (rho=0.988, p=0.002) only at T4. In NS a correlation between NT-proCNP and NT-proBNP at T1 was observed (rho=-0.900, p=0.037). Both IL-6 and TNF-alpha sustained higher in NS patients than in S; in particular, statistical significance was observed for IL-6. The study of new peptides, such as NT-proCNP, would provide additional information for identifying patients who are more likely to recover. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Oral Levosimendan Increases Cerebral Blood Flow Velocities in Patients with a History of Stroke or Transient Ischemic Attack: A Pilot Safety Study

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    Matti Kivikko, MD, PhD

    2015-12-01

    Conclusions: Oral levosimendan increases cerebral blood flow velocities and diminishes NT-pro-BNP levels in patients with earlier ischemic cerebrovascular event. Daily doses up to 1.0 mg were well tolerated, whereas the 2.0 mg dose level induced an increase in ventricular extrasystoles. ClinicalTrials.gov identifier: NCT00698763.

  17. Association between cardiac biomarkers and the development of ESRD in patients with type 2 diabetes mellitus, anemia, and CKD

    DEFF Research Database (Denmark)

    Desai, Akshay S; Toto, Robert; Jarolim, Petr

    2011-01-01

    In patients with chronic kidney disease (CKD), as in other populations, elevations in cardiac biomarker levels predict increased risk of cardiovascular events. We examined the value of troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in assessing the risk of developing e...

  18. Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

    DEFF Research Database (Denmark)

    Fakhri, Yama; Schoos, Mikkel Malby; Sejersten-Ripa, Maria;

    2017-01-01

    BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acu...

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

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens Oscar; Kjær, Andreas;

    2010-01-01

    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...

  20. The prognostic value of plasma soluble ST2 in hospitalized Chinese patients with heart failure.

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    Rongcheng Zhang

    Full Text Available BACKGROUND: sST2 has been shown to be a risk predictor in heart failure (HF. Our aim was to explore the characteristics and prognostic value of soluble ST2 (sST2 in hospitalized Chinese patients with HF. METHODS AND RESULTS: We consecutively enrolled 1528 hospitalized patients with HF. Receiver operating characteristic (ROC and multivariable Cox proportional hazards analysis were used to assess the prognostic values of sST2. Adverse events were defined as all-cause death and cardiac transplantation. During a median follow-up of 19.1 months, 325 patients experienced adverse events. Compared with patients free of events, sST2 concentrations were significantly higher in patients with events (P55.6 ng/mL independently predicted events in comparison to the lowest quartile (≤25.2 ng/mL when adjusted by multivariable model. In ROC analysis, the area under the curve for sST2 was not different from that for NT-proBNP in short and longer term. Over time, sST2 also improved discrimination and reclassification of risk beyond NT-proBNP. CONCLUSIONS: sST2 is a strong independent risk predictor in Chinese patients hospitalized with HF and can significantly provide additional prognostic value to NT-proBNP in risk prediction.

  1. N-terminal pro-B-type natriuretic peptide as a marker of blunt cardiac contusion in trauma.

    Science.gov (United States)

    Dogan, Halil; Sarikaya, Sezgin; Neijmann, Sebnem Tekin; Uysal, Emin; Yucel, Neslihan; Ozucelik, Dogac Niyazi; Okuturlar, Yıldız; Solak, Suleyman; Sever, Nurten; Ayan, Cem

    2015-01-01

    Cardiac contusion is usually caused by blunt chest trauma and, although it is potentially a life-threatening condition, the diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardiac enzymes, such as creatine kinase (CK), creatine kinase MB fraction (CK-MB), cardiac troponin I (cTn-I), and cardiac troponin T (cTn-T) were used in previous studies to demonstrate the blunt cardiac contusion (BCC). Each of these diagnostic tests alone is not effective for diagnosis of BCC. The aim of this study was to investigate the serum heart-type fatty acid binding protein (h-FABP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), CK, CK-MB, and cTn-I levels as a marker of BCC in blunt chest trauma in rats. The eighteen Wistar albino rats were randomly allocated to two groups; group I (control) (n=8) and group II (blunt chest trauma) (n=10). Isolated BCC was induced by the method described by Raghavendran et al. (2005). All rats were observed in their cages and blood samples were collected after five hours of trauma for the analysis of serum h-FABP, NT-pro BNP, CK, CK-MB, and cTn-I levels. The mean serum NT-pro BNP was significantly different between group I and II (10.3 ± 2.10 ng/L versus 15.4 ± 3.68 ng/L, respectively; P=0.0001). NT-pro BNP level >13 ng/ml had a sensitivity of 87.5%, a specificity of 70%, a positive predictive value of 70%, and a negative predictive value of 87.5% for predicting blunt chest trauma (area under curve was 0.794 and P=0.037). There was no significant difference between two groups in serum h-FABP, CK, CK-MB and c Tn-I levels. A relation between NT-Pro BNP and BCC was shown in this study. Serum NT-proBNP levels significantly increased with BCC after 5 hours of the blunt chest trauma. The use of NT-proBNP as an adjunct to other diagnostic tests, such as troponins, electrocardiography (ECG), chest x-ray and echocardiogram may be beneficial for diagnosis of

  2. Cystatin C, N-terminal probrain natriuretic peptides and outcomes in acute heart failure with acute kidney injury in a 12-month follow-up: Insights into the cardiorenal syndrome

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    Zhong-bao Ruan

    2014-01-01

    Full Text Available Background: Cystatin C (Cys C has been implicated as a prognostic marker in cardiovascular disease. The aim of this study was to evaluate the value of Cys C as a marker of acute kidney injury (AKI in acute heart failure (AHF, the impact of Cys C and N-terminal probrain natriuretic peptides (NT-proBNP on in-hospital and 12 months mortality were also investigated. Materials and Methods: A total of 162 patients with AHF were enrolled. NT-proBNP, Cys C, serum creatinine (Scr, blood urea nitrogen (BUN and parameters of echocardiography were measured for analyze. The in-hospital and 12 months mortality was analyzed. Results: There was 28 (17% of all AHF patients with AKI. Compared with no-AKI patients, the levels of Cys C (1.51 ± 0.34 vs. 1.32 ± 0.29, P = 0.003 and NT-proBNP (8163.87 ± 898.06 vs. 5922.45 ± 576.73, P = 0.001 were higher in AKI patients. Higher levels of NT-proBNP (odds ratio (OR = 1.92, 95% confidence interval (CI: 2.19-10.98, P = 0.018, OR = 4.31, 95% CI: 2.35-9.82, P = 0.002, respectively and Cys C (OR = 1.48, 95% CI: 1.75-4.16, P = 0.027, OR = 2.72, 95% CI: 1.92-4.28, P = 0.017, respectively were independent association with the in-hospital and 12 months mortality. Cys C was positively correlated with NT-proBNP (r = 0.87, P < 0.001. Combining tertiles of Cys C and NT-proBNP improved risk stratification further. Compared with patients without AKI cysC , patients with AKI cysC was associated with higher in-hospital (7/28 vs. 10/134, P = 0.002 and 12-month mortality (13/28 vs. 32/134, P = 0.001. Conclusion: Cys C was not only a promising risk marker in patients hospitalized for AHF, but also an independent predictor of 12-month mortality. Combining tertiles of Cys C and NT-proBNP could be used to distinguish the mortality risk identification of patients with AHF. AKI was an independent predictor of in-hospital and 12-month mortality.

  3. N末端B型利钠肽原和胱抑素C联合检测对Ⅱ型心肾综合征的诊断价值%Diagnostic value of combined serum N-terminal pro-B-type natriuretic peptide and cystatin-C measurements in type Ⅱ cardiorenal syndrome

    Institute of Scientific and Technical Information of China (English)

    梁继铁; 郭应军

    2014-01-01

    Objective To explore the diagnostic value of measurement of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP)combined with cystatin-C (Cys-C)in patients with typeⅡcardiore-nal syndrome (CRS). Methods A total of 238 patients with chronic heart failure were assigned to a type ⅡCRS group (n =130,GFR60 ml/min)ac-cording to the estimated glomerular filtration rate (GFR).The levels of serum NT-proBNP ,Cys-C and Scr of both groups were measured and compared. Results The levels of serum NT-proBNP,Cys-C and Scr in the type Ⅱ CRS group were significantly higher than those of the simple heart failure group (three P <0.01). In type Ⅱ CRS group,the higher the NYHA grade and renal function phase were,the higher the levels of ser-um NT-proBNP ,Cys-C and Scr were (NYHA grade ⅡNT-proBNP and Cys-C can be used as biomarkers of CRS,combined NT-proBNP and Cys-C measurements has an important value of evaluating the severity and prognosis of CRS.%目的:探讨血清 N 末端 B 型利钠肽原(NT-proBNP)和胱抑素 C(Cys-C)联合检测对Ⅱ型心肾综合征(CRS)的诊断价值。方法选择238例慢性心力衰竭患者,根据肾小球滤过率(GFR)水平将患者分为Ⅱ型 CRS 组130例(GFR<60 ml/min)和单纯心力衰竭组108例(GFR>60 ml/min)。分别采血检测两组 NT-proBNP 、Cys-C 和血清肌酐(Scr)水平并进行比较分析。结果Ⅱ型 CRS 组血清 NT-proBNP 、Cys-C 及 Scr 水平较单纯心力衰竭组明显升高(P 均<0.01)。Ⅱ型 CRS 组中,NYHA 分级和肾功能分期越高,NT-proBNP 、Cys-C 及 Scr 水平也越高(NYHA 分级Ⅱ级<Ⅲ级<Ⅳ级,肾功能分期Ⅰ期<Ⅱ期<Ⅲ期<Ⅳ期,P 均<0.01)。结论血清 NT-proBNP 和 Cys-C 均可作为 CRS 的生物标志物,两者联合检测对判定患者的病情严重程度及预后有重要价值。

  4. N-terminal pro-brain natriuretic peptide can be an adjunctive diagnostic marker of hyper-acute phase of Kawasaki disease.

    Science.gov (United States)

    Kwon, Hyuksool; Lee, Jin Hee; Jung, Jae Yun; Kwak, Young Ho; Kim, Do Kyun; Jung, Jin Hee; Chang, Ikwan; Kim, Kyuseok

    2016-12-01

    The purpose of this study was to determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level could be a useful marker for Kawasaki disease in the pediatric emergency department (PED) and in the presence of fever duration of 4 days or less (hyper-acute phase of Kawasaki disease). Medical records of patients who were 1 month to 15 years old of age and presented at the PED with suspected Kawasaki disease from January 1, 2010, to December 31, 2014, were collected retrospectively. Two hundred thirty-nine patients with a history of fever for 4 days or less were diagnosed with Kawasaki disease, as well as 111 patients with other febrile diseases, and were enrolled. The NT-proBNP level was significantly higher in patients with Kawasaki disease (Kawasaki disease vs. other febrile disease group, 444.8 (189.7-951.5) vs. 153.4 (68.9-287.6) pg/mL; p Kawasaki disease was 0.763 (95 % CI 0.712-0.814). NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease in the PED. What is Known: • N-terminal pro-brain natriuretic peptide level has been reported as a useful marker for diagnosis in patients with the acute phase of Kawasaki disease. • But, in the cases of less than 5 days of fever, the appropriate level of NT-proBNP for differentiating Kawasaki disease in PED has not been yet evaluated. What is New: • NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease.

  5. Impact of polyphenols on physiological stress and cardiac burden in marathon runners - results from a substudy of the BeMAGIC study.

    Science.gov (United States)

    Clauss, Sebastian; Scherr, Johannes; Hanley, Alan; Schneider, Jens; Klier, Ina; Lackermair, Korbinian; Hoster, Eva; Vogeser, Michael; Nieman, David C; Halle, Martin; Nickel, Thomas

    2017-01-16

    Introduction Both physiologic stress and chronic heart disease are associated with increased systemic levels of chromogranin A (CGA) and NT-proBNP. Marathon running causes physiological stress and imposes a significant cardiac burden. Polyphenol-rich Mediterranean and Asian diets have been demonstrated to exert beneficial effects on the cardiovascular system. In this study we investigated whether pretreatment with a polyphenol beverage could attenuate the physiological and cardiac stress associated with a marathon. Methods In the BeMaGIC trial 277 athletes were randomized into two groups in a double-blinded fashion receiving 1-1.5 L/day of the same beverages either with (study beverage) or without (placebo) polyphenol enrichment (about 400 mg of gallic acid equivalents per day of a complex mixture of polyphenols).Blood samples were taken three weeks before (V1), one day before (V2), and immediately (V3), 24 hours (V4) and 72 hours (V5) after running a marathon. In our current sub-study CGA and NT-proBNP levels were analyzed by ELISA in the fastest 18 and the slowest 22 runners. Results CGA and NT-proBNP levels increased significantly after the marathon (V3) and returned to baseline 72 hours after the marathon (V5). Neither CGA nor NT-proBNP differed significantly between athletes receiving study beverage versus placebo. Separating our cohort into fast and slow runners did not reveal any significant difference regarding CGA or NT-proBNP levels between groups. Conclusion Our study provides no evidence that polyphenol supplementation attenuates marathon running induced physiological stressor cardiac burden in fast or slow runners.

  6. Soluble Angiotensin Converting Enzyme 2 in Human Heart Failure: Relation with Myocardial Function and Clinical Outcomes

    Science.gov (United States)

    Epelman, Slava; Shrestha, Kevin; Troughton, Richard W.; Francis, Gary S.; Sen, Subha; Klein, Allan L.; Tang, W .H. Wilson

    2011-01-01

    Objective Angiotensin converting enzyme 2 (ACE2) is an endogenous counter-regulator of the renin-angiotensin system. The relationship between soluble ACE2 (sACE2), myocardial function, and clinical outcomes in patients with chronic systolic heart failure is not well established. Methods We measured sACE2 activity in 113 patients with chronic systolic heart failure (left ventricular ejection fraction [LVEF] ≤ 35%, NYHA class II-IV). Comprehensive echocardiography was performed at the time of blood sampling. We prospectively examined adverse clinical events (death, cardiac transplant, and heart failure hospitalizations) over 34 ± 17 months. Results Patients who had higher sACE2 plasma activity were more likely to have a lower LVEF (Spearman’s r= −0.36, p <0.001), greater RV systolic dysfunction (r=0.33, p<0.001), higher estimated pulmonary artery systolic pressure (r=0.35, p=0.002), larger LV end diastolic diameter (r=0.23, p=0.02), and higher plasma NT-proBNP levels (r=0.35, p<0.001). sACE2 was less associated with diastolic dysfunction (r=0.19, p=0.05), and was similar between patients with ischemic and non-ischemic cardiomyopathies. There was no relationship between sACE2 activity and markers of systemic inflammation. After adjusting for NT-proBNP and LVEF, sACE2 activity remained an independent predictor of adverse clinical events (HR=1.7 [95% CI: 1.1 – 2.6], p=0.018). Conclusions Elevated plasma sACE2 activity was associated with greater severity of myocardial dysfunction and was an independent predictor of adverse clinical events. PMID:19700132

  7. Sensitive cardiac troponins and N-terminal pro-B-type natriuretic peptide in stable coronary artery disease: correlation with left ventricular function as assessed by myocardial strain.

    Science.gov (United States)

    Smedsrud, Marit Kristine; Gravning, Jørgen; Omland, Torbjørn; Eek, Christian; Mørkrid, Lars; Skulstad, Helge; Aaberge, Lars; Bendz, Bjørn; Kjekshus, John; Edvardsen, Thor

    2015-06-01

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponins (cTns) measured with sensitive assays provide strong prognostic information in patients with stable coronary artery disease. However, the relationship between these biomarkers and myocardial contractile function, as well as infarct size, in this patient group, remains to be defined. The study population consisted of 160 patients referred to a follow-up echocardiography scheduled 1 year after coronary revascularization. Concentrations of NT-proBNP, high-sensitive cTnT (hs-cTnT) and sensitive cTnI assays were assessed. Left ventricular function was measured as global peak systolic longitudinal strain by speckle tracking echocardiography and infarct size was assessed by late-enhancement MRI. NT-proBNP and sensitive cTnI levels were significantly associated with left ventricular function by peak systolic strain (R-values 0.243 and 0.228, p = 0.002 and 0.004) as well as infarct size (R-values 0.343 and 0.366, p = 0.014 and p = 0.008). In contrast, hs-cTnT did not correlate with left ventricular function (R = 0.095, p = 0.231) and only marginally with infarct size (R = 0.237, p = 0.094). NT-proBNP and sensitive cTnI levels correlate with left ventricular function and infarct size in patients with stable coronary artery disease after revascularization. As opposed to hs-cTnT, NT-proBNP and cTnI seem to be indicators of incipient myocardial dysfunction and the extent of myocardial necrosis.

  8. Biomarkers of Hemodynamic Stress and Aortic Stiffness after STEMI: A Cross-Sectional Analysis

    Directory of Open Access Journals (Sweden)

    Sebastian Johannes Reinstadler

    2015-01-01

    Full Text Available Aim. Increased aortic stiffness might adversely affect cardiac structure, function, and perfusion. Release of biomarkers of hemodynamic stress is thought to be enhanced by these alterations. We aimed to evaluate the association between biomarkers of hemodynamic stress and aortic stiffness assessed at a chronic stage after ST-segment elevation myocardial infarction (STEMI. Methods. Fifty-four patients four months after STEMI were enrolled in this cross-sectional, single-center study. N-terminal pro–B-type natriuretic peptide (NT-proBNP, mid-regional pro–A-type natriuretic peptide (MR-proANP, and mid-regional proadrenomedullin (MR-proADM levels were measured by established assays. Aortic stiffness was assessed by the measurement of pulse wave velocity using phase-contrast cardiovascular magnetic resonance. Results. NT-proBNP, MR-proANP, and MR-proADM concentrations were all correlated with aortic stiffness in univariate analysis (r=0.378, r=0.425, and r=0.532; all P<0.005, resp.. In multiple linear regression analysis, NT-proBNP (β=0.316, P=0.005 and MR-proADM (β=0.284, P<0.020 levels were associated with increased aortic stiffness independently of age, blood pressure, and renal function. NT-proBNP was the strongest predictor for high aortic stiffness (area under the curve: 0.82, 95% CI 0.67–0.96. Conclusion. At a chronic stage after STEMI, concentrations of biomarkers for hemodynamic stress, especially NT-proBNP, are positively correlated with aortic stiffness. These biomarkers might also be useful as predictors of high aortic stiffness after STEMI.

  9. 麝香保心丸治疗冠心病慢性心力衰竭患者临床疗效观察%Clinical Observation on Shexiang Baoxin Pil in the Treatment of Chronic Heart Failure Induced by Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    李蓉; 吴泰蓉; 朱灿宏; 黄根牙; 彭良欢

    2015-01-01

    Objective To investigate the efficacy of Shexiang Baoxin pil (SBP)in treating chronic heart failure(CHF)induced by coro-nary heart disease(CHD).Methods One hundred patients with CHF induced by CHD were randomly divided into two groups:The control group(n=50)treated with routine treatment,and the treatment group(n=50)treated with routine treatment plus SBP for 6 weeks.The cardiac function,plasma N terminal pro brain type natriuretic peptide (NT proBNP)and serum heart fatty acid binding protein (H FABP)levels were observed.Results After treatment,left ventricular(LV)ejection fraction (LVEF),LV end di-astolic diameter (LVEDD),LV end systolic diameter(LVESD),cardiac output (CO),SV and 6 min walking distance were improved in two groups,the degree of improvement in treatment group was better than that in control group(P<0.05).The levels of plasma NT proBNP and serum H FABP in treatment group was lower than that in control group(P<0.05).The clinical efficacy in treat-ment group was better than that in control group(P<0.05).Conclusion SBP can improve the cardiac function,reduce the levels of plasma NT proBNP and serum H FABP in patients with CHF induced by CHD.%目的:观察麝香保心丸对冠心病慢性心力衰竭患者的心功能、血流动力学及相关指标影响。方法100例冠心病慢性心力衰竭患者随机分为观察组和对照组,各50例。对照组采用西医常规治疗,观察组在西医常规治疗的基础上加用麝香保心丸。治疗6周后比较两组患者心功能、血浆 N末端脑钠肽前体(NT proBNP)和血清心型脂肪酸结合蛋白(H FABP)水平。结果两组治疗后左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、心输出量(CO)、每搏量(SV)及6 min步行距离均较治疗前有改善,观察组改善的程度优于对照组(P<0.05);治疗后观察组血浆 NT proBNP和血清 H FABP水平均低于对照组(P<0.05),观察组临床疗效优于对照组(P<0.05)。结

  10. Expression of pericardial fluid T-cells and related inflammatory cytokines in patients with chronic heart failure.

    Science.gov (United States)

    Iskandar, Reinard; Liu, Shengchen; Xiang, Fei; Chen, Wen; Li, Liangpeng; Qin, Wei; Huang, Fuhua; Chen, Xin

    2017-05-01

    Pericardial fluid, as a biochemical indicator of heart status, directly indicates pathological alteration to the heart. The accumulation of pericardial fluid can be attributed to an underlying systemic or local inflammatory process. However, the pericardial fluid expression of cellular surface markers, as well as several cytokines in chronic heart failure (CHF), remain unclear. In order to evaluate these issues further the pericardial fluid expression of several cytokines and the surface expression of activity markers between CHF patients and non-heart failure (NHF) patients were analyzed. The pericardial fluid expression of cytokines was measured by immunofluorescence and biomarker of plasma N-terminal propeptide of B-type natriuretic peptide (NT-proBNP), while pericardial fluid levels of soluble glycoprotein 130 (sgp130) were analyzed by ELISA in 50 CHF and 24 NHF patients. In addition, the surface expression of activation markers for T-cells was measured by immunohistochemistry. Patients with CHF demonstrated increased levels of plasma NT-proBNP and pericardial fluid sgp130. Surface expression of cellular activation markers CD25 and Foxp3 in the pericardial fluid was increased in patients with CHF. Moreover, the pro- and anti-inflammatory cytokines interferon (IFN)-γ, interleukin (IL)-6 and IL-10 in patients with CHF also demonstrated an increased expression within its pericardial fluid. In addition, there was infiltration of inflammatory cells and enhanced expression of inflammatory cytokines in the pericardial fluid of patients with CHF, which may reflect T cell activation, suggesting that systemic inflammation is important in the progression of CHF. This evidence could indicate a possible novel target for future therapeutics and prevention of CHF.

  11. Cardiac Effects of Thyrotropin Oversuppression with Levothyroxine in Young Women with Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Kyung-Soon Hong

    2016-01-01

    Full Text Available Background. We investigated the cardiac effects of TSH (thyroid-stimulating hormone oversuppression in women with thyroidectomized differentiated thyroid cancer (DTC during levothyroxine suppression therapy. Methods. Fourteen young female patients with DTC were enrolled. The duration of TSH-suppressive therapy was 5 to 9 years. They satisfied the following criteria: (1 a serum level of TSH < 0.1 mU/L in the intermediate-risk or TSH < 0.3 mU/L in the low-recurrence-risk group and (2 having been receiving a fixed dose of LT4 before the study. Controls matched for age, sex, and body mass index (BMI were compared in terms of the levels of serum free T4, free T3, TSH, plasma N-terminal pro-brain natriuretic peptide (NT-pro-BNP, and cardiac functions and structures. Results. DTC patients and control subjects were well matched in heart rate and blood pressure. There were marked differences in serum TSH (P=0.001 and free T4 (P=0.002. However, there were no differences between the groups in serum free T3 and plasma NT-pro-BNP. Furthermore, there were nonsignificant differences in cardiac functions and structures between the groups. Conclusions. This study shows that TSH suppression therapy in women with DTC may be safe with respect to cardiac functions and structures despite intermittent oversuppression of TSH during long-term suppressive therapy. Trial Registration. This trial is registered with clinicaltrials.gov identifier NCT02645786.

  12. Evaluation of the Incremental Prognostic Utility of Increasingly Complex Testing in Chronic Heart Failure.

    Science.gov (United States)

    Ahmad, Tariq; O'Brien, Emily C; Schulte, Phillip J; Stevens, Susanna R; Fiuzat, Mona; Kitzman, Dalane W; Adams, Kirkwood F; Kraus, William E; Piña, Ileana L; Donahue, Mark P; Zannad, Faiez; Whellan, David J; O'Connor, Christopher M; Felker, G Michael

    2015-07-01

    Current heart failure (HF) risk prediction models do not consider how individual patient assessments occur in incremental steps; furthermore, each additional diagnostic evaluation may add cost, complexity, and potential morbidity. Using a cohort of well-treated ambulatory HF patients with reduced ejection fraction who had complete clinical, laboratory, health-related quality of life, imaging, and exercise testing data, we estimated incremental prognostic information provided by 5 assessment categories, performing an additional analysis on those with available N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. We compared the incremental value of each additional assessment (quality of life screen, laboratory testing, echocardiography, and exercise testing) to baseline clinical assessment for predicting clinical outcomes (all-cause mortality, all-cause mortality/hospitalization, and cardiovascular death/HF hospitalizations), gauging incremental improvements in prognostic ability with more information using area under the curve and reclassification improvement (net reclassification index), with and without NT-proBNP availability. Of 2331 participants, 1631 patients had complete clinical data; of these, 1023 had baseline NT-proBNP. For prediction of all-cause mortality, models with incremental assessments sans NT-proBNP showed improvements in C-indices (0.72 [clinical model alone]-0.77 [complete model]). Compared with baseline clinical assessment alone, net reclassification index improved from 0.035 (w/laboratory data) to 0.085 (complete model). These improvements were significantly attenuated for models in the subset with measured NT-proBNP data (c-indices: 0.80 [w/laboratory data]-0.81 [full model]); net reclassification index improvements were similarly marginal (0.091→0.096); prediction of other clinical outcomes had similar findings. In chronic HF patients with reduced ejection fraction, the marginal benefit of complex prognostic evaluations should be

  13. 二维斑点追踪技术对评价左室射血分数保留的心力衰竭的价值%The value of 2-dimensional speckle tracking imaging in evaluating heart failure with persevered left ventricular ejection fraction

    Institute of Scientific and Technical Information of China (English)

    陈晓梅; 张丽丽; 李红瑜; 张帆; 张超; 赵丽荣

    2015-01-01

    目的:本研究应用二维斑点追踪成像(2DSTI)技术,比较左室射血分数保留的心力衰竭(HFPEF)患者及无症状的左室舒张功能障碍(LVDD)患者的左室舒张功能及心肌运动同步性,并观察其与血浆 N 末端 B 型钠尿肽前体(NT-pro BNP)之间的相关性。方法实验组 HFPEF 25例,对照组无症状的 LVDD 25例。测量血浆 NT-pro BNP水平;采集左室心尖二腔、三腔、四腔心观动态图像,应用2DSTI 分析测量。结果实验组舒张早期应变率峰值(GLSRe,02-LSRe,03-LSRe,04-LSRe)明显减低(P <0.05);16节段、12节段收缩应变达峰时间的标准差(Ts-SD16、Ts-SD12)增大,任意对应两节段的收缩应变达峰时间的最长时间间隔(Ts-diff)延长(P <0.05)。Log NT-pro BNP 与GLSRe,02-LSRe,03-LSRe,04-LSRe、Ts-SD16显著相关(P <0.05)。结论2DSTI 能够较为准确地评价舒张功能,区分其受损程度;同时可测定心肌运动的不同步性,为 HFPEF 的诊断和治疗提供新的思路。%Objective To assess the diastolic function and synchronicity of heart failure with persevered left ventric-ular ejection fraction (HFPEF)patients and asymptomatic with left ventricular diastolic dysfunction (LVDD)patients using two dimensional speckle-tracking imaging(2DSTI)and observe the correlation between the 2DSTI measured indi-cators and plasma NT-pro BNP levels.Methods Patients with HFPEF 25 examples,and a control group of asympto-matic with LVDD 25 examples,determined of the plasma NT- pro BNP level,collected apical four-chamber,three-chamber,two-chamber view dynamic two-dimensional image,analysed by 2DSTI.Results HFPEF patients’global and two-chamber,three-chamber,four-chamber early diastolic strain rate (GLSRe,02-LSRe,03-LSRe,04-LSRe)was signif-icantly lower than the asymptomatic with LVDD group (P <0.05);the value of 16,12 segments’Ts-SD,Ts-diff is big-ger(P <0.05).LogNT-pro BNP and

  14. Early Change of Extracellular Matrix and Diastolic Parameters in Metabolic Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Angela B. S., E-mail: angelabssantos@yahoo.com.br [Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Junges, Mauricio; Silvello, Daiane; Macari, Adriana; Araújo, Bruno S. de [Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Seligman, Beatriz G. [Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Duncan, Bruce B. [Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Rohde, Luis Eduardo P.; Clausell, Nadine; Foppa, Murilo [Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2013-10-15

    Metabolic syndrome (MS) is associated with increased cardiovascular risk. It is not clear whether myocardial changes showed in this syndrome, such as diastolic dysfunction, are due to the systemic effects of the syndrome, or to specific myocardial effects. Compare diastolic function, biomarkers representing extracellular matrix activity (ECM), inflammation and cardiac hemodynamic stress in patients with the MS and healthy controls. MS patients (n = 76) and healthy controls (n=30) were submitted to a clinical assessment, echocardiographic study, and measurement of plasma levels of metalloproteinase-9 (MMP9), tissue inhibitor of metalloproteinase-1 (TIMP1), ultrasensitive-reactive-C-Protein (us-CRP), insulin resistance (HOMA-IR) and natriuretic peptide (NT-proBNP). MS group showed lower E' wave (10.1 ± 3.0 cm/s vs 11.9 ± 2.6 cm/s, p = 0.005), increased A wave (63.4 ± 14.1 cm/s vs. 53.1 ± 8.9 cm/s; p < 0.001), E/E' ratio (8.0 ± 2.2 vs. 6.3 ± 1.2; p < 0.001), MMP9 (502.9 ± 237.1 ng / mL vs. 330.4±162.7 ng/mL; p < 0.001), us-CRP (p = 0.001) and HOMA-IR (p < 0.001), but no difference for TIMP1 or NT-proBNP levels. In a multivariable analysis, only MMP9 was independently associated with MS. MS patients showed differences for echocardiographic measures of diastolic function, ECM activity, us-CRP and HOMA-IR when compared to controls. However, only MMP9 was independently associated with the MS. These findings suggest that there are early effects on ECM activity, which cannot be tracked by routine echocardiographic measures of diastolic function.

  15. Early change of extracellular matrix and diastolic parameters in metabolic syndrome.

    Science.gov (United States)

    Santos, Angela B S; Junges, Mauricio; Silvello, Daiane; Macari, Adriana; Araújo, Bruno S de; Seligman, Beatriz G; Duncan, Bruce B; Rohde, Luis Eduardo P; Clausell, Nadine; Foppa, Murilo

    2013-10-01

    Metabolic syndrome (MS) is associated with increased cardiovascular risk. It is not clear whether myocardial changes showed in this syndrome, such as diastolic dysfunction, are due to the systemic effects of the syndrome, or to specific myocardial effects. Compare diastolic function, biomarkers representing extracellular matrix activity (ECM), inflammation and cardiac hemodynamic stress in patients with the MS and healthy controls. MS patients (n = 76) and healthy controls (n=30) were submitted to a clinical assessment, echocardiographic study, and measurement of plasma levels of metalloproteinase-9 (MMP9), tissue inhibitor of metalloproteinase-1 (TIMP1), ultrasensitive-reactive-C-Protein (us-CRP), insulin resistance (HOMA-IR) and natriuretic peptide (NT-proBNP). MS group showed lower E' wave (10.1 ± 3.0 cm/s vs 11.9 ± 2.6 cm/s, p = 0.005), increased A wave (63.4 ± 14.1 cm/s vs. 53.1 ± 8.9 cm/s; p < 0.001), E/E' ratio (8.0 ± 2.2 vs. 6.3 ± 1.2; p < 0.001), MMP9 (502.9 ± 237.1 ng/mL vs. 330.4 ± 162.7 ng/mL; p < 0.001), us-CRP (p = 0.001) and HOMA-IR (p < 0.001), but no difference for TIMP1 or NT-proBNP levels. In a multivariable analysis, only MMP9 was independently associated with MS. MS patients showed differences for echocardiographic measures of diastolic function, ECM activity, us-CRP and HOMA-IR when compared to controls. However, only MMP9 was independently associated with the MS. These findings suggest that there are early effects on ECM activity, which cannot be tracked by routine echocardiographic measures of diastolic function.

  16. Quality of Life Score as a Predictor of Death in Dogs with Degenerative Mitral Valve Disease.

    Science.gov (United States)

    Strunz, Célia M C; Marcondes-Santos, Mário; Takada, Julio Yoshio; Fragata, Fernanda S; Mansur, Antônio de Pádua

    2017-04-01

    The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner. O conhecimento das variáveis preditoras de mortalidade é importante para a prática clínica e para o acompanhamento terapêutico na doença da valva mitral. Determinar se um escore de qualidade de vida avaliado com o Functional Evaluation of Cardiac Health poderia auxiliar na predição de mortalidade em cães com doença degenerativa da valva mitral (DDVM). Trinta e seis cães de estimação com doença valvar mitral foram submetidos a avaliação clínica, laboratorial e ecocardiográfica no início do estudo e monitorizados durante 6 meses. A morte cardiovascular foi o desfecho primário. Os 36 cães foram classificados como

  17. Clinical and Hemodynamic Correlates and Prognostic Value of VE/VCO2 Slope in Patients With Heart Failure With Preserved Ejection Fraction and Pulmonary Hypertension.

    Science.gov (United States)

    Klaassen, Sebastiaan H C; Liu, Licette C Y; Hummel, Yoran M; Damman, Kevin; van der Meer, Peter; Voors, Adriaan A; Hoendermis, Elke S; van Veldhuisen, Dirk J

    2017-07-20

    Impaired exercise capacity is one of the hallmarks of heart failure with preserved ejection fraction (HFpEF), but the clinical and hemodynamic correlates and prognostic value of exercise testing in patients with HFpEF is unknown. Patients with HFpEF (left ventricular ejection fraction [LVEF] ≥45%) and pulmonary hypertension underwent cardiopulmonary exercise test (CPX) to measure maximal (peak VO2) and submaximal (ventilatory equivalent for carbon dioxide [VE/VCO2] slope) exercise capacity. In addition, right heart catheterization was performed. Patients were grouped in tertiles based on the VE/VCO2 slope. Univariate and multivariate regression analyses were performed. A Cox regression analysis was performed to determine the mortality during follow-up. We studied 88 patients: mean age 73 ± 9 years, 67% female, mean LVEF 58%, median N-terminal pro-B-type natriuretic peptide (NT-proBNP) 840 (interquartile range 411-1938) ng/L. Patients in the highest VE/VCO2 tertile had the most severe HF, as reflected in higher New York Heart Association functional class and higher NT-proBNP plasma levels (all P < .05 for trend), whereas LVEF was similar between the groups. Multivariable regression analysis with backward elimination on invasive hemodynamic measurements showed that VE/VCO2 slope was independently associated with pulmonary vascular resistance (PVR). Cox regression analysis showed that increased VE/VCO2 slope (but not peak VO2) was independently associated with increased mortality. Increased VE/VCO2 slope was associated with more severe disease and higher PVR and was independently associated with increased mortality in patients with HFpEF. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. The Relationship among Carotid Artery Remodeling, Cardiac Geometry, and Serum N-Terminal Pro-B-Type Natriuretic Peptide Level in Asymptomatic Asians: Sex-Differences and Longitudinal GEE Study.

    Directory of Open Access Journals (Sweden)

    Chen-Yen Chien

    Full Text Available Carotid artery remodeling is known to be associated with a variety of cardiovascular diseases. However, there is limited information regarding gender differences in carotid remodeling. We sought to investigate the associations among blood pressure (BP, carotid artery remodeling and cardiac geometries, and further explore gender differences.In a large cohort of asymptomatic adults undergoing routine health screening with repeated observations, we related measures of carotid artery diameter (CCAD to various BP components, cardiac geometries and blood N-terminal pro-brain natriuretic peptide (NT-proBNP level, both from baseline cross-sectional and longitudinal dataset using generalized estimating equations (GEE.A total of 2,914 person-visits (baseline: n=998, mean age: 47 ± 8.9 years, 34% female were studied (median: 6 ± 1.73 years follow up. We observed that CCAD was larger in men (p=300pg/mL; AUROC: 0.79, CCAD cut-off: 7.95mm, all p<0.05, which remained significant in multi-variate and longitudinal models. There was a prominent sex interaction (p for interaction with age and systolic BP: 0.004 and 0.028 respectively, where the longitudinal associations of age and systolic BP with increasing CCAD as more pronounced in women than men.These data demonstrated that carotid artery remodeling may parallel subclinical biomarker of cardiac dysfunction, and further showed greater effects of aging and higher blood pressure on such remodeling process in women than men. Further study is warranted to understand how this predisposition of elderly hypertensive women to vascular remodeling may play a role in clinical settings.

  19. Modulation of plasma fibrinogen levels by medication

    NARCIS (Netherlands)

    Maat, M.P.M. de; Kodex, M.; Kastelein, J.J.P.

    1996-01-01

    Elevated plasma fibrinogen levels represent an increased risk for cardiac events. This has enhanced the interest in identifying agents that can normalize elevated plasma fibrinogen levels. Agents that have this capacity are the lipid lowering fibric acid derivatives (e.g. ciprofibrate) and the plate

  20. Additive prognostic value of plasma N-terminal pro-brain natriuretic peptide and coronary artery calcification for cardiovascular events and mortality in asymptomatic patients with type 2 diabetes

    DEFF Research Database (Denmark)

    von Scholten, Bernt Johan; Reinhard, Henrik; Hansen, Tine Willum;

    2015-01-01

    BACKGROUND: In patients with type 2 diabetes, cardiovascular disease (CVD) is the major cause of morbidity and mortality. We evaluated the combination of NT-proBNP and coronary artery calcium score (CAC) for prediction of combined fatal and non-fatal CVD and mortality in patients with type 2...... treatment. Patients with baseline NT-proBNP > 45.2 ng/L and/or CAC ≥ 400 were stratified as high-risk patients (n = 133). Occurrence of fatal- and nonfatal CVD (n = 40) and mortality (n = 26), was traced after 6.1 years (median). RESULTS: High-risk patients had a higher risk of the composite CVD endpoint...... (adjusted hazard ratio [HR] 10.6 (95 % confidence interval [CI] 2.4-46.3); p = 0.002) and mortality (adjusted HR 5.3 (95 % CI 1.2-24.0); p = 0.032) compared to low-risk patients. In adjusted continuous analysis, both higher NT-proBNP and CAC were strong predictors of the composite CVD endpoint and mortality...

  1. Clinical value of N-terminal pro-brain natriuretic peptide for evaluating acute heart failure in patients undergoing hemodialysis%前体脑钠肽对血液透析患者发生急性心功能不全的临床诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘国望; 晏德华; 叶燕丽

    2012-01-01

    目的 在维持性血液透析患者中,研究前体脑钠肽(NT-proBNP)对评价急性心功能不全的临床价值.方法 检测113人次以呼吸困难就诊,临床上怀疑存在急性心功能不全的血液透析患者的NT-proBNP水平.根据定义的临床指标判断急性左心力衰竭.结果 急性心力衰竭组NT-proBNP水平高于非急性心力衰竭组.NT-proBNP和年龄、透析时间以及左心室厚度无关,和右心房大小正相关.对于急性心力衰竭的患者,NT-proBNP水平和心力衰竭临床分级呈正相关性(rs=0.526,P=0.012).多变量分析显示,NT-proBNP水平每升高100 pg/ml,急性心力衰竭的危险性增加2.01倍(OR 3.01,95% CI 2.11~3.85).经ROC曲线分析,NT-proBNP诊断急性心力衰竭的曲线下面积为0.819(95% CI 0.728~0.842).结论 对于血液透析患者,NT-proBNP能作为诊断急性心力衰竭的生物学标志物.%Objective To investigate the clinical value of N-terminal pro-brain natriuretic peptide( NT-proBNP )for evaluating acute heart failure in patients undergoing hemodialysis. Methods NT-proBNP levels of 113 hemodialysis cases were measured,who were hospitalized with tachypnea and were suspected to be with acute heart failure. The diagnosis of acute heart failure was made by the definition of the guideline for diagnosis and therapy of acute left heart failure. Results The level of NT-proBNP was higher in the patients with acute heart failure than those without. The level of NT-proBNP was not associated with age, dialysis time and thickness of left ventricle, whereas correlated with right atrium. The level of NT-proBNP in those with acute left heart failure was also related to class of clinical heart failure( rs = 0. 526, P =0.012 ). The level of NT-proBNP increased 100 pg/ml,the risk for acute heart failure increased 2 fold( odds ratio 3. 01,95% confidence interval 1. 11-3. 85 ). The area under ROC curve of the NT-proBNP for diagnosis of acute heart failure was 0.819(95% confidence

  2. Plasma substance P levels in fibrositis.

    Science.gov (United States)

    Reynolds, W J; Chiu, B; Inman, R D

    1988-12-01

    The mechanism of pain in the fibrositis syndrome is unknown. We measured plasma levels of substance P in 32 patients with fibrositis and 26 sex and age matched controls using a radioimmunoassay. The mean plasma level of substance P in the patients with fibrositis was 371 +/- 91 pg/ml and in controls 397 +/- 84 pg/ml (p = NS). We conclude that determination of plasma levels of substance P in fibrositis is of no diagnostic value. This does not exclude the possible role of substance P as a neurotransmitter in the fibrositis syndrome.

  3. The Early Diagnosis and Prognosis Evaluation of Elderly Pulmonary Heart Disease Patients by High-sensitivity Cardiac Tro pon in a nd Amino Terminal Brain Natriuretic Peptide Precursor%高敏肌钙蛋白及氨基末端脑钠肽前体在老年肺心病患者早期诊断及预后评估的临床意义

    Institute of Scientific and Technical Information of China (English)

    郑咏仪; 郑国雄; 朱建宏; 陈厅厅; 苏小虎

    2014-01-01

    Objective:To study the early diagnosis and prognosis evaluation clinical significance of eld-erly pulmonary heart disease patients by high-sensitivity cardiactroponin and amino terminal brain natriuretic peptide precursor .Method: 60 elderly pulmonary heart disease patients were selected as the observation group, The patients with chronic obstructive pulmonary disease were divided into mild moderate and severe according to the pulmonary arterial hypertension 20 cases patients were selected as the control group ,the NT-proBNP and hs-TnT were measured at the acute exacerbation and remission , NT-proBNP and hs-TnT and the readmission rate and mortality rate after six months were compared .Resutl :In acute aggravating period , NT-proBNP and hs-TnT level of the observation group patients was significantly higher than that of the con-trol group (P<0.05),There was statistically significant difference among light , medium and severe pulmona-ry artery pressure , even in remission , NT-proBNP and hs-TnT level of the observation group patients was still higher than that of the control group ,the readmission rate and mortality after six months was significantly higher than that of the control group .Conclusion:High-sensitivity cardiactroponin and amino terminal brain natriuretic peptide precursor can obviously increase the elderly pulmonary heart disease diagnostic sensitivity , it was an indicator of the severity of CCP as long-term prognostic risk factors .%目的:探讨高敏肌钙蛋白( hs-TnT)及氨基末端脑钠肽前体( NT-proBNP )对老年肺心病早期诊断以及预后临床价值。方法:选60例老年肺心病患者为观察组,分别按肺动脉高压分成轻中重度各20例,慢性阻塞性肺疾病20例作为对照组,测定各组急性加重期和缓解期的NT-proBNP 及hs-TnT,比较各组间两指标的差异及缓解期6个月的再入院率及死亡率。结果:在急性加重期,观察组患者hs-TnT及NT-proBNP 的含量明

  4. Heart-type fatty acid binding protein for the assessment of the short-term prognosis in acute pulmonary embolism patients with hemodynamic stability on admission%心脏型脂肪酸结合蛋白对人院时血流动力学稳定的急性肺栓塞患者短期预后的评估

    Institute of Scientific and Technical Information of China (English)

    陈勇; 刘双; 郭伟; 王增智

    2013-01-01

    patients [37 men and 53 women;age (61.1 ± 14.6)years],who were taken blood samples before thrombolysis or anticoagulation for plasma H-FABP level measurement by a solid-phase enzyme-linked immunoabsorbent assay based on the sandwich principle,cardiac troponin Ⅰ (cTnI)and Nterminal pro-brain natriuretic peptide (NT-proBNP)by heterogeneous immunoassay.All had 30-day followup and divided them into the complicated clinical course group (n =7)and the simple clinical course group (n =83).The clinical and follow-up data was analyzed by Mann-Whitney U test,Pearson Chi-Square test,Continuity Correction test and logistic regression.Results The level of H-FABP was higher in the complicated clinical course group than it in the simple clinical course group (U =54.000,P <0.01).With ROC analysis,7 μg/L was identified as the best cutoff value of H-FABP in this study,and the differences of AUC among H-FABP,cTnI and NT-proBNP were no statistical significance.By univariable logistic regression,H-FABP ≥ 6 μg/L,heart rate ≥ 106 beats/min and syncope (all P <0.01)may predict the short-term prognosis in APE patients with hemodynamic stability.H-FABP ≥ 6 μg/L and syncope (both P < 0.05)may also be 30-day predictor by multivariable logistic regression.NT-proBNP or cTnI combined with H-FABP may increase 30-day prognosis value in APE patients with hemodynamic stability.Conclusions H-FABP,alone or in combination with other clinical data may predict 30-day prognosis in APE patients with hemodynamic stability on admission.H-FABP is superior to cTnI and NT-proBNP in the predication of 30-day prognosis in APE patients with hemodynamic stability on admission.

  5. 慢性充血性心力衰竭患者血浆BCAAs水平的临床研究%Clinical research of plasma BCAAs level in patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    赵晓丽; 朱迪; 张静隆; 廉坤; 刘毅; 虞成凯; 陶凌

    2015-01-01

    目的:探讨研究慢性充血性心力衰竭(CHF)患者血浆支链氨基酸(BCAAs)水平的变化,及其与氨基末端脑钠尿肽前体(NT-pro-BNP)和左室射血分数(LVEF)的相关性.方法:共纳入168例诊断为CHF患者作为病例组,同时随机选择同期体检的41例健康成年人作为对照组.采用ELISA方法测定空腹血浆BCAAs水平、NT-pro-BNP,超声心动图检测LVEF值.比较两组血浆BCAAs水平及其与NT-pro-BNP、LVEF的关系.结果:两组受试者基线资料无明显差异;CHF患者血浆BCAA水平、LVEF均低于对照组,血浆NT-pro-BNP高于对照组(P<0.01);随着NYHA分级增加,NT-pro-BNP逐渐升高,LVEF逐渐降低(P<0.01),而BCAAs水平无明显变化;Spearson偏相关分析显示经性别、年龄、收缩压、舒张压、体质量指数校正后,CHF组BCAAs水平与NT-pro-BNP呈负相关(r=-0.168,P<0.05),而与LVEF无关(r=0.069,P>0.05).结论:CHF患者血浆BCAAs水平明显低于正常对照组,与NT-pro-BNP水平呈负相关.

  6. Different impact of aortic regurgitation assessed by aortic root angiography after transcatheter aortic valve implantation according to baseline left ventricular ejection fraction and N-terminal pro-B-type natriuretic peptide.

    Science.gov (United States)

    Kaneko, Hidehiro; Hoelschermann, Frank; Schau, Thomas; Tambor, Grit; Neuss, Michael; Butter, Christian

    2017-05-31

    Transcatheter aortic valve implantation (TAVI) is an alternative therapeutic option for severe aortic stenosis. Aortic regurgitation (AR) is commonly observed after TAVI and increases the mortality rate. We hypothesized that the influence of significant AR, defined as that more severe than mild AR, on survival rate after TAVI might differ according to the baseline left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NT-pro BNP) level. We categorized 856 patients who underwent transfemoral TAVI into 2 groups according to their baseline LVEF (pro BNP levels (≤5000 and >5000 pg/mL). Significant AR was observed in 92 patients (11%). Among patients with significant AR, the proportion of patients with CoreValve/EvolutR implantation was higher than that of patients with SAPIEN XT/3 implantation. Kaplan-Meier curves and the log-rank test showed that significant AR was not associated with 1-year mortality in patients with LVEF ≥40% and those with NT-pro BNP level ≤5000 pg/mL. On the other hand, it was significantly associated with a higher 1-year mortality in patients with LVEF pro BNP level >5000 pg/mL (p = 0.011). Similarly, multivariate Cox regression analysis showed that the presence of AR was significantly associated with a higher 1-year mortality in patients with LVEF pro BNP level >5000 pg/mL (p = 0.004, HR = 3.221). However, AR was not significantly associated with a higher 1-year mortality in patients with LVEF ≥40% and NT-pro BNP level ≤5000 pg/mL. Thus, the impact of significant AR on mortality after TAVI seems to be considerable in patients with reduced LVEF or high NT-pro BNP levels, but not those with preserved LVEF or low NT-pro BNP levels, suggesting that the influence of AR differs depending on the baseline LVEF and NT-pro BNP level.

  7. Mendelian randomization study of B-type natriuretic peptide and type 2 diabetes: evidence of causal association from population studies.

    Directory of Open Access Journals (Sweden)

    Roman Pfister

    2011-10-01

    Full Text Available BACKGROUND: Genetic and epidemiological evidence suggests an inverse association between B-type natriuretic peptide (BNP levels in blood and risk of type 2 diabetes (T2D, but the prospective association of BNP with T2D is uncertain, and it is unclear whether the association is confounded. METHODS AND FINDINGS: We analysed the association between levels of the N-terminal fragment of pro-BNP (NT-pro-BNP in blood and risk of incident T2D in a prospective case-cohort study and genotyped the variant rs198389 within the BNP locus in three T2D case-control studies. We combined our results with existing data in a meta-analysis of 11 case-control studies. Using a Mendelian randomization approach, we compared the observed association between rs198389 and T2D to that expected from the NT-pro-BNP level to T2D association and the NT-pro-BNP difference per C allele of rs198389. In participants of our case-cohort study who were free of T2D and cardiovascular disease at baseline, we observed a 21% (95% CI 3%-36% decreased risk of incident T2D per one standard deviation (SD higher log-transformed NT-pro-BNP levels in analysis adjusted for age, sex, body mass index, systolic blood pressure, smoking, family history of T2D, history of hypertension, and levels of triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. The association between rs198389 and T2D observed in case-control studies (odds ratio = 0.94 per C allele, 95% CI 0.91-0.97 was similar to that expected (0.96, 0.93-0.98 based on the pooled estimate for the log-NT-pro-BNP level to T2D association derived from a meta-analysis of our study and published data (hazard ratio = 0.82 per SD, 0.74-0.90 and the difference in NT-pro-BNP levels (0.22 SD, 0.15-0.29 per C allele of rs198389. No significant associations were observed between the rs198389 genotype and potential confounders. CONCLUSIONS: Our results provide evidence for a potential causal role of the BNP

  8. Clinical Value of Natriuretic Peptides in Predicting Time to Dialysis in Stage 4 and 5 Chronic Kidney Disease Patients

    Science.gov (United States)

    Sundqvist, Sofia; Larson, Thomas; Cauliez, Bruno; Bauer, Fabrice; Dumont, Audrey; Le Roy, Frank; Hanoy, Mélanie; Fréguin-Bouilland, Caroline; Godin, Michel

    2016-01-01

    Background Anticipating the time to renal replacement therapy (RRT) in chronic kidney disease (CKD) patients is an important but challenging issue. Natriuretic peptides are biomarkers of ventricular dysfunction related to poor outcome in CKD. We comparatively investigated the value of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) as prognostic markers for the risk of RRT in stage 4 and 5 CKD patients, and in foretelling all-cause mortality and major cardiovascular events within a 5-year follow-up period. Methods Baseline plasma BNP (Triage, Biosite) and NT-proBNP (Elecsys, Roche) were measured at inclusion. Forty-three patients were followed-up during 5 years. Kaplan-Meier analysis, with log-rank testing and hazard ratios (HR), were calculated to evaluate survival without RRT, cardiovascular events or mortality. The independent prognostic value of the biomarkers was estimated in separate Cox multivariate analysis, including estimated glomerular filtration rate (eGFR), creatininemia and comorbidities. Results During the first 12-month follow-up period, 16 patients started RRT. NT-proBNP concentration was higher in patients who reached endpoint (3221 ng/L vs 777 ng/L, p = 0.02). NT-proBNP concentration > 1345 ng/L proved significant predictive value on survival analysis for cardiovascular events (p = 0.04) and dialysis within 60 months follow-up (p = 0.008). BNP concentration > 140 ng/L was an independent predictor of RRT after 12 months follow-up (p<0.005), and of significant predictive value for initiation of dialysis within 60 months follow-up. Conclusions Our results indicate a prognostic value for BNP and NT-proBNP in predicting RRT in stage 4 and 5 CKD patients, regarding both short- and long-term periods. NT-proBNP also proved a value in predicting cardiovascular events. Natriuretic peptides could be useful predictive biomarkers for therapeutic guidance in CKD. PMID:27548064

  9. Breed differences in natriuretic peptides in healthy dogs

    DEFF Research Database (Denmark)

    Sjöstrand, K.; Wess, G.; Ljungvall, I.

    2014-01-01

    BACKGROUND: Measurement of plasma concentration of natriuretic peptides (NPs) is suggested to be of value in diagnosis of cardiac disease in dogs, but many factors other than cardiac status may influence their concentrations. Dog breed potentially is 1 such factor. OBJECTIVE: To investigate breed...... variation in plasma concentrations of pro-atrial natriuretic peptide 31-67 (proANP 31-67) and N-terminal B-type natriuretic peptide (NT-proBNP) in healthy dogs. ANIMALS: 535 healthy, privately owned dogs of 9 breeds were examined at 5 centers as part of the European Union (EU) LUPA project. METHODS: Absence...... the median concentration in Doberman Pinschers. CONCLUSIONS AND CLINICAL IMPORTANCE: Considerable interbreed variation in plasma NP concentrations was found in healthy dogs. Intrabreed variation was large in several breeds, especially for NT-proBNP. Additional studies are needed to establish breed...

  10. Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care

    Directory of Open Access Journals (Sweden)

    Wachter Rolf

    2008-02-01

    Full Text Available Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.46 (95% CI, 0.41 to 0.50. AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.64 (95% CI, 0.59 to 0.67. 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p Conclusion The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients.

  11. Pro-A-type natriuretic peptide, proadrenomedullin, and N-terminal pro-B-type natriuretic peptide used in a multimarker strategy in primary health care in risk assessment of patients with symptoms of heart failure

    DEFF Research Database (Denmark)

    Alehagen, Urban; Dahlström, Ulf; Rehfeld, Jens F;

    2013-01-01

    Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), midregional pro-A-type natriure......Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), midregional pro......-A-type natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM), individually or combined, gives prognostic information regarding cardiovascular and all-cause mortality that could motivate use in elderly patients presenting with symptoms suggestive of heart failure in primary health care....

  12. Effects of body mass index and age on N-terminal pro brain natriuretic peptide are associated with glomerular filtration rate in chronic heart failure patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kistorp, Caroline N

    2007-01-01

    BACKGROUND: Obesity is a state characterized by glomerular hyperfiltration and age-related decreases in glomerular filtration rate (GFR). Body mass index (BMI), age, and GFR are associated with plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) in chronic heart failure...... (CHF) patients. We hypothesized that the effects of BMI and age on plasma concentrations of NT-proBNP are associated with GFR. METHODS: We obtained clinical data and laboratory test results from 345 CHF patients at the baseline visit in our heart failure clinic and examined the hypothesis using...... multiple linear regression models. RESULTS: Age (P = 0.0184), BMI (P = 0.0098), hemoglobin (P = 0.0043), heart rhythm (P proBNP). After adjustment for GFR estimated by the Cockcroft and Gault equation, the parameter...

  13. N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates

    DEFF Research Database (Denmark)

    Sellmer, Anna; Hjortdal, Vibeke Elisabeth; Bjerre, Jesper Vandborg

    2015-01-01

    three and bronchopulmonary dysplasia (BPD) or death and further to assess the impact of patent ductus arteriosus (PDA) on this association in neonates born before 32 gestational weeks. METHODS: A cohort study of 183 neonates born before 32 gestational weeks consecutively admitted to the Neonatal......-proBNP to be associated with BPD or death in very preterm neonates. This association was not only explained by the PDA. We speculate that NT-proBNP may help the identification of neonates at risk of BPD as early as postnatal day three....... Intensive Care Unit, Aarhus University Hospital, Denmark. On day three plasma samples were collected and echocardiography carried out. NT-proBNP was measured by routine immunoassays. The combined outcome BPD or death was assessed at 36 weeks of postmenstrual age. Receiver operator characteristic (ROC...

  14. Testosterone level and mortality in elderly men with systolic chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Hai-Yun Wu; Xiao-Fei Wang; Jun-Hua Wang; Jiang-Yuan Li

    2011-01-01

    @@ Previous studies on the prognostic significance of serum levels of androgens in patients with chronic heart failure (CHF) have yielded conflicting results.The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHF.A total of 175 elderly men (age>60 years) with CHF were recruited.Total testosterone (TT)and sex hormone-binding globulin (SHBG) were measured,and estimated free testosterone (eFT) was calculated.The median follow-up time was 3.46 years.Of these patients,17 had a TT level below 8 nmoll-1 (230 ng dl-1),27 had an eFT level below 0.225 nmoll-1(65 pg ml-1) and 12 had both.Using the age-specific tenth percentiles of TT and eFT in healthy men in our laboratory as cutoff points,the prevalences of TT and eFT deficiency was 21.7% (38/175) and 27.4% (48/175),respectively.Both TT and eFT were inversely associated with left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) (all P<0.01).Kaplan-Meier curves for patients in low,medium and high tertiles according to TT and eFT level showed significantly different cumulative survival rate (both P<0.01 by log-rank test).However,after adjustment for clinical variables,there were no significant associations of either TT or eFT levels with survival time (OR=0.97,95% CI: 0.84-1.12,P=0.28 and OR=0.92,95% CI: 0.82-1.06,P=0.14,respectively).Our study showed that levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity,but they are not independent predictors for mortality.

  15. Prevalence of pulmonary hypertension in hereditary spherocytosis.

    Science.gov (United States)

    Crary, Shelley E; Ramaciotti, Claudio; Buchanan, George R

    2011-12-01

    Vascular complications, including pulmonary hypertension (PH), have been reported to occur following splenectomy for various disorders,including hereditary spherocytosis (HS). We performed a prospective cross-sectional study of 36 adults with HS (78% with prior splenectomy)utilizing echocardiography to estimate tricuspid regurgitant jet velocity (TRV) as well as measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP) to screen for PH. No participant with HS hada significantly elevated TRV or NT-proBNP level, despite a median 25-year interval since splenectomy (95% confidence interval for point prevalence 0, 0.097). Although our study was limited by a small sample size, it appears that persons with HS, following splenectomy, appear unlikely to be at significantly increased risk of developing PH to the degree reported for thalassemia and sickle cell disease

  16. Non-invasive measurement of right atrial pressure by near-infrared spectroscopy: preliminary experience. A report from the SICA-HF study.

    Science.gov (United States)

    Pellicori, Pierpaolo; Clark, Andrew L; Kallvikbacka-Bennett, Anna; Zhang, Jufen; Urbinati, Alessia; Monzo, Luca; Dierckx, Riet; Anker, Stefan D; Cleland, John G F

    2017-07-01

    To assess the clinical value of measuring right atrial pressure (RAP) using near-infrared spectroscopy (NIRS) in patients with chronic heart failure (CHF). RAP was measured non-invasively using NIRS over the external jugular vein (Venus 1000, Mespere LifeSciences, Canada) in ambulatory patients with CHF enrolled in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) programme. Comparing 243 patients with CHF (mean age 71 years; mean left ventricular ejection fraction (LVEF) 45%, median NT-proBNP 788 ng/L) to 49 controls (NT-proBNP ≤125 ng/L), RAP was 7 [interquartile range (IQR) 4-11] mmHg vs. 4 (IQR 3-8) mmHg (P < 0.001). Those with RAP ≥10 mmHg (n = 75) were older, had more severe clinical congestion and renal dysfunction, higher plasma NT-proBNP, larger left atrial volume, higher systolic pulmonary pressure and were more often in atrial fibrillation but their LVEF was similar to patients with lower RAP. During a median follow-up of 595 (IQR: 492-714) days, 49 patients (20%) died or were hospitalized for worsening CHF. Compared with patients with RAP ≤5 mmHg, those with RAP ≥10 mmHg had a greater risk of an event (hazard ratio 2.38, 95% confidence interval 1.19-4.75, P = 0.014). RAP measured by NIRS predicted outcome, competing with NT-proBNP in multivariable models. Measuring RAP using NIRS identifies ambulatory patients with CHF who have more severe congestion and a worse outcome. The device might be a useful objective method of monitoring RAP, especially for those inexperienced in eliciting physical signs or when measurement of natriuretic peptides is not immediately available. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  17. Cardiac resynchronization therapy and B-type natriuretic peptide in heart failure

    Institute of Scientific and Technical Information of China (English)

    HUANG De-jia

    2009-01-01

    @@ Cardiac resynchronization therapy (CRT) improves left ventricular function, symptom status, quality of life and reduces hospitalization and mortality in patients with New York Heart Association (NYHA) Class Ⅲ or IV heart failure and intraventricular conduction delay despite optimal medical management.1 B-type natriuretic peptide (BNP) and its amino terminal cleavage equivalent (NT-pro BNP) levels correlate with the severity of heart failure and predict prognosis of heart failure patients.2

  18. Assessment Indexes of Cardiac Function in Elderly Patients with Nosocomial Pneumonia and Heart Failure%医院获得性肺炎伴心力衰竭老年患者的心功能评价指标研究

    Institute of Scientific and Technical Information of China (English)

    余昌平

    2012-01-01

    Objective To detect and analyze the biochemical indexes of elderly patients with nosocomial pneumonia complicated by heart failure so as to find out the sensitive indexes to assess the cardiac functions. Methods Totally 80 elderly patients with nosocomial pneumonia who were definitely diagnosed as having chronic heart failure were recruited as the trial group, and another 80 with no chronic hear failure were chosen as controls. The bidirectional lateral flow immunoassay was used to detect the concentration of serum N - terminal - pro - brain natriuretic peptide ( NT - proBNP ); and AIA360 Automatic Enzyme Immunoassay System was taken to determine the contests of aspartate aminotransferase ( AST ), lactate dehydrogenase ( LDH ), crea-tine phosphate kinase - MB ( CK - MB ) and cardiac troponin I ( cTnl). The heart function classification was performed according to criteria of New York Heart Association ( NYHA ). Results The logNT - proBNP in the trial group was ( 3. 42 ± 0. 19 ) pg/ml, being significantly higher than ( 2. 65 ± 0. 16 ) pg/ml in the control group ( P ( 3. 36 ±0. 14 ) pg/ml of patients at NYHAⅢ grade > ( 2. 88 ±0. 12 ) pg/ml of patients at NYHA Ⅱ grade ( F = 183. 36, P = 0. 00 ) . Conclusion The level of serum NT - proBNP in elderly patients with nosocomial pneumonia complicated by heart failure increases with the severity of the heart failure, which is a sensitive biomarker to evaluate heart function.%目的 检测医院获得性肺炎(HAP)伴心力衰竭(心衰)老年患者的生化指标并进行分析,以寻找评价心功能的敏感性指标.方法 选择明确诊断为慢性心衰的HAP老年患者80例作为观察组,不伴心衰者80例作为对照组.利用双向侧流免疫法检测血清氨基末端脑钠肽前体(NT-proBNP)浓度,血清天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(cTnI)用AIA360全自动荧光磁微粒酶免疫分析仪检测.心功能按照纽约心

  19. Natriuretic peptides and Galectin-3 in senile heart failure patients with preserved ejection fraction.

    Directory of Open Access Journals (Sweden)

    Malinova L.I.

    2015-03-01

    Full Text Available Purpose: to characterize biomarker panel in senile patients with heart failure with preserved ejection fraction (HF-pEF. Material and Methods. 356 senile patients with chronic heart failure with preserved ejection fraction (HFpEF were examined to form the study sample of 48 male patients without atrium fibrillation, anemia, diabetes mellitus, onco-pathology and missing clinical data. NT-proBNP, galectin-3 (gal-3 and proANT assay was performed by commercially available ELISA kits. Results. In patients without left ventricular (LV regional wall motion abnormalities (RWMA. gal-3 (2,13 (0,98; 3,50 vs 5.16 (4,34;9.63 ng/mL, p = 0.011 and NT-proBNP (5,59 (1,00; 10.13 vs 32,04 (15,40; 46,18 fmol/mL, p=0,006 levels were significantly lower than in patients with LV RWMA. Contrarily proANP level was lower in patients with LV RWMA (3,24 (2,47; 3,75 vs 1,38 (0,83; 2,29 nmol/mL, p=0.071. proANP was the only biomarker to increase significantly in long livers (7,30 (4,52; 7,63 vs 2,68 (1,88; 3,32 nmol/mL, p=0.006. NT-proBNP positively correlated with glucose level and negatively with hsCRP (R=0,52, p=0,007. Conclusion. Biomarker panel in senile heart failure patients with preserved ejection fraction has characterized: increase in NT-proBNP and galectin-3 is associated with more severe clinical course and presence of regional wall motion abnormalities in senile patients.

  20. Relationship between myocardial extracellular space expansion estimated with post-contrast T1 mapping MRI and left ventricular remodeling and neurohormonal activation in patients with dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ji Hyun; Son, Jung Woo; Chung, Hye Moon [Cardiology Division, Dept. of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

    2015-10-15

    Post-contrast T1 values are closely related to the degree of myocardial extracellular space expansion. We determined the relationship between post-contrast T1 values and left ventricular (LV) diastolic function, LV remodeling, and neurohormonal activation in patients with dilated cardiomyopathy (DCM). Fifty-nine patients with DCM (mean age, 55 ± 15 years; 41 males and 18 females) who underwent both 1.5T magnetic resonance imaging and echocardiography were enrolled. The post-contrast 10-minute T1 value was generated from inversion time scout images obtained using the Look-Locker inversion recovery sequence and a curve-fitting algorithm. The T1 sample volume was obtained from three interventricular septal points, and the mean T1 value was used for analysis. The N-Terminal pro-B-type natriuretic peptide (NT-proBNP) level was measured in 40 patients. The mean LV ejection fraction was 24 ± 9% and the post-T1 value was 254.5 ± 46.4 ms. The post-contrast T1 value was significantly correlated with systolic longitudinal septal velocity (s'), peak late diastolic velocity of the mitral annulus (a'), the diastolic elastance index (Ed, [E/e']/stroke volume), LV mass/volume ratio, LV end-diastolic wall stress, and LV end-systolic wall stress. In a multivariate analysis without NT-proBNP, T1 values were independently correlated with Ed (β = -0.351, p = 0.016) and the LV mass/volume ratio (β = 0.495, p = 0.001). When NT-proBNP was used in the analysis, NT-proBNP was independently correlated with the T1 values (β = -0.339, p = 0.017). Post-contrast T1 is closely related to LV remodeling, diastolic function, and neurohormonal activation in patients with DCM.

  1. N-terminal pro-B-type natriuretic peptide detection for elderly emergency patients with dyspnea%快速检测氨基末端-脑钠肽前体在急诊老年呼吸困难患者中的应用价值

    Institute of Scientific and Technical Information of China (English)

    苏琴; 张宪; 党伟; 孙荣距; 马俊勋; 袁晓玲; 刘红升; 姚咏明; 赵晓东

    2011-01-01

    目的 探讨快速检测氨基末端-脑钠肽前体( NT-proBNP)在急诊老年呼吸困难患者中的临床应用价值.方法 根据病因将202例老年急性呼吸困难患者分为单纯肺源性呼吸困难组(A组);单纯心源性呼吸困难组(B组);混合性呼吸困难组(肺源性+心源性,C组).床旁快速检测NT-proBNP水平,并行超声心动图检查,测量左心室射血分数(LVEF).比较各组间NT-proBNP水平的差异及B,C两组中NT-proBNP水平与NYHA心功能分级和LVEF的相关性.结果 A组NT-proBNP水平明显低于B,C两组[(197.5±64.3) vs( 1873.9±857.1)和(1952.4±914.8) ng/L,P<0.01].B,C两组NT-proBNP水平差异无显著统计学意义(P>0.05),说明有心源性呼吸困难的患者NT-proBNP水平明显高于单纯肺源性呼吸困难患者.心功能Ⅱ级、Ⅲ级、Ⅳ级患者中,NT-proBNP水平依次升高,说明患者NT-proBNP水平越高,心功能分级越高[分别( 562.37±102.45),(2736.72±81.67),(5873.19±127.73) ng/L,P<0.01].Person直线相关分析发现,NT-proBNP水平与LVEF呈负相关(r=- 0.689,P<0.01),提示NT-proBNP水平越高,LVEF值越低,心功能越差.结论 NT-proBNP水平检测在判断老年肺源性与心源性呼吸困难方面具有较好的临床鉴别诊断价值,其水平高低与心力衰竭严重程度密切相关.%Objective To evaluate the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) detection in elderly patients with acute dyspnea. Methods Based on the etiology, 202 elderly patients with acute dyspnea were divided into three groups: simple pulmonary disease(PD) group(A), simple congestive heart failure(CHF) group (B), and CHF and PD combination group (C). NT-proBNP levels, echocardiogram, left ventricular ejection fraction (LVEF), and New York Heart Association (NYHA) classification were assessed in all subjects. NT-proBNP levels were compared between different groups. Correlations of NT-proBNP levels with NYHA classification and LVEF in group B and

  2. Prediction of cardiovascular events in statin-treated stable coronary patients of the treating to new targets randomized controlled trial by lipid and non-lipid biomarkers.

    Directory of Open Access Journals (Sweden)

    Benoit J Arsenault

    Full Text Available Several plasma non-lipid biomarkers have been shown to predict major cardiovascular events (MCVEs in population studies. Our objective was to investigate the relationship between lipid and non-lipid biomarkers levels achieved during statin therapy and the incidence of MCVEs in patients with stable coronary heart disease (CHD. We conducted a substudy of the TNT (Treating to New Targets study, which was a randomized trial that compared the efficacy of high (80 mg versus low (10 mg dose atorvastatin for the secondary prevention of CHD. Fasting plasma levels of standard lipids and of 18 non-lipid biomarkers were obtained after an 8-week run-in period on atorvastatin 10 mg in 157 patients who experienced MCVEs during the 4.9 years of study follow-up and in 1349 controls. MCVE was defined as CHD death, nonfatal, non-procedure-related myocardial infarction, resuscitated cardiac arrest, and fatal or nonfatal stroke. After adjusting for age, sex and treatment arm, plasma levels of high-density lipoprotein (HDL cholesterol, triglycerides, high-sensitivity C-reactive protein (hsCRP, insulin, neopterin, N-terminal pro-brain natriuretic peptide (BNP, lipoprotein(a [Lp(a], and the soluble receptor for advanced glycation end products (sRAGE were predictive of recurrent MCVEs (P ≤ 0.02 for each doubling of plasma concentration. However, no significant association was observed between the risk of recurrent MCVEs and plasma levels of low-density lipoprotein cholesterol, adiponectin, cystatin C, lipoprotein-associated phospholipase A2, monocyte chemotactic protein-1, matrix metalloproteinase-9, myeloperoxidase, osteopontin, soluble CD40 ligand, soluble intercellular adhesion molecule-1, or soluble vascular cell adhesion molecule-1. After further adjustment for diabetes, hypertension, smoking, and BMI, the relationship between hsCRP, insulin and MCVE were no longer significant, while the relationship between Lp(a, neopterin, NT-proBNP and sRAGE and MCVE remained

  3. A prognostic model for short term adverse events in normotensive patients with pulmonary embolism.

    Science.gov (United States)

    Agterof, Mariette J; Schutgens, Roger E G; Moumli, Noureddine; Eijkemans, M J C; van der Griend, René; Tromp, Ellen A M; Biesma, Douwe H

    2011-08-01

    Risk stratification of patients with PE has gained interest in terms of the identification of patients in whom treatment on an outpatient base can be considered. Previous studies are of limited value due to their focus on adverse clinical events within several months after diagnosis of PE. We developed a prognostic model, based on easily accessible, clinical, and laboratory parameters, to predict adverse events during the first 10 days after the diagnosis of acute PE. We have analyzed the data of 210 outpatients with confirmed PE. Collected data included medical history, pulse rate, blood pressure, NT-proBNP, and D-dimer concentrations. The primary outcome was the occurrence of adverse clinical events in a 10 day follow-up period. Our final prognostic model to predict short-term adverse events consists of NT-proBNP levels, D-dimer concentrations, pulse rate, and the occurrence of active malignancy; the total score ranges from 0 to 37 points. Patients with a low score (no active malignancy, pulse rate rate, D-dimer concentrations, and NT-proBNP levels. Our prognostic model, once prospectively validated in an independent sample of patients, can be used in the early risk stratification of PE to estimate the risk of adverse events and to differentiate between candidates for in- or out- hospital treatment. Copyright © 2011 Wiley-Liss, Inc.

  4. Intestinal Microbiota-Dependent Phosphatidylcholine Metabolites, Diastolic Dysfunction and Adverse Clinical Outcomes in Chronic Systolic Heart Failure

    Science.gov (United States)

    Wilson Tang, W. H.; Wang, Zeneng; Shrestha, Kevin; Borowski, Allen G; Wu, Yuping; Troughton, Richard W; Klein, Allan L; Hazen, Stanley L

    2014-01-01

    Background Trimethylamine-N-oxide (TMAO) has been linked to increased cardiovascular risk. We aim to determine the prognostic value of TMAO and its dietary precursors, choline and betaine, in heart failure (HF). Methods and Results In 112 patients with chronic systolic HF with comprehensive echocardiographic evaluation, we measured plasma TMAO, choline, and betaine by mass spectrometry. Median TMAO levels, choline, and betaine levels were 5.8 [3.6, 12.1] μM, 10.9 [8.4, 14.0] μM, 43.8 [37.1, 53.0] μM, respectively, and were correlated with each other (all p<0.0001 for both). TMAO levels were significantly higher in patients with diabetes mellitus (9.4 [4.9, 13.2] vs 4.8 [3.4, 9.8] μM, p=0.005) and in subjects with New York Heart Association (NYHA) class III or greater (7.0 [4.7, 14.8] vs 4.7 [3.4, 11.3] μM, p=0.02). Elevated TMAO, choline, and betaine levels were each associated with higher plasma NT-proBNP levels and more advanced left ventricular diastolic dysfunction, but not systolic dysfunction or inflammatory and endothelial biomarkers. Higher choline (Hazard ratio (HR) 1.64 [95% CI: 1.22 2.20], p=0.001), betaine (HR 1.51 [1.10–2.08], p=0.01), and TMAO (HR 1.48 [1.10–1.96], p=0.01) predicted increased risk for 5-year adverse clinical events (death/transplant). Only higher TMAO levels predicted incident adverse clinical events independent of age, eGFR, mitral E/septal Ea, and NT-proBNP levels (HR 1.46 [1.03 2.14], p=0.03). Conclusion Elevated plasma TMAO, choline and betaine levels are each associated with more advanced left ventricular diastolic dysfunction and portend poorer long-term adverse clinical outcomes in chronic systolic HF. However, only higher plasma TMAO levels was associated with poor prognosis after adjustment for cardio-renal indices. PMID:25459686

  5. Cardiac response to exercise in mild-to-moderate chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    Hao-Yan Wang; Qiu-Fen Xu; Yao Xiao

    2009-01-01

    Objective Chronic obstructive pulmonary disease (COPD) increases the risk of cardiovascular problem.The symptom of dyspnea on exertion may be associated with pulmonary dysfunction or heart failure, or both. The study objective was to determine whether cardiac dysfunction adds to the mechanism of dyspnea caused mainly by impaired lung function in patients with mild-to-moderate COPD. Methods Patients with COPD and healthy controls performed incremental and constant work rate exercise testing. Venous blood samples were collected in 19 COPD patients and 10 controls before and during constant work exercise for analysis of N-terminal-pro-BNP (NT-pro-BNP). Results Peak oxygen uptake and constant work exercise time (CWET) were significantly lower in COPD group than in control group (15.81±3.65 vs 19.19a±6.16 ml/min kg, P=0.035 and 7.78±6.53 rain vs 14.77±7.33 min, P=0.015, respectively). Anaerobic threshold, oxygen pulse and heart rate reserve were not statistically significant between COPD group and control group. The NT-pro-BNP levels both at rest and during constant work exercise were higher in COPD group compared to control group, but without statistical significance. The correlations between CWET and NT-proBNP at rest or during exercise in patients with COPD were not statistically significant. Conclusions Heart failure does not contribute to exercise intolerance in mild-to-moderate COPD.

  6. Primary care REFerral for EchocaRdiogram (REFER) in heart failure: a diagnostic accuracy study

    Science.gov (United States)

    Taylor, Clare J; Roalfe, Andrea K; Iles, Rachel; Hobbs, FD Richard; Barton, P; Deeks, J; McCahon, D; Cowie, MR; Sutton, G; Davis, RC; Mant, J; McDonagh, T; Tait, L

    2017-01-01

    Background Symptoms of breathlessness, fatigue, and ankle swelling are common in general practice but deciding which patients are likely to have heart failure is challenging. Aim To evaluate the performance of a clinical decision rule (CDR), with or without N-Terminal pro-B type natriuretic peptide (NT-proBNP) assay, for identifying heart failure. Design and setting Prospective, observational, diagnostic validation study of patients aged >55 years, presenting with shortness of breath, lethargy, or ankle oedema, from 28 general practices in England. Method The outcome was test performance of the CDR and natriuretic peptide test in determining a diagnosis of heart failure. The reference standard was an expert consensus panel of three cardiologists. Results Three hundred and four participants were recruited, with 104 (34.2%; 95% confidence interval [CI] = 28.9 to 39.8) having a confirmed diagnosis of heart failure. The CDR+NT-proBNP had a sensitivity of 90.4% (95% CI = 83.0 to 95.3) and specificity 45.5% (95% CI = 38.5 to 52.7). NT-proBNP level alone with a cut-off need to be revised. PMID:27919937

  7. Factors Affecting Canagliflozin-Induced Transient Urine Volume Increase in Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Tanaka, Hiroyuki; Takano, Kazuhiko; Iijima, Hiroaki; Kubo, Hajime; Maruyama, Nobuko; Hashimoto, Toshio; Arakawa, Kenji; Togo, Masanori; Inagaki, Nobuya; Kaku, Kohei

    2017-02-01

    Sodium glucose co-transporter 2 (SGLT2) inhibitors exhibit diuretic activity, which is a possible mechanism underlying the cardiovascular benefit of these inhibitors. However, the osmotic diuresis-induced increase in urine volume, and the risk of dehydration have been of concern with SGLT2 inhibitor treatment. This study aimed to investigate the mechanism underlying SGLT2 inhibitor canagliflozin-induced diuresis in Japanese type 2 diabetes mellitus (T2DM) patients. Thirteen T2DM patients received a daily oral dose of 100 mg canagliflozin before breakfast for 6 days. Blood and urine samples were collected at predetermined time points. The primary endpoint was evaluation of correlations between changes from baseline in urine volume and factors that are known to affect urine volume and between actual urine volume and these factors. Canagliflozin transiently increased urine volume and urinary sodium excretion on Day 1 with a return to baseline levels thereafter. Canagliflozin administration increased urinary glucose excretion, which was sustained during repeated-dose administration. Plasma atrial natriuretic peptide (ANP) and N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels decreased, while plasma renin activity increased. On Day 1 of treatment, changes in sodium and potassium excretion were closely correlated with changes in urine output. A post hoc multiple regression analysis showed changes in sodium excretion and water intake as factors that affected urine volume change at Day 1. Furthermore, relative to that at baseline, canagliflozin decreased blood glucose throughout the day and increased plasma total GLP-1 after breakfast. Canagliflozin induced transient sodium excretion and did not induce water intake at Day 1; hence, natriuresis rather than glucose-induced osmotic diuresis may be a major factor involved in the canagliflozin-induced transient increase in urine output. In addition, canagliflozin decreased plasma ANP and NT-proBNP levels and

  8. Clinical Trial of Sertraline in Elderly Patients with Acute Coronary Syndrome Complicating Depression%老年急性冠状动脉综合征并抑郁患者舍曲林治疗研究

    Institute of Scientific and Technical Information of China (English)

    方飞; 赵进和; 史佳

    2015-01-01

    Objective To investigate the clinical effects of sertraline in elderly patients with acute coronary syndrome complicating de-pression. Methods 57 patients were randomly divided into two groups :control group and observation group. The control group re-ceived regular therapy ;the observation group received oral sertraline and regular therapy . The cardiovascular events (angina pectoris , myocardial infarction ,congestive heart failure and death ) were carefully observed in one year. Results There were no significant dif-ferences between baseline values ,Hamilton’s depression scale (HAMD scale) ,the level of Amino terminal pro brain natriuretic pep-tide (NT Pro BNP) ,Plasma cortisol ,left ventriculear ejection fraction (LVEF) ,left ventricular end diastolic diameter (LVEDD) , plasma homocysteine levels among the two groups before research ( P>0.05). After the treatment ,LVEF in observation group was statistically significant higher than that in the control group ,HAMD scale ,the level of NT Pro BNP ,Plasma cortiso ,plasma homocys-teine were significantly decreased ( P0.05). The total incident rates of cardiovascular events were significantly lower in observation group than in control group ( P<0.05). Con-clusions Sertraline can restrain the hypothalamic pituitary adrenal axis and decrease the serum homocysteine ,that maybe the reason for sertraline could improve the prognosis of elderly patients with acute coronary syndrome complicating depression .%目的:观察舍曲林干预急性冠状动脉综合征合并抑郁患者的疗效。方法57例急性冠状动脉综合征合并抑郁患者随机分成两组,对照组给予基础治疗,观察组在基础治疗上加用舍曲林干预。观察两组患者1年的心血管事件发生率及其相关指标变化的情况。结果两组治疗前汉密尔顿抑郁量表评分(HAMD评分)、左心室射血分数(LVEF )、左心室舒张末期内径(LVEDD )、外周血氨基末端脑钠肽前体(NT Pro

  9. Dairy products and plasma cholesterol levels

    Directory of Open Access Journals (Sweden)

    Lena Ohlsson

    2010-08-01

    Full Text Available Cholesterol synthesized in the body or ingested is an essential lipid component for human survival from our earliest life. Newborns ingest about 3–4 times the amount per body weight through mother's milk compared to the dietary intake of adults. A birth level of 1.7 mmol/L plasma total cholesterol will increase to 4–4.5 mmol/L during the nursing period and continue to increase from adulthood around 40% throughout life. Coronary artery disease and other metabolic disorders are strongly associated with low-density lipoprotein (LDL and high-density lipoprotein (HDL cholesterol as well as triacylglycerol concentration. Milk fat contains a broad range of fatty acids and some have a negative impact on the cholesterol rich lipoproteins. The saturated fatty acids (SFAs, such as palmitic acid (C16:0, myristic acid (C14:0, and lauric acid (C12:0, increase total plasma cholesterol, especially LDL, and constitute 11.3 g/L of bovine milk, which is 44.8% of total fatty acid in milk fat. Replacement of dairy SFA and trans-fatty acids with polyunsaturated fatty acids decreases plasma cholesterol, especially LDL cholesterol, and is associated with a reduced risk of cardiovascular disease. Available data shows different effects on lipoproteins for different dairy products and there is uncertainty as to the impact a reasonable intake amount of dairy items has on cardiovascular risk. The aim of this review is to elucidate the effect of milk components and dairy products on total cholesterol, LDL, HDL, and the LDL/HDL quotients. Based on eight recent randomized controlled trials of parallel or cross-over design and recent reviews it can be concluded that replacement of saturated fat mainly (but not exclusively derived from high-fat dairy products with low-fat dairy products lowers LDL/HDL cholesterol and total/HDL cholesterol ratios. Whey, dairy fractions enriched in polar lipids, and techniques such as fermentation, or fortification of cows feeding can be used

  10. 先天性心脏病患儿术前充血性心力衰竭年龄分层后血浆氨基末端B型脑利钠肽前体诊断界值的研究%Cut-off values of amino-terminal pro-B-type natriuretic peptide for the diagnosis of chronic heart failure in children of age stratification with congenital heart disease prior to heart surgery

    Institute of Scientific and Technical Information of China (English)

    林春旺; 曾祥林; 孟秀会; 江少虎; 欧阳辉

    2013-01-01

    目的 通过检测先天性心脏病(congenital heart disease,CHD)患儿在行心脏手术前血浆中的氨基末端B型脑利钠肽前体(amino-terminal pro-B-type natriuretic peptide,NT-proBNP)血浆浓度,绘制ROC曲线分析其敏感度、特异度及约登指数,探讨0~5岁经年龄分层前后充血性心力衰竭(congestiveheart failure,CHF)患儿血浆NT-proBNP诊断界值.方法 测定2011年1月至2013年1月收治的100例CHD术前患儿(试验组)及100例正常儿童(对照组)血浆NT-proBNP,合并CHF的CHD患儿(CHF组)经年龄分层又分为0~1岁组、~3岁组和~5岁组,探讨各自的NT-proBNP诊断CHF的界值.结果 100例CHD患儿中,34例符合改良Ross心力衰竭诊断标准,试验组在年龄分层前按照ROC曲线选取的NT-proBNP诊断CHF界值为502 ng/L,经年龄分层后0~1岁组、~3岁组、~5岁组的NT-proBNP诊断CHF界值分别为552 ng/L、449ng/L、349 ng/L.结论 该研究结果显示,合并CHF的CHD术前患儿经年龄分层后0~1岁组、~3岁组、~5岁组的NT-proBNP诊断CHF界值分别为552 ng/L、449ng/L、349 ng/L.%Objective To detect the plasma amino-terminal pro-B-type natriuretic peptide (NT-ProBNP) of children with congenital heart disease(CHD) prior to heart surgery,to analysize its sensitivity,specificity and Youden index by receiver operating characteristic(ROC) curve,to explore the cut-off values of plasma NTProBNP for the diagnosis of congestive heart failure(CHF) in children under 5 years old before and after age stratification.Method The plasma NT-proBNP was detected for 100 children with CHD prior to heart surgery (experimental group) and 100 normal children(control group) between January 2011 to January 2013.Age stratification(0 ~ 1 year group,~3 years group and ~ 5 year group) was conducted in children with CHF younger than 5 years old to explore the cut-off values of plasma NT-ProBNP for the diagnosis of CHF.Results The NT-proBNP of 34 patients with CHF(n =100) was in

  11. Plasma homocysteine levels in female patients with eating disorders.

    NARCIS (Netherlands)

    Levine, J.; Gur, E.; Loewenthal, R.; Vishne, T.; Dwolatzky, T.; Beijnum, I.M. van; Sela, B.A.; Vered, I.; Yosef, G.; Stein, D.

    2007-01-01

    OBJECTIVE: To examine plasma homocysteine, vitamin B(12), and folate levels in females with restricting and bingeing/purging eating disorders (EDs). METHOD: Adolescent and adult female patients were compared to appropriate control groups with regard to plasma homocysteine levels. RESULTS: The plasma

  12. 试析心功能Ⅲ、Ⅳ级慢性心衰患者血清CA125与NT Pro-BNP浓度相关性

    Institute of Scientific and Technical Information of China (English)

    李金怡; 吕敏

    2016-01-01

    目的:探讨慢性心衰患者III、IV级心功能血清CA125与NT Pro-BNP浓度的相关性。方法将我院心血管内科收治的慢性心衰患者70例选为研究对象,心功能为III级、IV级,检测血清CA125与NT Pro-BNP浓度,探讨二者间相关性。结果心功能IV级血清CA125水平与NT Pro-BNP浓度明显高于心功能III级,对比差异明显(P<0.05),治疗后CA125与NT Pro-BNP浓度明显低于治疗前,对比差异明显(P<0.05)。结论CA125与NT Pro-BNP浓度呈正相关;对慢性心衰患者可采取CA125、NT Pro-BNP联合检测法。%Objective: To investigate patients with chronic heart failure III, IV grade heart function and serum CA125 NT Pro-BNP concentration correlation. Methods: Patients with chronic heart failure in cardiovascular medicine in our hospital treated 70 patients chosen for the study, cardiac function grade III, IV level, serum CA125 and Pro-BNP concentration NT, investigate the correlation between the two. Results:Class IV heart function and serum CA125 levels of NT Pro-BNP concentration was significantly higher than Class III heart function, contrast significantly different (P<0.05), after treatment, CA125 and NT Pro-BNP concentration was significantly lower than before treatment, significant differences in contrast (P<0.05). Conclusion:CA125 and NT Pro-BNP concentration was positively correlated;chronic heart failure patients can take CA125, NT Pro-BNP joint detection method.

  13. Older Adults, "Malignant" Left Ventricular Hypertrophy, and Associated Cardiac-Specific Biomarker Phenotypes to Identify the Differential Risk of New-Onset Reduced Versus Preserved Ejection Fraction Heart Failure: CHS (Cardiovascular Health Study).

    Science.gov (United States)

    Seliger, Stephen L; de Lemos, James; Neeland, Ian J; Christenson, Robert; Gottdiener, John; Drazner, Mark H; Berry, Jarett; Sorkin, John; deFilippi, Christopher

    2015-06-01

    This study hypothesized that biomarkers of subclinical myocardial injury (high-sensitivity cardiac troponin T [hs-cTnT]) and hemodynamic stress (N-terminal pro-B-type natriuretic peptide [NT-proBNP]) would differentiate heart failure (HF) risk among older adults with left ventricular hypertrophy (LVH). The natural history of LVH, an important risk factor for HF, is heterogeneous. NT-proBNP and hs-cTnT were measured at baseline and after 2 to 3 years in older adults without prior HF or myocardial infarction in the CHS (Cardiovascular Health Study). LVH and left ventricular ejection fraction were determined by echocardiography. HF events were adjudicated over a median of 13.1 years and classified as preserved or reduced left ventricular ejection fraction (heart failure with preserved ejection fraction or heart failure with reduced ejection fraction [HFrEF]). Adjusted risk of HF by LVH and biomarker tertiles, and by LVH and longitudinal increase in each biomarker was estimated using Cox regression. Prevalence of LVH was 12.5% among 2,347 participants with complete measures. Adjusted risk of HF (N = 643 events) was approximately 3.8-fold higher among participants with LVH and in the highest biomarker tertile, compared with those with low biomarker levels without LVH (NT-proBNP, hazard ratio [HR]: 3.78; 95% confidence interval [CI]: 2.78 to 5.15 and hs-cTnT, HR: 3.86; 95% CI: 2.84 to 5.26). The adjusted risk of HFrEF was 7.8 times higher among those with the highest tertile of hs-cTnT and LVH (HR: 7.83; 95% CI: 4.43 to 13.83). Those with LVH and longitudinal increases in hs-cTnT or NT-proBNP were approximately 3-fold more likely to develop HF, primarily HFrEF, compared with those without LVH and with stable biomarkers. The combination of LVH with greater hs-cTnT or NT-proBNP levels, and their longitudinal increase, identifies older adults at highest risk for symptomatic HF, especially HFrEF. These biomarkers may characterize sub-phenotypes in the transition from LVH

  14. 大强度耐力运动对大学生运动员NT-proBNP、血清铁、血红蛋白、白介素-6和心功能的影响%Effect of Intensive Endurance Exercise on NT-proBNP IL-6 Serum Iron Hemoglobin and Cardiac Efficiency of College Athletes

    Institute of Scientific and Technical Information of China (English)

    王坤

    2012-01-01

    目的:评价大强度耐力训练对大学生运动员心脏标志物、血清铁、血红蛋白、白介素-6和心功能的影响.方法:随机选取30名男性学生运动员,在100 min内完成20 000m长跑和哈佛台阶试验,心率控制在180~200次/min.在运动前(T1)、运动后即刻(T2)和运动后3 h(T3)测定运动员的心率、血压、血浆NT-proBNP、血清铁、血红蛋白以及白介素-6的表达.结果:运动后即刻的心率、收缩压、舒张压、NT-proBNP含量较运动前显著增加(P<0.05),血清铁和白介素-6含量较运动前显著降低(P<0.05),血红蛋白含量无显著性变化;运动后3h,心率、收缩压、舒张压、血浆NT- proBNP、血清铁、血红蛋白以及白介素-6的表达均与运动前无显著性差异.结论:大强度耐力训练后心脏损伤标志物NT- proBNP含量显著性增高,应该是对运动刺激的一种生理适应,不具有病理性改变意义.白介素-6浓度发生显著性上升,并不能表明发生运动性炎性反应,并未对心功能造成伤害.血清铁含量的下降,表明运动并未过量,没有对机体造成损伤.

  15. Clinical pharmacology of levosimendan.

    Science.gov (United States)

    Antila, Saila; Sundberg, Stig; Lehtonen, Lasse A

    2007-01-01

    Levosimendan has been developed for the treatment of decompensated heart failure and is used intravenously when patients with heart failure require immediate initiation of drug therapy. It increases cardiac contractility and induces vasodilatation. The pharmacokinetics of levosimendan are linear at the therapeutic dose range of 0.05-0.2 microg/kg/minute. The short half-life (about 1 hour) of the parent drug, levosimendan, enables fast onset of drug action, although the effects are long-lasting due to the active metabolite OR-1896, which has an elimination half-life of 70-80 hours in patients with heart failure (New York Heart Association functional class III-IV). Although levosimendan is administered intravenously, it is excreted into the small intestine and reduced by intestinal bacteria to an amino phenolpyridazinone metabolite (OR-1855). This metabolite is further metabolised by acetylation to N-acetylated conjugate (OR-1896). The circulating metabolites OR-1855 and OR-1896 are formed slowly, and their maximum concentrations are seen on average 2 days after stopping a 24-hour infusion. The haemodynamic effects after levosimendan seem to be similar between fast and slow acetylators despite the fact that the enzyme N-acetyltransferase-2, which is responsible for the metabolism of OR-1855 to OR-1896, is polymorphically distributed in the population. Levosimendan reduces peripheral vascular resistance and has direct contractility-enhancing effects on the failing left ventricle. It also improves indices of diastolic function and seems to improve the function of stunned myocardium. Despite an improvement in ventricular function, levosimendan does not increase myocardial oxygen uptake significantly. An increase in coronary blood flow and a reduction in coronary vascular resistance have been observed. Levosimendan reduces plasma brain natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) levels substantially, and a decrease in plasma endothelin-1 has been

  16. Amino-terminal pro-brain natriuretic peptide and brain natriuretic peptide measurements under various detection conditions in patients with chronic heart failure%心力衰竭时N末端B型利钠肽原与B型利钠肽检测时受干扰的分析

    Institute of Scientific and Technical Information of China (English)

    王伟佳; 张秀明; 王前; 温冬梅; 欧阳能良; 崔亚丽; 李飞

    2011-01-01

    Objective To find the potential interference factors for the detection of NT-proBNP and BNP in patients with chronic heart failure. Methods EP15-A2 issued by Clinical and Laboratory Standards Institute (CLSI) was employed to compare the precision and accuracy of commercial NT-proBNP and BNP analyzer electrochemiluminescence immunoassay system Cobas E601 and chemiluminescence system ADVIA Centaur. Moreover, NT-proBNP and BNP were detected in different time interval and in different interfered sampling conditions (haematolysis, choloplania, lipemia). NT-proBNP and BNP of 203 patients with heart failure or heart failure complicated with acute cerebral infarction were analyzed to find the deviation caused by patients' endogenous factors. Results The precision and accuracy were comparable for NT-proBNP and BNP detection using Cobas E601 and ADVIA Centaur (total-CV below 2. 9% and 3.5%, the deviation from definite value below 2. 38% and 3.91% ). The most suitable sample type for NT-proBNP and BNP detection was serum and EDTA- anticoagulant plasma. The detection results of NT-proBNP and BNP were comparable for at least 120 min post sampling and not affected by Hb(2 g/L), DB(428 μmol/L) and chyle(2000FIU). NT-proBNP was significantly higher in heart failure patients complicated with cerebral infarction( P =0. 003) than in heart failure patients. BNP was significantly higher in heart failure grade Ⅲ patients complicated with cerebral infarction ( P < 0. 01 ). Conclusions Cobas E601 and ADVIA Centaur supplied satisfactory detection of NT-proBNP and BNP in patients with chronic heart failure with strong anti-interference capacity. The diagnostic value of NT-proBNP and BNP for chronic heart failure should be analyzed objectively in the presence of complicating diseases.%目的 探讨心力衰竭(心衰)标志物N末端B型利钠肽原(NT-proBNP)与B型利钠肽(BNP)检测结果对心衰评价的潜在干扰因素,为临床医生正确选择分析物与合理分析

  17. Plasma and semen ascorbic levels in spermatogenesis

    African Journals Online (AJOL)

    were significant decreases in the seminal and plasma ascorbic acid concentrations ... maintenance of sperm cell lipid membrane has generated increasing interest. .... function and its association with the genesis of reactivc oxygen species.

  18. N-terminal pro brain natriuretic peptide in arterial hypertension--a marker for left ventricular dimensions and prognosis

    DEFF Research Database (Denmark)

    Hildebrandt, Per; Boesen, Mikael; Olsen, Michael

    2004-01-01

    and preserved LV function demonstrated that NT-proBNP was a very strong prognostic marker, especially combined with a history of cardiovascular disease. Patients with high NT-proBNP and known cardiovascular disease had a seven-fold increase in CV events compared to patients with low NT-proBNP and no CV disease...... is present in arterial hypertension, risk factor evaluation would be easier. In 36 patients with arterial hypertension, electrocardiographic LV hypertrophy and preserved left ventricular function, NT-proBNP was eight-fold higher than in healthy subjects. The log NT-proBNP correlated with LV mass index (R=0...

  19. The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction.

    Science.gov (United States)

    Kocaman, Sinan Altan; Taçoy, Gülten; Ozdemir, Murat; Açıkgöz, Sadık Kadri; Cengel, Atiye

    2010-12-01

    Autonomic dysfunction is an important marker of prognosis in congestive heart failure (CHF) and may determine the symptoms and progression of CHF. The aim of our study was to investigate whether preserved autonomic function assessed by heart rate variability (HRV) analyses is related to absence of CHF symptoms despite prominently reduced systolic function. The study had a cross-sectional observational design. Fifty patients with left ventricular ejection fraction (EF) below 40% were enrolled. The patients were divided into two groups according to their CHF symptomatic status as Group 1 (NYHA functional class I, asymptomatic group) and Group 2 (NYHA functional class ≥ II, symptomatic group). Plasma C-reactive protein (CRP), N-terminal proB-type natriuretic peptide (NT-proBNP) levels, echocardiographic parameters and HRV indices were measured while the patients were clinically stable in each group. Possible factors associated with the development of CHF symptoms were assessed by using multiple regression analysis. Baseline clinical characteristics and left ventricular EF were similar in the two groups. Serum CRP (15 ± 21 vs 7 ± 18 mg/L, p=0.011) and NT-proBNP levels (1935 ± 1088 vs 1249 ± 1083 pg/mL, p=0.020) were significantly higher in symptomatic group. The HRV parameters (SDNN: 78 ± 57 vs 122 ± 42 ms, p=0.001; SDANN: 65 ± 55 vs 84 ± 38 ms, p=0.024; SDNNi: 36 ± 41 vs 70 ± 46 ms, p<0.001; triangular index [Ti]: 17 ± 12 vs 32 ± 14, p<0.001) were also significantly depressed in symptomatic group. When multiple regression analysis was performed, only HRV indices of autonomic function were significantly associated with the asymptomatic status (SDNN, OR: 1.016, 95%CI: 1.002-1.031, p=0.028; SDNNi, OR: 1.030, 95%CI: 1.008-1.052, p=0.006; TI, OR: 1.088, 95%CI: 1.019-1.161, p=0.011). Preserved autonomic functions were shown to be associated with absence of CHF symptoms independently of angiotensin converting enzyme inhibitor/angiotensin receptor blocker

  20. Clinical prognostic value of cardiac biochemical markers combined determination in mortality of patients with AECOPD%心脏生化标志物测定对AECOPD死亡率的预测价值

    Institute of Scientific and Technical Information of China (English)

    刘威威; 胡波; 殷青; 陈晓香

    2014-01-01

    Objective To evaluate the prognostic value of Troponin I and NT-proBNP for the recent prog-nosis in patients with AECOPD. Methods 210 patients with AECOPD were given arterial blood gas analysis, CURB65 scores, detection of C-reaction protein, body mass index, NT-proBNP and Troponin I. All patients were fol-lowed-up to compare the differences of each value between groups and evaluate the relationship between each value and prognosis in patients with AECOPD. Results The levels of PaCO2 , CURB65, Troponin I and NT-proBNP were obviously correlated with the death of AECOPD patient (all P<0. 05), which was reflected by Logistic multivariate analysis. NT-proBNP and troponin I levels appeared to have additive associations with mortality. Mortality among pa-tients with abnormalities of both NT-proBNP and troponin I was obviously higher than among patients with normal val-ues (P<0. 001). NT-proBNP and troponin I levels were positively correlated (P<0. 01). Conclusion NT-proB-NP and troponin I are strong predictors of early mortality among patients with AECOPD independent to other prognos-tic indicators. The joint detection has a better predictive value.%目的:研究升高的肌钙蛋白I和N-末端脑钠肽前体( NT-proBNP)水平对慢性阻塞性肺疾病急性加重期( AECOPD)患者近期预后的预测价值。方法210名AECOPD患者入院时进行动脉血气、社区获得性肺炎评分( CURB65评分)、C反应蛋白、体重指数、NT-proBNP及肌钙蛋白I测定,所有患者随访临床结局(存活和死亡),比较不同预后患者之间各指标的差异,评价这些指标与AECOPD预后的关系。结果 Logistic多因素分析显示,CURB65评分、血二氧化碳分压( PaCO2)、NT-proBNP和肌钙蛋白I水平与死亡率明显相关( P<0.05)。 NT-proBNP和肌钙蛋白I与死亡率有叠加关系:两者均升高组较正常组死亡率明显升高( P<0.001),NT-proBNP与肌钙蛋白I呈正相关( P<0.01)。结论肌钙蛋白I和NT-proBNP可作为

  1. Paradoxical sleep deprivation increases plasma endothelin levels

    Directory of Open Access Journals (Sweden)

    B.D. Palma

    2002-01-01

    Full Text Available The endothelins (ET-1, 2 and 3 constitute a family of 21 amino acid peptides with potent biological activities. ET-1 is one of the most potent endogenous vasoconstrictors so far identified and its increased concentration in plasma appears to be closely related to the pathogenesis of arterial hypertension as well as to obstructive sleep apnea (OSA. OSA patients exhibit repetitive episodes of apnea and hypopnea that result in hypoxia and consecutive arousals. These patients are chronically sleep deprived, which may aggravate the hypertensive features, since literature data show that sleep deprivation results in hypertension both in humans and in animals. Based on the reported relationship between ET-1, hypertension and sleep deprivation consequences, the purpose of the present study was to determine plasma ET concentrations in paradoxical sleep-deprived animals. Male Wistar rats, 3 to 4 months old (N = 10 per group, were deprived of sleep for 24 and 96 h by the platform technique and plasma ET-1/2 was measured by radioimmunoassay. Analysis of plasma revealed that 96 h of sleep deprivation induced a significant increase in ET-1/2 release (6.58 fmol/ml compared to control (5.07 fmol/ml. These data show that sleep deprivation altered plasma ET-1/2 concentrations, suggesting that such an increase may participate in the genesis of arterial hypertension and cardiorespiratory changes observed after sleep deprivation.

  2. Low arginine plasma levels in patients after thoracoabdominal aortic surgery.

    Science.gov (United States)

    Nijveldt, R J; Prins, H A; Siroen, M P; Rauwerda, J A; Teerlink, T; van Leeuwen, P A

    2000-08-01

    Thoracoabdominal aortic surgery is a high-risk procedure and associated with a significant morbidity and mortality. Ischemia reperfusion of visceral organs and lower extremities is one of the most important determinants of this morbidity. Arginine is the precursor of nitric oxide and arginine plasma levels are important in maintaining organ blood flow. Furthermore, arginine is important in wound healing and the immune system. Because of increased utilization of arginine, low arginine plasma levels could be expected after thoracoabdominal aortic surgery. We therefore measured arginine plasma levels in these patients. Six patients with thoracoabdominal aortic aneurysm were included in this study. University Hospital Vrije Universiteit, Department of Surgery, Amsterdam, The Netherlands. Six patients undergoing thoracoabdominal aortic surgery. Plasma levels of arginine were measured by high-performance liquid chromatography. Very low arginine plasma levels were seen on the first postoperative day. From day 1 arginine slowly increased, but did not reach normal plasma levels on day 6. A significant decrease of arginine plasma levels was found and because of the fact that arginine has multiple functions, it may be important to keep these arginine plasma levels at normal or even higher levels in patients undergoing major vascular surgery. European Journal of Clinical Nutrition (2000) 54, 615-617.

  3. Determinants of Left Atrial Volume in Patients with Atrial Fibrillation

    Science.gov (United States)

    Hochgruber, Thomas; Krisai, Philipp; Zimmermann, Andreas J.; Aeschbacher, Stefanie; Pumpol, Katrin; Kessel-Schaefer, Arnheid; Stephan, Frank-Peter; Handschin, Nadja; Sticherling, Christian; Osswald, Stefan; Kaufmann, Beat A.; Paré, Guillaume; Kühne, Michael; Conen, David

    2016-01-01

    Introduction Left atrial (LA) enlargement is an important risk factor for incident stroke and a key determinant for the success of rhythm control strategies in patients with atrial fibrillation (AF). However, factors associated with LA volume in AF patients remain poorly understood. Methods Patients with paroxysmal or persistent AF were enrolled in this study. Real time 3-D echocardiography was performed in all participants and analyzed offline in a standardized manner. We performed stepwise backward linear regression analyses using a broad set of clinical parameters to determine independent correlates for 3-D LA volume. Results We included 210 patients (70.9% male, mean age 61±11years). Paroxysmal and persistent AF were present in 95 (45%) and 115 (55%) patients, respectively. Overall, 115 (55%) had hypertension, 11 (5%) had diabetes, and 18 (9%) had ischemic heart disease. Mean indexed LA volume was 36±12ml/m2. In multivariable models, significant associations were found for female sex (β coefficient -10.51 (95% confidence interval (CI) -17.85;-3.16), p = 0.0053), undergoing cardioversion (β 11.95 (CI 5.15; 18.74), p = 0.0006), diabetes (β 14.23 (CI 2.36; 26.10), p = 0.019), body surface area (BSA) (β 34.21 (CI 19.30; 49.12), pglomerular filtration rate (β -0.21 (CI -0.36; -0.06), p = 0.0064) and plasma levels of NT-pro brain natriuretic peptide (NT-proBNP) (β 6.79 (CI 4.05; 9.52), p<0.0001), but not age (p = 0.59) or hypertension (p = 0.42). Our final model explained 52% of the LA volume variability. Conclusions In patients with AF, the most important correlates with LA volume are sex, BSA, diabetes, renal function and NT-proBNP, but not age or hypertension. These results may help to refine rhythm control strategies in AF patients. PMID:27701468

  4. Plasma levels of acylated ghrelin in patients with functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    Yeon Soo Kim; Joon Seong Lee; Tae Hee Lee; Joo Young Cho; Jin Oh Kim; Wan Jung Kim; Hyun Gun Kim; Seong Ran Jeon; Hoe Su Jeong

    2012-01-01

    AIM:To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional dyspepsia.METHODS:Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the study.The functional dyspepsia patients were each diagnosed based on the Rome Ⅲ criteria.Eligible patients completed a questionnaire concerning the severity of 10 symptoms.Plasma acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit; electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 kcal.RESULTS:There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional dyspepsia.However,in patients with functional dyspepsia,there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain (r =-0.427,P =0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety (r =0.428,P =0.047).Additionally,there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria (%) (r =-0.522,P =0.013).Interestingly,two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the meal.CONCLUSION:Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia.

  5. Plasma glutamine levels and falciparum malaria.

    Science.gov (United States)

    Cowan, G; Planche, T; Agbenyega, T; Bedu-Addo, G; Owusu-Ofori, A; Adebe-Appiah, J; Agranoff, D; Woodrow, C; Castell, L; Elford, B; Krishna, S

    1999-01-01

    Glutamine deficiency is associated with increased rates of sepsis and mortality, which can be prevented by glutamine supplementation. Changes in glutamine concentration were examined in Ghanaian children with acute falciparum malaria and control cases. The mean (SD) plasma glutamine concentration was lower in patients with acute malaria (401 (82) mumol/L, n = 50) than in control patients (623 (67) mumol/L, n = 7; P sepsis and dyserythropoeisis.

  6. Pitavastatin-attenuated cardiac dysfunction in mice with dilated cardiomyopathy via regulation of myocardial calcium handling proteins

    Directory of Open Access Journals (Sweden)

    Hu Wei

    2014-03-01

    Full Text Available C57BL/6 mice with dilated cardiomyopathy (DCM were randomly divided to receive placebo or pitavastatin at a dose of 1 or 3 mg kg-1d-1. After 8 weeks treatment, mice with dilated cardiomyopathy developed serious cardiac dysfunction characterized by significantly enhanced left ventricular end-diastolic diameter (LVIDd, decreased left ventricular ejection fraction (LVEF as well as left ventricular short axis fractional shortening (LVFS, accompanied with enlarged cardiomyocytes, and increased plasma levels of N-terminal pro-B type natriuretic peptide (NT-proBNP and plasma angiotensin II (AngII concentration. Moreover, myocardium sarcoplasmic reticulum Ca2+ pump (SERCA-2 activity was decreased. The ratio of phosphorylated phospholamban (PLB to total PLB decreased significantly with the down-regulation of SERCA- -2a and ryanodine receptor (RyR2 expression. Pitavastatin was found to ameliorate the cardiac dysfunction in mice with dilated cardiomyopathy by reversing the changes in the ratios of phosphorylated PLB to total PLB, SERCA-2a and RyR2 via reducing the plasma AngII concentration and the expressions of myocardium angiotensin II type 1 receptor (AT1R and protein kinase C (PKCb2. The possible underlying mechanism might be the regulation of myocardial AT1R-PKCb2-Ca2+ handling proteins.

  7. C-type natriuretic peptide is closely associated to obesity in Caucasian adolescents.

    Science.gov (United States)

    Del Ry, Silvia; Cabiati, Manuela; Bianchi, Vanessa; Caponi, Laura; Maltinti, Maristella; Caselli, Chiara; Kozakova, Michaela; Palombo, Carlo; Morizzo, Carmela; Marchetti, Sara; Randazzo, Emioli; Clerico, Aldo; Federico, Giovanni

    2016-09-01

    CNP is a natural regulator of adipogenesis playing a role in the development of obesity in childhood. Aim of the study was to evaluate CNP plasma levels in normal-weight (N), overweight (OW) and obese adolescents (O). Eighty two subjects (age:12.8±2.4, years) without cardiac dysfunction were enrolled and CNP plasma levels were measured by RIA. NT-proBNP, MR-proANP, AGEs, reactive hyperemia index (RHI) and standard clinical chemistry parameters were also measured. O and OW adolescents had higher values of BMI and fat mass than N. CNP levels were significantly lower in OW:4.79[3.29-21.15] and O:3.81[1.55-13.4] than in N:13.21[7.6-37.8]; pobesity resulted significantly (p≪0.0001) associated with CNP values (AUC=0.9724). These results suggest that CNP may play a more important role than BNP and ANP related peptides, as risk marker of obesity, in addition to its involvement in adipogenesis and endothelial dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Methodological Studies on Plasma Endotoxin Level and Endotoxin Inactivation Capacity

    Institute of Scientific and Technical Information of China (English)

    姚国相; 杨乃发; 薛新波; 赵玉沛; 蒋朱明

    2004-01-01

    To establish stable methods for detecting plasma endotoxin level and endotoxin inactivation capacity in a normal population and general surgical patients and evaluate their perioperative changes, 50 healthy people and 50 patients receiving gastrointestinal operation were enrolled, their plasma endotoxin levels and plasma endotoxin inactivation capacity were assayed. Our results showed that plasma endotoxin levels were 0.044±0.009 EU/ml in the normal population and 0.044±0.023 EU/ml in the preoperative patients. Endotoxin level peaked 3 h after the operation (0.223±0.041 EU/ml), and then decreased rapidly on the first day after the operation (0.134±0.164EU/ml). Endotoxin inactivation capacity also had the same time course as endotoxin level. Systemic inflammatory response syndrome and infection induced another elevation in the time course. It is concluded that establishing the endotoxin standard curve by using pyrogenic free water is better than by using plasma. Plasma endotoxin inactivation capacity can be used as an indirect indicator of postoperative immune depression. Plasma endotoxin level and endotoxin inactivation capacity peaked shortly after operation, indicating surgical stress is closely related with the changes.

  9. [Plasma homocysteine levels in patients with ischemic heart disease].

    Science.gov (United States)

    Márk, L; Erdei, F; Márki-Zay, J; Nagy, E; Kondacs, A; Katona, A

    2001-07-29

    In the latest years it became clear that beside traditional cardiovascular risk factors the high plasma homocysteine level increases the risk of atherosclerotic diseases too. Metaanalysis of 27 papers found that 10% of population's coronary risk is attributable to homocysteine and a 5 mumol/l increase in its plasma level elevates the coronary risk by as much as 0.5 mumol/l cholesterol increase. Recent studies have shown an inverse relation between the levels of plasma homocysteine and that of folic acid, vitamin B6, vitamin B12. The latters are cofactors and substrates of the homocysteine and methionin metabolism. The plasma total cholesterol, HDL-cholesterol, triglyceride, lipoprotein(a), Apo A1, Apo B and homocysteine concentrations were examined in 39 patients suffering from coronary artery disease treated in the Cardiac Rehabilitation Department of our hospital. Twenty of them were treated by folic acid and vitamin B6 for a three week period. The mean (+/- SD) plasma homocysteine concentration was 15.60 +/- 6.14 mumol/l. In the treated subgroup the mean (+/- SD) plasma homocysteine concentration was 17.3 +/- 7.00 mumol/l, the mean (+/- SD) plasma folic acid level was 8.58 +/- 4.6 mumol/l. After the three week treatment period (folic acid and vitamin B6) the plasma homocysteine level decreased by 26.5% (p = 0.012), that of folic acid increased by 68.7% (p = 0.002). From the plasma lipids the level of total- and LDL-cholesterol decreased significantly (6.7% and 10.4%, P gen of the metylenetetrahydrofolate-reductase (MTHFR) enzyme there was a significant correlation with homocysteine level (r = 0.436, p = 0.010), and a negative, but not significant correlation with the folic acid level (r = -0.354).

  10. Human plasma DNP level after severe brain injury

    Institute of Scientific and Technical Information of China (English)

    GAO Yi-lu; XIN Hui-ning; FENG Yi; FAN Ji-wei

    2006-01-01

    Objective: To determine the relationship between DNP level after human severe brain injury and hyponatremia as well as isorrhea.Methods: The peripheral venous plasma as control was collected from 8 volunteers. The peripheral venous plasma from 14 severe brain injury patients were collected in the 1, 3, 7 days after injury. Radioimmunoassay was used to detect the DNP concentration. Meanwhile, daily plasma and urine electrolytes, osmotic pressure as well as 24 h liquid intake and output volume were detected.Results: The normal adult human plasma DNP level was 62. 46 pg/ml ± 27. 56 pg/ml. In the experimental group, the plasma DNP levels were higher from day 1 today 3 in 8 of the 14 patients than those in the control group (P1 =0.05, P3 =0.03). Negative fluid balance occurred in 8 patients and hyponatremia in 7 patients. The increase of plasma DNP level was significantly correlated with the development of a negative fluid balance (r=-0.69,P<0.01) and hyponatremia (x2 =4.38, P<0.05).Conclusions: The increase of plasma DNP level is accompanied by the enhancement of natriuretic and diuretic responses in severe brain-injured patients, which is associated with the development of a negative fluid balance and hyponatremia after brain injury.

  11. The alternative complement pathway is dysregulated in patients with chronic heart failure

    Science.gov (United States)

    Shahini, Negar; Michelsen, Annika E.; Nilsson, Per H.; Ekholt, Karin; Gullestad, Lars; Broch, Kaspar; Dahl, Christen P.; Aukrust, Pål; Ueland, Thor; Mollnes, Tom Eirik; Yndestad, Arne; Louwe, Mieke C.

    2017-01-01

    The complement system, an important arm of the innate immune system, is activated in heart failure (HF). We hypothesized that HF patients are characterized by an imbalance of alternative amplification loop components; including properdin and complement factor D and the alternative pathway inhibitor factor H. These components and the activation product, terminal complement complex (TCC), were measured in plasma from 188 HF patients and 67 age- and sex- matched healthy controls by enzyme immunoassay. Our main findings were: (i) Compared to controls, patients with HF had significantly increased levels of factor D and TCC, and decreased levels of properdin, particularly patients with advanced clinical disorder (i.e., NYHA functional class IV), (ii) Levels of factor D and properdin in HF patients were correlated with measures of systemic inflammation (i.e., C-reactive protein), neurohormonal deterioration (i.e., Nt-proBNP), cardiac function, and deteriorated diastolic function, (iii) Low levels of factor H and properdin were associated with adverse outcome in univariate analysis and for factor H, this was also seen in an adjusted model. Our results indicate that dysregulation of circulating components of the alternative pathway explain the increased degree of complement activation and is related to disease severity in HF patients. PMID:28195242

  12. EFFECT OF ACUPUNCTURE ON PLASMA GLUCOSE LEVEL IN HUMAN VOLUNTEERS

    Institute of Scientific and Technical Information of China (English)

    Amit Kumar Chakraborty; Mrigendranath Gantait; Biswapati Mukherjee

    2006-01-01

    Objective To observe the changes of plasma glucose level (PGL) in human volunteers after acupuncture. Methods Seventy-seven human volunteers were taken up from the acupuncture clinic. All of pletion of acupuncture. All cases were at four hours abstinence from food before doing acupuncture. Results Plasma glucose level varied 5 mg% or more in 62 cases (80.51%) and only those were considered for computation. PGL increased in cases who had generally plasma glucose level below 90 mg% before acupuncture;and PGL decreased in cases who had plasma glucose 90 mg% or above. In 10 control cases there was no variation of the considerable level of 5 mg% in any case. Conclusion Bi-directional variation of PGL after acupuncture indicates that acupuncture can be used to maintain optimum PGL through endogenous mechanism,suggesting that it is applicable in controlling hyperglycemia in diabetes mellitus patients.

  13. Assessing plasma glucose and lipid levels, body weight and acute ...

    African Journals Online (AJOL)

    Assessing plasma glucose and lipid levels, body weight and acute toxicity following oral ... Diabetes was induced in male and female Wistar rats with alloxan ... had good hypoglycemic activity and good effects on cardiovascular risk factors.

  14. Sequential mechanical ventilation improves hemodynamics, cardiac function and neurohumoral status in elderly patients with acute left heart failure

    Institute of Scientific and Technical Information of China (English)

    Xing-Hong Zeng; Ming Chen; Qi Cao; Yan-Xia Chen

    2016-01-01

    Objective:To analyze the effect of sequential mechanical ventilation on improving hemodynamics, cardiac function and neurohumoral status in elderly patients with acute left heart failure.Methods:A total of 90 cases of elderly patients with acute left heart failure were randomly divided into observation group and control group, control group received conventional mechanical ventilation therapy, observation group received sequential mechanical ventilation, and then differences in hemodynamics, cardiac function and neurohumoral status were compared between two groups after treatment.Results:24 h after treatment, mPAP, PCWP and RAP levels of observation group after treatment were lower than those of control group, and CO level was higher than that of control group; LVEF value was higher than that of control group, and SVR, LVEDV and LVESV values were lower than those of control group; 12 h and 24 h after treatment, plasma Nt-proBNP, ANP, R, AngⅡ and ALD levels of observation group were significantly lower than those of control group.Conclusion:Sequential mechanical ventilation can optimize the illness in elderly patients with acute left heart failure, and plays a positive role in promoting patients' cardiac function recovery, restoring homeostasis and other aspects.

  15. Concentrations in plasma clozapine levels in schizophrenic and schizoaffective patients.

    Science.gov (United States)

    Iglesias García, Celso; Iglesias Alonso, Ana; Bobes, Julio

    2017-08-22

    There is great variability in plasma levels of clozapine. The objective of this study is to know the characteristics of patients treated with clozapine and the relationship between them and the variability of plasma levels. Descriptive, cross-sectional study of all patients currently treated with clozapine in a Psychiatric Service with a diagnosis of schizophrenic psychosis or schizoaffective disorder. The present study assessed physical situation, psychopathology and functionality of the patients and explored the associations and correlations between clinical variables and plasma levels. We studied 39 patients, predominantly men, with negative and depressive symptoms and cardiovascular risk factors (metabolic syndrome and smoking). Significant variability in dose and even greater in clozapine levels were observed. The levels of clozapine at equal doses/kg of body weight were higher in non-smokers, they had positive correlation with BMI and negative correlation with systolic BP, disruptive behaviors and number of cigarettes consumed. Plasma level monitoring clozapine is an important tool to avoid clozapine plasma levels monitoring and minimize undesirable clinical situations (metabolic syndrome, sedation, negative symptoms and functional impairment). It is also important to control the effects of a smoking habit for optimum drug bioavailability. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Plasma obestatin levels in normal weight, obese and anorectic women.

    Science.gov (United States)

    Zamrazilová, H; Hainer, V; Sedlácková, D; Papezová, H; Kunesová, M; Bellisle, F; Hill, M; Nedvídková, J

    2008-01-01

    Obestatin is a recently discovered peptide produced in the stomach, which was originally described to suppress food intake and decrease body weight in experimental animals. We investigated fasting plasma obestatin levels in normal weight, obese and anorectic women and associations of plasma obestatin levels with anthropometric and hormonal parameters. Hormonal (obestatin, ghrelin, leptin, insulin) and anthropometric parameters and body composition were examined in 15 normal weight, 21 obese and 15 anorectic women. Fasting obestatin levels were significantly lower in obese than in normal weight and anorectic women, whereas ghrelin to obestatin ratio was increased in anorectic women. Compared to leptin, only minor differences in plasma obestatin levels were observed in women who greatly differed in the amount of fat stores. However, a negative correlation of fasting obestatin level with body fat indexes might suggest a certain role of obestatin in the regulation of energy homeostasis. A significant relationship between plasma obestatin and ghrelin levels, independent of anthropometric parameters, supports simultaneous secretion of both hormones from the common precursor. Lower plasma obestatin levels in obese women compared to normal weight and anorectic women as well as increased ghrelin to obestatin ratio in anorectic women might play a role in body weight regulation in these pathologies.

  17. Clinical significance of plasma metastin level in pancreatic cancer patients.

    Science.gov (United States)

    Katagiri, Fumihiko; Nagai, Kazuyuki; Kida, Atsushi; Tomita, Kenji; Oishi, Shinya; Takeyama, Masaharu; Doi, Ryuichiro; Fujii, Nobutaka

    2009-03-01

    Metastin, which is a 54-residue peptide coded by KiSS-1 gene, is an endogenous ligand to a G-protein-coupled receptor GPR54. Metastin suppresses a malignant tumor to metastasize and regulates secretion of gonadotropine releasing hormone. Physiological action of metastin has been focused on in oncology. It is reported that less KiSS-1 gene and more hOT7T175 gene which codes GPR54 are expressed in pancreatic cancers than in normal pancreatic tissues; however, there is no study that investigates the relationship between clinicopathological characteristics and plasma metastin concentration in pancreatic cancer patients. The purpose of this study was to investigate the relationship between plasma metastin-like immunoreactive substance (LI) levels and clinical characteristics in pancreatic cancer patients. Thirty-three patients with pathologically confirmed pancreatic cancer before or just after treatments and 24 healthy volunteers were included in the study. Patients were grouped according to the International Union Against Cancer TNM classification. Plasma metastin-LI was measured by enzyme immunoassay. The plasma metastin-LI levels of cancer patients were significantly higher when compared with healthy volunteers. Significant relationship was not found between the plasma metastin-LI levels and the clinicopathological factors such as tumor size, invasion, lymph node metastasis and distant metastasis. The plasma metastin levels may be a significant biomarker to predict the presence of pancreatic cancer and could be used in pancreatic cancer screening.

  18. Association of plasma manganese levels with chronic renal failure.

    Science.gov (United States)

    Sánchez-González, Cristina; López-Chaves, Carlos; Gómez-Aracena, Jorge; Galindo, Pilar; Aranda, Pilar; Llopis, Juan

    2015-01-01

    Manganese (Mn) is an essential trace element involved in the formation of bone and in amino acid, lipid and carbohydrate metabolism. Mn excess may be neurotoxic to humans, affecting specific areas of the central nervous system. However, relatively little is known about its physiological and/or toxicological effects, and very few data are available concerning the role of Mn in chronic renal failure (CRF). This paper describes a 12-month study of the evolution of plasma Mn levels in predialysis patients with CRF and the relationship with energy and macronutrient intake. The participants in this trial were 64 patients with CRF in predialysis and 62 healthy controls. Plasma levels of creatinine, urea, uric acid, total protein and Mn were measured. The glomerular filtration rate (GFR) was calculated using the Cockcroft-Gault index. The CRF patients had higher plasma levels of creatinine, urea, uric acid and Mn and a lower GFR than the controls. Plasma Mn was positively correlated with creatinine, plasma urea and plasma uric acid and was negatively correlated with the GFR and the intake of energy and macronutrients. In conclusion, CRF in predialysis patients is associated with increases in circulating levels of Mn.

  19. [Atypical form of tako-tsubo cardiomyopathy in a patient with atrial fibrillation in Wolff-Parkinson-White syndrome complicated with ventricular fibrillation: the diagnostic problems].

    Science.gov (United States)

    Kukla, Piotr; Stec, Sebastian; Karbarz, Dariusz; Wrzosek, Bożena; Jastrzębski, Marek; Kluczewski, Maciej; Kurdzielewicz, Wojciech

    2013-01-01

    Atypical form of tako-tsubo cardiomyopathy (TTC) is associated with regional wall motion abnormalities in basal and/or middle segments or only middle segments with sparing of apical segments or apical and basal segments. We described a case of47-year-old female with atypical form of TTC due to fast atrial fibrillation that converted into ventricular fibrillation in WPW syndrome. The echocardiogram made after direct current cardioversion revealed decreased left ventricular ejection fraction (LVEF 35%) with akinesis of inferior and posterior walls and anterior part of interventricular septum in the middle and the basal segments with hyperkinesis of apical segments. The biochemistry blood samples revealed elevated both troponin T- 0.35 ng/mL and NT-proBNP - 3550 pg/mL plasma level. The ECG showed sinus rhythm 62 bpm, shortened PQ interval 100 ms, widened QRS duration - 115 ms with delta wave, prolonged QT interval - 520 ms, QS in leads: II, III, aVF. NegativeT waves in leads: I, aVL and positive, symmetrical T waves in leads V1-V6. The coronarography revealed normal coronaryarteries. The control echocardiography after 10 days showed normal LVEF 70%, without any wall motion abnormalities. TTC was recognised based on: history of sudden stress situation before, ischaemic ECG changes, positive markers of myocardial injury, transient segmental wall motion abnormalities and normal coronary arteries. The ablation of right postero-septal accessory pathway was successfully performed.

  20. [Efficacy of inhaled iloprost on top of other targeted therapies for patients with pulmonary hypertension and severe right heart failure].

    Science.gov (United States)

    Ning, Ning; Wang, Lan; Zhang, Hongda; Liu, Qianqian; Peng, Fuhua; Zhao, Qinhua; Jiang, Xin; He, Jing; Jiang, Rong; Jing, Zhicheng

    2015-09-01

    To investigate the efficacy and safety of inhaled iloprost on top of other pulmonary hypertension (PH) specific therapies for patients with PH and severe right heart failure. We consecutively enrolled WHO functional class IV patients with PH and chronic thromboembolic pulmonary hypertension (CTEPH) in Shanghai Pulmonary Hospital from January 2011 to January 2013. Inhaled iloprost was administrated to all enrolled patients, oral endothelin antagonist receptors (ERAs) and/or type 5 phosphodiasterase inhibitors (PDE5-I) were also used as basis therapies. The in-hospital outcomes and the changes of right heart functional parameters were observed. Twenty-four patients with PH and 5 patients with CTEPH were enrolled. After a mean treatment duration of (23 ± 13) days, 3 patients dead and significant improvement was observed in the remaining 26 patients. Compared with the baseline, heart rate decreased from (99 ± 14) to (91 ± 12) bpm (P = 0.001), plasma NT-proBNP level decreased from 5 823 (3 029-13 248) to 3 220 (1 678-6 720) ng/L (P iloprost on top of other PAH-specific target therapy medications is effective and safe for PH patients with severe right heart failure.

  1. Long-term effects of intermittent Iloprost infusion on pulmonary arterial pressure in connective tissue disease.

    Science.gov (United States)

    Caravita, Sergio; Wu, Sheng Chin; Secchi, Maria Beatrice; Dadone, Viola; Bencini, Chiara; Pierini, Simona

    2011-10-01

    Intravenous periodic Iloprost is proven effective in the treatment of Raynaud phenomenon (RP) related to connective tissue disorder (CTD). It's well known that synthetic prostaglandins are effective drugs for the treatment of pulmonary arterial hypertension (PAH), and that PAH is frequently associated with CTD. The aim of the study is to evaluate in the chronic effect of cyclic intravenous Iloprost on pulmonary arterial pressure. We studied 17 consecutive patients with CTD (14 systemic sclerosis, 3 mixed CTD) and RP, at the entry and after at least 6months of treatment of RP with cyclic Iloprost. On both occasions, in all patients we performed transthoracic Doppler echocardiography and we determined NT-proBNP plasma levels, NYHA functional class, 6 Minute-Walk Distance (6MWD). At follow-up (8.2±1.9months; range 6-12) mean values of pulmonary arterial systolic pressure (PASP) significantly decreased (from 32.2±9.2 to 29.2±7.6mmHg, pIloprost may protect against the development or worsening of PAH in patients with CTD and RP. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  2. Cardiac Effects of Thyrotropin Oversuppression with Levothyroxine in Young Women with Differentiated Thyroid Cancer

    Science.gov (United States)

    Hong, Kyung-Soon; Son, Jung-Woo; Ryu, Ohk Hyun; Choi, Moon-Gi; Hong, Ji Yeon; Lee, Seong Jin

    2016-01-01

    Background. We investigated the cardiac effects of TSH (thyroid-stimulating hormone) oversuppression in women with thyroidectomized differentiated thyroid cancer (DTC) during levothyroxine suppression therapy. Methods. Fourteen young female patients with DTC were enrolled. The duration of TSH-suppressive therapy was 5 to 9 years. They satisfied the following criteria: (1) a serum level of TSH DTC patients and control subjects were well matched in heart rate and blood pressure. There were marked differences in serum TSH (P = 0.001) and free T4 (P = 0.002). However, there were no differences between the groups in serum free T3 and plasma NT-pro-BNP. Furthermore, there were nonsignificant differences in cardiac functions and structures between the groups. Conclusions. This study shows that TSH suppression therapy in women with DTC may be safe with respect to cardiac functions and structures despite intermittent oversuppression of TSH during long-term suppressive therapy. Trial Registration. This trial is registered with clinicaltrials.gov identifier NCT02645786. PMID:27418929

  3. Local electrogram delay recorded from left ventricular lead at implant predicts response to cardiac resynchronization therapy: Retrospective study with 1 year follow up

    Directory of Open Access Journals (Sweden)

    Polasek Rostislav

    2012-05-01

    Full Text Available Abstract Background Considerable proportion of patients does not respond to the cardiac resynchronization therapy (CRT. This study investigated clinical relevance of left ventricular electrode local electrogram delay from the beginning of QRS (QLV. We hypothesized that longer QLV indicating more optimal lead placement in the late activated regions is associated with the higher probability of positive CRT response. Methods We conducted a retrospective, single–centre analysis of 161 consecutive patients with heart failure and LBBB or nonspecific intraventricular conduction delay (IVCD treated with CRT. We routinely intend to implant the LV lead in a region with long QLV. Clinical response to CRT, left ventricular (LV reverse remodelling (i.e. decrease in LV end-systolic diameter - LVESD ≥10% and reduction in plasma level of NT-proBNP >30% at 12-month post-implant were the study endpoints. We analyzed association between pre-implant variables and the study endpoints. Results Clinical CRT response rate reached 58%, 84% and 92% in the lowest (≤105 ms, middle (106-130 ms and the highest (>130 ms QLV tertile (p  Conclusion LV lead position assessed by duration of the QLV interval was found the strongest independent predictor of beneficial clinical response to CRT.

  4. Structural and functional cardiac changes in myotonic dystrophy type 1: a cardiovascular magnetic resonance study

    Directory of Open Access Journals (Sweden)

    Hermans Mieke CE

    2012-07-01

    Full Text Available Abstract Background Myotonic dystrophy type 1 (MD1 is a neuromuscular disorder with potential involvement of the heart and increased risk of sudden death. Considering the importance of cardiomyopathy as a predictor of prognosis, we aimed to systematically evaluate and describe structural and functional cardiac alterations in patients with MD1. Methods Eighty MD1 patients underwent physical examination, electrocardiography (ECG, echocardiography and cardiovascular magnetic resonance (CMR. Blood samples were taken for determination of NT-proBNP plasma levels and CTG repeat length. Results Functional and structural abnormalities were detected in 35 patients (44%. Left ventricular systolic dysfunction was found in 20 cases, left ventricular dilatation in 7 patients, and left ventricular hypertrophy in 6 patients. Myocardial fibrosis was seen in 10 patients (12.5%. In general, patients had low left ventricular mass indexes. Right ventricular involvement was uncommon and only seen together with left ventricular abnormalities. Functional or structural cardiac involvement was associated with age (p = 0.04, male gender (p Conclusions CMR can be useful to detect early structural and functional myocardial abnormalities in patients with MD1. Myocardial involvement is strongly associated with conduction abnormalities, but a normal ECG does not exclude myocardial alterations. These findings lend support to the hypothesis that MD1 patients have a complex cardiac phenotype, including both myocardial and conduction system alteration.

  5. Plasma Adiponectin Levels in Acute Liver Failure Patients Treated with Plasma Filtration with Dialysis and Plasma Exchange.

    Science.gov (United States)

    Yamamoto, Hiroshi; Nakae, Hajime; Uji, Yoshitaka; Maeda, Kazuhisa; Tani, Tohru; Eguchi, Yutaka

    2015-08-01

    Plasma filtration with dialysis (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. Improvement of hypoadiponectinemia is considered to be a useful therapeutic approach for ameliorating fatal conditions including cardio-metabolic and infectious disease. We investigated the effects of PDF in comparison to PE in terms of plasma adiponectin (APN) changes in patients with acute liver failure. Seventeen patients with liver failure were studied; PDF was performed 55 times and PE 14 times. Plasma APN levels increased significantly after PDF, while decreasing significantly after PE. PDF appears to be among the most useful blood purification therapies in acute liver failure cases in terms of increasing APN levels.

  6. Level crossings, excess times and transient plasma-wall interactions in fusion plasmas

    CERN Document Server

    Theodorsen, Audun

    2016-01-01

    Based on a stochastic model for intermittent fluctuations in the boundary region of magnetically confined plasmas, an expression for the level crossing rate is derived from the joint distribution of the process and its derivative. From this the average time spent by the process above a certain threshold level is obtained. This provides novel predictions of plasma-wall interactions due to transient transport events associated with radial motion of blob-like structures in the scrape-off layer.

  7. Acute effect of smoking on plasma Obestatin levels

    Directory of Open Access Journals (Sweden)

    Saroglou Maria

    2010-01-01

    Full Text Available Abstract Background Smoking and smoking cessation are considered to be associated with weight changes. We have recently shown that smoking acutely increases plasma levels of ghrelin, a known orexigenic hormone. Obestatin is a peptide encoded by the ghrelin gene, which opposes ghrelin effects on food intake. We conducted a study in adult volunteers measuring plasma levels of obestatin immediately after initiation of smoking. Methods 31 volunteers (mean age 32.2 ± 9.2 years and mean BMI 25.7 ± 4.1, 17 smokers and 14 non-smokers, were enrolled in our study. The 2 groups were matched in age and BMI. Plasma obestatin concentrations were determined at baseline (T0, 2 (T2, 5 (T5, 15 (T15, and 60 (T60 minutes after the initiation of smoking. Results In all 31 subjects, no significant difference in the mean values of plasma obestatin levels was observed from baseline at T2, T5, T15 and T60 after initiation of smoking (overall p = 0.15. However, a trend for higher obestatin levels was noted in smokers vs non-smokers (overall p = 0.069, which was not related to the pack-years. Conclusion On the contrary with ghrelin's response after smoking initiation, there is no such an acute response of plasma obestatin levels.

  8. Plasminogen and fibrinogen plasma levels in coronary artery disease

    Science.gov (United States)

    Lima, Luciana Moreira; Carvalho, Maria das Graças; Sousa, Marinez de Oliveira

    2012-01-01

    Objective The formation of thrombi at the site of atherosclerotic lesions plays a central role in atherothrombosis. Impaired fibrinolysis may exacerbate pre-existing coronary artery disease and potentiate its evolution. While the fibrinogen plasma level has been strongly associated with the severity of coronary artery disease, its relevance in the evaluation of plasminogen in coronary artery disease patients remains unclear. This study evaluated fibrinogen and plasminogen levels in subjects with coronary artery disease as diagnosed by angiography. Methods This is a cross-sectional study. Blood samples obtained from 17 subjects with angiographically normal coronary arteries (controls), 12 with mild/moderate atheromatosis and 28 with severe atheromatosis were evaluated. Plasma plasminogen and fibrinogen levels were measured by chromogenic and coagulometric methods, respectively. Results Fibrinogen levels were significantly higher in the severe atheromatosis group compared to the other groups(p-value < 0.0001). A significant positive correlation was observed between the severity of coronary artery diseaseand increasing fibrinogen levels (r = 0.50; p-value < 0.0001) and between fibrinogen and plasminogen levels (r =0.46; p-value < 0.0001). There were no significant differences in the plasminogen levels between groups. Conclusion Plasma fibrinogen, but not plasminogen levels were higher in patients with coronary artery disease compared to angiographically normal subjects. The plasma fibrinogen levels also appear to be associated with the severity of the disease. The results of this study provide no evidence of a significant correlation between plasma plasminogen levels and the progress of coronary stenosis in the study population. PMID:23049444

  9. Plasma BDNF levels following weight recovery in anorexia nervosa.

    Science.gov (United States)

    Phillips, Kathryn E; Jimerson, David C; Pillai, Anilkumar; Wolfe, Barbara E

    2016-10-15

    Preclinical studies have implicated brain-derived neurotrophic factor (BDNF) in the regulation of eating behavior and body weight. As reviewed in this report, prior studies of BDNF levels in anorexia nervosa have yielded variable results, perhaps reflecting effects of malnutrition and psychiatric comorbidity. The goal of the current report was to assess plasma BDNF as a biomarker in weight-recovered individuals with a history of anorexia nervosa (ANWR). Study groups included women meeting criteria for ANWR and healthy female controls. Participants were in a normal weight range, free of current major psychiatric disorder, and free of medication. Self-ratings included eating disorder symptoms, depression and anxiety. Plasma BDNF levels were measured by enzyme linked immunoassay. Plasma BDNF levels were not significantly different for ANWR and control groups. Plasma BDNF levels were inversely correlated with anxiety ratings in controls (p<0.02) but not in the ANWR group. This report provides new evidence that circulating BDNF concentrations do not differ in healthy controls and ANWR free of psychiatric comorbidity. Additionally, the data provide new information on the relationship between plasma BDNF and anxiety in these two study groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. 成纤维细胞生长因子23与血液透析患者心血管疾病的关系%Relationship between fibroblast growth factor-23 and cardiovascular disease in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    刘华; 杨敏; 高小夏; 李旻; 陈宇

    2014-01-01

    group(n = 24)and non-cardiovascular disease group(n = 46). Serum levels of blood hemoglobin( Hb),albumin( ALB),creatinine( Cr),blood urea nitrogen( BUN),uric acid( UA),calcium( Ca),phos-phorus(P),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL -C),low density lipoprotein cholesterol (LDL-C),fasting plasma glucose(FPG),iPTH and FGF-23 were detected in all of the subjects. Detection of C-reactive protein(CRP), cystatin C( CysC)and plasma N-terminal B-type natriuretic peptide precursor( NT-pro BNP)levels were taken in the study group. Color Doppler ultrasound was used in study group to calculate left ventricular ejection fraction( LVEF)and left ventricular mass index( LVMI),and comparative analysis was undertaken. Results Serum levels of Hb,ALB and Ca in the study group were significantly lower than the control group;Cr,BUN,UA,P,iPTH,and FGF-23 were significantly higher than the control group(all P 0. 05). FGF-23,CysC,NT-pro BNP and LVMI in cardiovascular disease group was significantly higher than non-cardiovascular disease group,and LVEF was significantly lower than non-cardiovascular disease group. On a varie-ty of indicators to detect cardiovascular disease in hemodialysis patients,stepwise logistic regression analysis showed that only FGF-23,NT-pro BNP and CysC entered the regression equation,with OR 3. 024,2. 783 and 2. 454,respectively. Conclusion FGF-23 is closely linked to car-diovascular disease in patients with maintenance hemodialysis,which is slightly better than NT-pro BNP and CysC in predicting the occurrence of cardiovascular disease and has important significance for the observation of occurrence and development of cardiovascular disease in hemodialysis patients.

  11. Plasma Actin, Gelsolin and Orosomucoid Levels after Eccentric Exercise.

    Science.gov (United States)

    Tékus, Éva; Váczi, Márk; Horváth-Szalai, Zoltán; Ludány, Andrea; Kőszegi, Tamás; Wilhelm, Márta

    2017-02-01

    The present study investigated the acute effect of eccentric exercise on blood plasma actin, gelsolin (GSN) and orosomucoid (AGP) levels in untrained and moderately trained individuals, and their correlation with exercise induced muscle damage (EIMD) markers (CK, intensity of muscle soreness and maximal voluntary contraction torque deficit). Healthy physical education students (6 untrained, 12 moderately trained) participated in this research. Actin, GSN, AGP and CK levels were measured in blood plasma at baseline, immediately, 1 h, 6 h and 24 h post-exercise comprising 90 eccentric quadriceps contractions performed on a dynamometer. There was significant time main effect for GSN, AGP, CK and significant difference was found between baseline and the lowest value of post-exercise GSN (p exercise AGP (p exercise and CK activity at 6 h, p exercise, p eccentric exercise do not seem sensitive to training status. The plasma actin level is used as an indicator of injury, however, our results suggest that it is not an accurate marker of EIMD, while plasma GSN concentrations show a better relationship with EIMD and the post-exercise inflammatory process. The elevated plasma AGP and the correlation between GSN and AGP seem to be promising for assessment of exercise-induced muscle injury.

  12. Assessing Stress in Arctic Lemmings: Fecal Metabolite Levels Reflect Plasma Free Corticosterone Levels.

    Science.gov (United States)

    Fauteux, Dominique; Gauthier, Gilles; Berteaux, Dominique; Bosson, Curtis; Palme, Rupert; Boonstra, Rudy

    Interest in the ecology of stress in wild populations has triggered the development of noninvasive methods for quantifying stress hormones. Measurement of fecal corticosteroid metabolites (FCMs) is one such method, but it is still unclear whether FCMs can be a reliable proxy of free plasma glucocorticoids. To assess the validity of this assumption, we carried out a robust assessment on brown lemmings (Lemmus trimucronatus) from Bylot Island, Nunavut, Canada, that were hand captured and anesthetized and related plasma glucocorticoid levels to fecal metabolite glucocorticoid levels. We examined endogenous factors that could explain interindividual variability. Blood corticosterone was measured from samples obtained on capture and 30 min later, and FCM levels were measured from animals kept in captivity for 72 h. Plasma free corticosterone increased 135-fold over baseline values 30 min after capture, which confirmed that initial handling was perceived as a stressor. We found that FCM levels were highly related with free (marginal [Formula: see text] = 0.53) but not with total ([Formula: see text] = 0.02) corticosterone levels, regardless of age, sex, and reproductive condition. FCM levels started increasing 2 h after capture and reached maximum levels 4 h after capture. No circadian rhythm in FCMs was found. Plasma total corticosterone levels were much higher in adult females compared with adult males, but this difference was much smaller when measuring free corticosterone levels and FCM levels. Our results suggest that FCM levels are good measures of stress by being closely related to plasma free corticosterone levels in brown lemmings.

  13. 冠心病患者甲状腺功能及FT3与冠状动脉病变关系的研究%Relationship among thyroid function,FT3 level and coronary artery disease in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    薛超; 卞玲; 王长谦; 解玉水; 许左隽; 陈启稚; 殷兆芳

    2014-01-01

    Objective:To explore the relationship among thyroid function ,free thyroxine (FT3) level and coronary artery disease in patients with coronary heart disease (CHD) .Methods :A total of 238 CHD patients ,who hospital-ized in our hospital from 2012 to 2014 and were proved by coronary angiography (CAG) ,were selected .Their thy-roid function was analyzed .After patients with hyperthyroidism ,hypothyroidism ,subclinical hyperthyroidism and subclinical hypothyroidism were excluded ,the remaining 217 patients were divided into normal FT3 group (n=192) and low FT3 group (n=25) according to FT3 level . General clinical condition and CAG results were compared be-tween two groups . Results:(1 ) Among the 238 CHD patients , there were two cases with hyperthyroidism (0.84% ) ,11 cases with hypothyroidism (4.62% ) ,three cases with subclinical hyperthyroidism (1.26% ) ,five ca-ses with subclinical hypothyroidism (2.10% ) and 25 cases with low T3 syndrome (10.50% );(2) Compared with normal FT3 group ,there were significant rise in levels of total cholesterol [TC ,(4.14 ± 1.59) mmol/L vs .(7.33 ± 1.72) mmol/L] ,apoprotein E [ApoE ,(3.91 ± 0.98) mmol/L vs .(4.55 ± 1.52) mmol/L] ,creatinine [Cr ,(97.99 ± 30.85)μmol/L vs .(116.64 ± 43.20) μmol/L] and N terminal pro brain natriuretic peptide [NT-proBNP ,140 (62~462) pg/ml vs .739 (304~4922) pg/ml] in low T3 group , P<0.01 all;(3) In CHD patients ,percentage of triple-vessel coronary disease in low FT3 group was significantly higher than that of normal FT3 group (76.0% vs . 40.1% , P<0.01) .Conclusion:Low free thyroxine syndrome is a most frequent thyroid dysfunction in patients with coronary heart disease ,and patients with low free thyroxine are more likely to involve multi-vessel disease .%目的:探讨冠心病患者甲状腺功能情况及游离甲状腺素(FT3)水平与冠脉病变的关系。方法:选择2012年至2014年期间入住我院,经冠脉造影证实的238名冠心病患者,分析其

  14. Plasma protein carbonyl levels and breast cancer risk.

    Science.gov (United States)

    Rossner, Pavel; Terry, Mary Beth; Gammon, Marilie D; Agrawal, Meenakshi; Zhang, Fang Fang; Ferris, Jennifer S; Teitelbaum, Susan L; Eng, Sybil M; Gaudet, Mia M; Neugut, Alfred I; Santella, Regina M

    2007-01-01

    To study the role of oxidative stress in breast cancer risk, we analysed plasma levels of protein carbonyls in 1050 cases and 1107 controls. We found a statistically significant trend in breast cancer risk in relation to increasing quartiles of plasma protein carbonyl levels (OR = 1.2, 95% CI = 0.9-1.5; OR = 1.5, 95% CI = 1.2-2.0; OR = 1.6, 95% CI = 1.2-2.1, for the 2(nd), 3(rd) and 4(th) quartile relative to the lowest quartile, respectively, P for trend = 0.0001). The increase in risk was similar for younger ( or = 15 grams/day for 4(th) quartile versus lowest quartile OR = 2.3, 95% CI = 1.1-4.7), and hormone replacement therapy use (HRT, OR = 2.6, 95% CI = 1.6-4.4 for 4(th) quartile versus lowest quartile). The multiplicative interaction terms were statistically significant only for physical activity and HRT. The positive association between plasma protein carbonyl levels and breast cancer risk was also observed when the analysis was restricted to women who had not received chemotherapy or radiation therapy prior to blood collection. Among controls, oxidized protein levels significantly increased with cigarette smoking and higher fruit and vegetable consumption, and decreased with alcohol consumption >30 grams per day. Women with higher levels of plasma protein carbonyl and urinary 15F(2t)-isoprostane had an 80% increase in breast cancer risk (OR = 1.8, 95% CI = 1.2-2.6) compared to women with levels below the median for both markers of oxidative stress. In summary, our results suggest that increased plasma protein carbonyl levels may be associated with breast cancer risk.

  15. 犬体内带钛镍记忆合金支架的人工血管移植可行性及心功能的评估分析%The feasibility of artificial blood vessel transplantation in dogs with titanium nickel memory alloy stent and evaluation of cardiac func-tion

    Institute of Scientific and Technical Information of China (English)

    郭建中; 杨传瑞; 缪卫东

    2015-01-01

    Objective To investigate the feasibility of artificial blood vessel with titanium nickel memory alloy stent graft in the dogˊs as-cending aorta,aortic arch and descending aorta,assessment on the anticipating value of the plasma N - terminal pro brain natriuretic peptide(NT proBNP)precursors,serum aspartate aminotransferase(AST)and creatine kinase(CK)on heart failure. Methods From March 2015 to May 2014,Selecting 23 15kg or more adult hybrid dogs. Under the condition of deep hypothermia circulatory arrest and retrograde perfusion of the su-perior vena cava,all thoracic aortic vascular grafts were performed. The physiological parameters,operation time,survival time and death cause were recorded. To investigate the relationship between plasma NT - proBNP,AST,CK concentration and heart failure at different time after opera-tion. Results The overall survival rate was 65. 2%(15 / 23)of 23 adult hybrid dogs in the whole group. Operation time was about(174. 6 ± 27. 0)min. The survival period of the dog in the 30 d,which the time of the artificial blood vessel anastomosis was significantly longer than that of over 30 d. 24 ~ 48 h after artificial blood vessel transplantation,NT - proBNP,AST and CK concentrations reached the highest level. With the extension of survival time,the concentration of above three index gradually decreased,but the concentration of the index of the dog reached the highest value 1 ~ 3 d before death. Conclusion Method of artificial blood vessel with titanium nickel memory alloy stent for the whole thoracic aortic transplantation is feasible. The shorter time of artificial blood vessel anastomosis,the smaller the impact on the physiological parameters,the function of heart,liver and kidney. The concentration of NT - proBNP,AST and CK can be estimated to the extent of heart failure after artificial blood vessel transplantation.%目的:探讨带钛镍记忆合金支架的人工血管将犬升主动脉、主动脉弓及降主动脉合为一体进行

  16. Effects of pioglitazone on ambulatory pulse pressure index in patients with elderly essential hypertension and impaired glucose tolerance%吡格列酮对老年原发性高血压伴糖耐量异常患者动态脉压指数的影响

    Institute of Scientific and Technical Information of China (English)

    吴艳霞; 吴婷玉; 李秀娟; 王巍; 张琼; 熊华玲; 叶红

    2013-01-01

    目的:观察吡格列酮对老年原发性高血压伴糖耐量异常患者血糖、血脂、动态脉压指数(PPI)和动态动脉硬化指数(AASI)及血浆氨基末端脑钠肽前体(NT-proBNP)的影响.方法:用随机法分组,比较67例老年原发性高血压伴糖耐量异常患者在饮食加运动控制的基础上给予口服吡格列酮干预(吡格列酮组,34例)或不干预(对照组,33例)治疗前和治疗6个月后空腹血糖(FPG),及75 g无水葡萄糖负荷后2h血糖(2 h PG)、糖化血红蛋白(HbA1c)、TC、TG、LDL、HDL及NT-proBNP水平的变化.同时进行24 h动态血压监测,计算24 h平均脉压(24 h PP)、PPI和AASI.结果:吡格列酮组糖尿病的发病率低于对照组(5.9%∶15.2%,P<0.01).吡格列酮组与对照组治疗后FPG、2 hPG、TC、TG与LDL均较治疗前明显下降(均P<0.01),HDL和NT-proBNP治疗前后差异均无统计学意义.与对照组治疗后相比,吡格列酮组治疗后24 h SBP、24 h PP、PPI及AASI均明显下降,24 h DBP则差异无统计学意义.结论:吡格列酮能够降低老年原发性高血压伴糖耐量异常人群糖尿病的发病率,调节血脂代谢,明显改善动脉血管弹性功能,同时不影响患者心功能.%Objective:To study the effects of pioglitazone on glucose and lipid metabolize,ambulatory pulse pressure index (PPI),ambulatory arteriosclerosis index (AASI) and the level of plasma NT-ProBNP in patients with elder essential hypertension (EH) and impaired glucose tolerance (IGT).Method:According to randomized test,67 patients with elder EH and IGT were divided into pioglitazone group (n=34) and control group (n=33).Patients in pioglitazone group received pioglitazone (30 mg/d) orally and blood pressure control therapy for six months,while patients in control group received blood pressure control therapy only,both groups received diets and sports therapy.The levels of fasting blood glucose (FPG),post prandial 2 hour blood glucose (2 h PG),glycated hemoglobin

  17. Plasma separation: physical separation at the molecular level

    Science.gov (United States)

    Gueroult, Renaud; Rax, Jean-Marcel; Fisch, Nathaniel J.

    2016-09-01

    Separation techniques are usually divided in two categories depending on the nature of the discriminating property: chemical or physical. Further to this difference, physical and chemical techniques differ in that chemical separation typically occurs at the molecular level, while physical separation techniques commonly operate at the macroscopic scale. Separation based on physical properties can in principle be realized at the molecular or even atomic scale by ionizing the mixture. This is in essence plasma based separation. Due to this fundamental difference, plasma based separation stands out from other separation techniques, and features unique properties. In particular, plasma separation allows separating different elements or chemical compounds based on physical properties. This could prove extremely valuable to separate macroscopically homogeneous mixtures made of substances of similar chemical formulation. Yet, the realization of plasma separation techniques' full potential requires identifying and controlling basic mechanisms in complex plasmas which exhibit suitable separation properties. In this paper, we uncover the potential of plasma separation for various applications, and identify the key physics mechanisms upon which hinges the development of these techniques.

  18. Influence of Spironolactone on Matrix Metalloproteinase-2 in Acute Decompensated Heart Failure

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    João Pedro Ferreira

    2015-04-01

    Full Text Available Background: Matrix metalloproteinases (MMPs are a family of enzymes important for the resorption of extracellular matrices, control of vascular remodeling and repair. Increased activity of MMP2 has been demonstrated in heart failure, and in acutely decompensated heart failure (ADHF a decrease in circulating MMPs has been demonstrated along with successful treatment. Objective: Our aim was to test the influence of spironolactone in MMP2 levels. Methods: Secondary analysis of a prospective, interventional study including 100 patients with ADHF. Fifty patients were non-randomly assigned to spironolactone (100 mg/day plus standard ADHF therapy (spironolactone group or standard ADHF therapy alone (control group. Results: Spironolactone group patients were younger and had lower creatinine and urea levels (all p < 0.05. Baseline MMP2, NT-pro BNP and weight did not differ between spironolactone and control groups. A trend towards a more pronounced decrease in MMP2 from baseline to day 3 was observed in the spironolactone group (-21 [-50 to 19] vs 1.5 [-26 to 38] ng/mL, p = 0.06. NT-pro BNP and weight also had a greater decrease in the spironolactone group. The proportion of patients with a decrease in MMP2 levels from baseline to day 3 was also likely to be greater in the spironolactone group (50% vs 66.7%, but without statistical significance. Correlations between MMP2, NT-pro BNP and weight variation were not statistically significant. Conclusion: MMP2 levels are increased in ADHF. Patients treated with spironolactone may have a greater reduction in MMP2 levels.

  19. Plasma brain natriuretic peptide levels in COPD without pulmonary hypertension

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    Ahmed G. El Gazzar

    2017-01-01

    Conclusion: Plasma BNP can be used as a useful prognostic biomarker of COPD and a good predictor of exacerbation, As BNP level was significantly higher in COPD patients than in control groups, (p < 0.005 and also significantly higher in grade (IV, III than grade (II and was significantly higher in grade (II than grade (I COPD patients, BNP level significantly higher (p < 0.005 during exacerbation than during remission of COPD patients.

  20. Plasma and platelet serotonin levels in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To analyze the relationship between plasmaand platelet serotonin levels and the degree of liverinsufficiency.METHODS: The prospective study included 30 patients with liver cirrhosis and 30 healthy controls. The degree of liver failure was assessed according to the Child-Pugh classification. Platelet and platelet poor plasma serotonin levels were determined.RESULTS: The mean plasma serotonin level was higher in liver cirrhosis patients than in healthy subjects (215.0± 26.1 vs 63.1 ± 18.1 nmol/L; P < 0.0001). The mean platelet serotonin content was not significantly different in patients with liver cirrhosis compared with healthy individuals (4.8 ± 0.6; 4.2 ± 0.3 nmol/platelet; P > 0.05).Plasma serotonin levels were significantly higher in ChildPugh grade A/B than in grade C patients (246.8 ± 35.0vs132.3 ± 30.7 nmol/L; P < 0.05). However, platelet serotonin content was not significantly different between Child-Pugh grade C and grade A/B (4.6 ± 0.7 vs 5.2 ± 0.8nmol/platelet; P > 0.05).CONCLUSION: Plasma serotonin levels are significantly higher in patients with cirrhosis than in the controls and represent the degree of liver insufficiency. In addition,platelet poor plasma serotonin estimation is a better marker for liver insufficiency than platelet serotonin content.

  1. Cardiac Biomarkers and Cycling Race

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    Caroline Le Goff, Jean-François Kaux, Sébastien Goffaux, Etienne Cavalier

    2015-06-01

    between T0 and T1 (p < 0.0001, before decreasing between T1 and T3 with the T3 levels remaining higher than T0 (p = 0.01. The changes in myoglobin and CK observed here probably reflect skeletal muscle damage rather than injury to cardiomyocytes (Le Goff et al., 2012. During a Marathon, it has been clearly observed a post-effort increase of CK-MB and myoglobin, accompanied by an increase in hs-TnI release, without demonstrating any presence of micro-infarction by myocardial scintigraphy (Shave et al., 2012. HsTnT increased significantly between T0 and T1 (p < 0.0001 and stayed high 3 hours after the end of the exercise (T0-T3: p < 0.0001. At T0, the values obtained for NT-proBNP were inside the normal range, but we noted an increase with time. Some subjects were above the upper reference value at T1. The intense exercise produced during the race induced a significant increase of NT-proBNP (Tschope et al., 2005. This evolution is probably due to increased parietal pressure, as a rise in NT-proBNP can be a physiological response to increased ventricular pressure at the end of the diastole (Scharhag et al., 2008. They had no particular physical complaints during or after the exercise, this marker is useful for the detection of diastolic dysfunction in patients with exertion dyspnea. We observed the same kinetic as for hs-TnT. We noticed statistically significant variation between T0 and T1 (p < 0.01 and stayed high 3 hours after the end of the exercise (T0-T3: p < 0.0001. At the start of the race, three of our cyclists showed levels of hs-TnT below the reference level. At the end of the race, all of them showed a rise above the cut-off, however, probably not indicative of any permanent damage to the heart. It is worth noting that the cyclists with the highest pre-race levels showed only a moderate post-race increase. Since two cyclists (4 and 6 in Table 1 had levels of hsTnT above 100 ng/L at T1, a cut-off used in diagnosis of acute myocardial infarction. According to these

  2. Effect of carvedilol on oxidative stress in rabbits With driamycin cardiomyopathy%卡维地洛对阿霉素心肌病兔氧化应激的影响

    Institute of Scientific and Technical Information of China (English)

    贺莉; 肖建明; 付晖; 肖幸; 肖志超; 张存泰; 顾晔; 马业新

    2012-01-01

    "1) twice a week for eight weeks to establish animal model of adriamycin cardiomyopathy, and the control ·group was injected with equal volume of saline at the same timepoint. Then, rabbits in the metoprolol group and the carvedilol group were intragastric administration with metoprolol (5 mg · kg-1 · d-1) and carvedilol (5 mg · kg"' · d-1) respectively, and those in the control group and the adriamycin group were intragastric administration with equal volume of saline. Two months later, left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were measured by echocardiogram. Plasma levels of N-terminal pro brain-type natriuretic peptide (NT-proBNP), superoxide dis-mutase (SOD) and malondialdehyde (MAD) were measured and the wedge preparations from the rabbit hearts were perfused with Tyrode's solution, and ventricular arrhythmias were recorded. Result; LVEDd and the serum MDA, NT-proBNP increased, whereas LVEF and the serum SOD decreased in the adriamycin group: compared with the control group. The incidences of ventricular arrhythmias were significantly higher in the adriamycin group than those in the control group (P<0. 05). Carvedilol increased serum SOD and LVEF, decreased MDA, NT-proBNP and LVEDd, inhibited the increase of incidences of ventricular arrhythmias (P<0. 05). Conclusion: Compared to metbprolol, carvedilol has protective function to adriamycin cardiomyopathy and can decrease occurrence of ventricular arrthymia whose mechanism is closely related to decrease of oxidative free radicals.

  3. A Prospective Cohort Study on Cardiotoxicity of Adjuvant Trastuzumab Therapy in Breast Cancer Patients

    Science.gov (United States)

    Matos, Erika; Jug, Borut; Blagus, Rok; Zakotnik, Branko

    2016-01-01

    Background Cardiotoxicity is an important side effect of trastuzumab therapy and cardiac surveillance is recommended. Objectives The aim of our study was to prospectively assess baseline patients' characteristics, level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and echocardiographic parameters as possible predictors of trastuzumab-related cardiac dysfunction. Methods In a prospective cohort study, clinical, echocardiographic and neurohumoral assessment was performed at baseline, after 4, 8 and 12 months in breast cancer patients undergoing post-anthracycline (3-4 cycles) adjuvant therapy with trastuzumab. Trastuzumab-related cardiac dysfunction was defined as a decline of ≥ 10% in left ventricular ejection fraction (LVEF). Results 92 patients (mean age, 53.6 ± 9.0 years) were included. Patients who developed trastuzumab-related LVEF decline ≥ 10% (20.6%) during treatment had significantly higher baseline LVEF (70.7 ± 4.4%) than those without (64.8 ± 5.5%) (p = 0.0035). All other measured baseline parameters (age, body mass index, arterial hypertension, level of NT-proBNP and other echocardiographic parameters) were not identified as significant. Conclusions Our findings suggest that baseline patient' characteristics, level of NT-proBNP and echocardiographic parameters, as long as they are within normal range, are not a reliable tool to predict early trastuzumab-related cardiac dysfunction in patients undergoing post-low dose anthracycline adjuvant trastuzumab therapy. A LVEF decline in patients with high-normal baseline level although statistically significant is not clinically relevant. PMID:27305108

  4. Change of plasma visfatin level in the population with different glucose tolerances

    Institute of Scientific and Technical Information of China (English)

    杨媚

    2006-01-01

    Objective To investigate the change of plasma visfatin level and the relationship of plasma visfatin level to body mass index (BMI) , waist hip ratio (WHR) , blood glucose, plasma insulin levels as well as other factors in the subjects with different glucose tolerances. Methods Fasting and glucose loading 2 h plasma visfatin levels were assayed by ELISA in patients with type 2 diabetes

  5. Changes in plasma taurine levels after different endurance events.

    Science.gov (United States)

    Ward, R J; Francaux, M; Cuisinier, C; Sturbois, X; De Witte, P

    1999-01-01

    The sulphonated amino acid taurine increased significantly in the plasma of trained athletes after three endurance exercises of different duration and intensity, a 90 min run on a treadmill at 75% of an individual's VO2 peak, a Marathon, 42.2 km and a 100 km run, by 19%, 77% and 36%, respectively. Such results indicated that the speed at which the exercise is performed, referred to as the intensity, rather than the duration of the exercise, correlated with the elevated taurine levels possibly indicating its release from muscle fibres. The plasma amino acid pool decreased significantly in relationship with the duration of the exercise, caused by their utilisation for glucogenesis. The possible sources of the increased plasma taurine are discussed.

  6. Evaluation of cardiac function tests in Sudanese adult patients with sickle cell trait

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    Kamal E.A. Abdelsalam

    2016-10-01

    Full Text Available Background: Cardiac dysfunctions have been recognized as a common complication of sickle cell anaemia (SCA, and together with pulmonary disorder accounts for many deaths in these patients. However, sickle cell traits appear clinically normal, although they have genetic abnormality. The aim of this study was to assess the effect of sickle cell trait on cardiac prognostic markers by measuring high density lipoprotein (HDL-C, low density lipoprotein (LDL-C, cardiac creatine kinase (CK-MB, ultra-sensitive C reactive protein (us-CRP, total homocysteine (Hyc, and N-terminal pro-brain natriuretic peptide (NT-pro BNP tests in adult Sudanese patients with sickle cell trait.Methods: A cross-sectional study was performed in 200 healthy volunteers as a control group and 200 diagnosed patients with sickle cell trait. It was carried out in Khartoum Specialized Hospital, Al-Bayan Hospital, Obayed Clinical Center and Dr. Nadir Specialized Hospital, Sudan between January 2015 and January 2016. All participants were between 20-32 years old. LDL-C, HDL-C, CK-MB, NT-proBNP and hs-CRP concentrations were measured by Hitachi 912 full-automated Chemistry Analyzer (Roche Diagnostics, Germany as manufacturer procedure, while homocysteine level was measured by ELISA technique using special kit.Results: When compared to control group, the levels of LDL-C, hs-CRP and NT-proBNP revealed significant increase in patients’ sera (p<0.001, while Hyc and CK-MB levels were increased insignificantly in patients with SCT (p=0.069, p=0.054 respectively. On the other hand, comparison to control group, HDL-C showed insignificant reduction in patients (p=0.099.Conclusion: The results suggest that sickle cell trait increased the risk of patient-related complication secondary to cardiac dysfunction.

  7. Polybiomarker approach in myocardial dysfunction assessment in senile patients

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    Malinova L.I.

    2015-03-01

    Full Text Available Purpose: to evaluate interaction of obesity, inflammation and myocardial dysfunction in senile myocardial infarction survivors. Material and Methods. Patients aged 70 and older were involved in the study (n=108 and divided into 2 groups according to the history of myocardial infarction (Ml — 5 years before involvement: senile Ml survivors (n=26 vs senile patients without history of Ml (n=82. Measurements of serum levels of adipokines (leptin, adiponectin, myocardial dysfunction markers (BNP, NT proBNP, proANP, galectin 3 and inflammatory cytokines (TNF, interleukin 6 were performed. Results. Both groups were comparable by age and major clinical characteristics. Ejection fraction was preserved in both groups under the study (67 (64; 70 %vs67 (64; 68 %, p=0,655. Frequency of diastolic dysfunction was comparable in both groups. However it was more severe in Ml survivors. BNP and NT proBNP levels were significantly lower in patients without the history of Ml (p=0,021; 0,004, respectively. On the contrary serum levels of proANP had tendency to increase in patients with the history of Ml, but not significantly: p=0,821. Adiponectin and galectin-3 were significantly higher in patients with the history of Ml (p=0,019and p=0,011. Conclusion. Pathogenetic peculiarities of chronic heart failure with preserved ejection fraction in senile patients with and without myocardial infarction history were revealed. More expedient biomarker panel appropriate for senile patients with probable heart failure should include NT-proBNP, galectin-3 and adiponectin.

  8. Two-dimensional knowledge-based volumetric reconstruction of the right ventricle documents short-term improvement in pulmonary hypertension.

    Science.gov (United States)

    Schwaiger, Johannes P; Knight, Daniel S; Kaier, Thomas; Gallimore, Adele; Denton, Christopher P; Schreiber, Benjamin E; Handler, Clive; Coghlan, John G

    2017-06-01

    Data are scarce about short-term right ventricular changes in pulmonary hypertension. Two-dimensional knowledge-based reconstruction of the right ventricle with 2D echocardiography (2DKBR) has been shown to be a valid alternative to Cardiac MRI. In this longitudinal study 25 pulmonary hypertension patients underwent 2DKBR of the right ventricle, assessment of NT-proBNP levels and functional class at baseline and after a mean follow-up of 6.1 months. Patients were followed up clinically for a further mean of 8.2 months. The majority of patients had connective tissue disease (CTD) associated pulmonary arterial hypertension (n=15) or chronic thromboembolic pulmonary hypertension (CTEPH; n=6). A total of 15 patients underwent an intervention, either new targeted therapy, escalation of targeted therapy or pulmonary endarterectomy. A total of 10 clinically stable patients were routinely followed up without any change in therapy. There were significant improvements in the right ventricular end-diastolic volume index (111±29 mL/m² vs 100±36 mL/m²; P=.038), end-systolic volume index (72±23 mL/m² vs 61±25 mL/m²; P=.001), and ejection fraction (35±10% vs 40±9%; P=.030). Changes in NT-proBNP levels correlated strongest with changes in end-systolic volume index (r=-.77; P=right ventricle was associated with clinical worsening. In a CTD and CTEPH dominated patient population significant reverse remodeling and improvement of ejection fraction occurred despite a short follow-up and was paralleled by significant changes in NT-proBNP levels. Further right ventricular dilatation was associated with worse clinical outcome. 2DKBR is a feasible substitute for Cardiac MRI to follow-up right ventricular indices in pulmonary hypertension. © 2017, Wiley Periodicals, Inc.

  9. Abnormal plasma prothrombin (PIVKA-II) levels in hepatocellular carcinoma.

    Science.gov (United States)

    Kawaguchi, Y

    1989-05-01

    The concentration of abnormal prothrombin, or the protein induced by vitamin K absence or antagonist II (PIVKA-II) in 102 patients with hepatic disorders was measured by an enzyme immunoassay method. The concentration of PIVKA-II in the plasma was elevated in 11 out of 18 patients with hepatocellular carcinoma and also in a patient with hepatoblastoma. There was no correlation between serum alpha-fetoprotein and plasma PIVKA-II levels. The PIVKA-II level was normal in 11 patients who had metastatic carcinoma or cholangiocellular carcinoma. Moreover, benign diseases of the liver did not cause an elevation in PIVKA-II. PIVKA-II might be an useful marker of hepatocellular carcinoma because, like alpha-fetoprotein, its level changes in close relation to the effects of treatment.

  10. Impaired fetal myocardial deformation in intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Fan, Xuemei; Zhou, Qichang; Zeng, Shi; Zhou, Jiawei; Peng, Qinghai; Zhang, Ming; Ding, Yiling

    2014-07-01

    To investigate changes in fetal myocardial deformation in intrahepatic cholestasis of pregnancy. Patients with intrahepatic cholestasis of pregnancy were divided into 2 groups according to the total maternal serum bile acid concentration: mild cholestasis (10-40 μmol/L) and severe cholestasis (>40 μmol/L). Fetal echocardiography and velocity vector imaging were performed on women with cholestasis and control patients. The left ventricular global longitudinal strain and strain rate were measured. Clinical characteristics, maternal serum bile acid levels, and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in umbilical vein blood were compared between groups. The relationships among fetal myocardial deformation, maternal total bile acids, and cord NT-proBNP were analyzed. Twenty women with mild cholestasis, 20 with severe cholestasis, and 40 control patients were enrolled. There were no significant differences in maternal and gestational ages between the case and control groups. Maternal bile acids and NT-proBNP were significantly higher in fetuses of mothers with cholestasis than control fetuses. The left ventricular longitudinal strain (-10.56% ± 1.83% versus -18.36% ± 1.11%; P cholestasis compared with control fetuses. There were positive correlations between fetal myocardial deformation and maternal total bile acids (r = 0.705, 0.643, and 0.690, respectively; P intrahepatic cholestasis of pregnancy. Further investigation is needed to determine whether fetal echocardiography and velocity vector imaging can help predict which fetuses of mothers with cholestasis are likely to have poor outcomes. © 2014 by the American Institute of Ultrasound in Medicine.

  11. An official American Thoracic Society clinical practice guideline: diagnosis, risk stratification, and management of pulmonary hypertension of sickle cell disease.

    Science.gov (United States)

    Klings, Elizabeth S; Machado, Roberto F; Barst, Robyn J; Morris, Claudia R; Mubarak, Kamal K; Gordeuk, Victor R; Kato, Gregory J; Ataga, Kenneth I; Gibbs, J Simon; Castro, Oswaldo; Rosenzweig, Erika B; Sood, Namita; Hsu, Lewis; Wilson, Kevin C; Telen, Marilyn J; Decastro, Laura M; Krishnamurti, Lakshmanan; Steinberg, Martin H; Badesch, David B; Gladwin, Mark T

    2014-03-15

    In adults with sickle cell disease (SCD), an increased tricuspid regurgitant velocity (TRV) measured by Doppler echocardiography, an increased serum N-terminal pro-brain natriuretic peptide (NT-pro-BNP) level, and pulmonary hypertension (PH) diagnosed by right heart catheterization (RHC) are independent risk factors for mortality. A multidisciplinary committee was formed by clinician-investigators experienced in the management of patients with PH and/or SCD. Clinically important questions were posed, related evidence was appraised, and questions were answered with evidence-based recommendations. Target audiences include all clinicians who take care of patients with SCD. Mortality risk stratification guides decision making. An increased risk for mortality is defined as a TRV equal to or greater than 2.5 m/second, an NT-pro-BNP level equal to or greater than 160 pg/ml, or RHC-confirmed PH. For patients identified as having increased mortality risk, we make a strong recommendation for hydroxyurea as first-line therapy and a weak recommendation for chronic transfusions as an alternative therapy. For all patients with SCD with elevated TRV alone or elevated NT-pro-BNP alone, and for patients with SCD with RHC-confirmed PH with elevated pulmonary artery wedge pressure and low pulmonary vascular resistance, we make a strong recommendation against PAH-specific therapy. However, for select patients with SCD with RHC-confirmed PH who have elevated pulmonary vascular resistance and normal pulmonary capillary wedge pressure, we make a weak recommendation for either prostacyclin agonist or endothelin receptor antagonist therapy and a strong recommendation against phosphodiesterase-5 inhibitor therapy. Evidence-based recommendations for the management of patients with SCD with increased mortality risk are provided, but will require frequent reassessment and updating.

  12. Radioimmunological analysis of plasma cortisole levels and daily plasma cortisole variation following triamcinolone acetonide therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, F.; Schuster, E.

    1980-08-01

    Plasma cortisol levels in a four-point daily profile were measured by radioimmunoassay before and during treatment with corticoid-containing ointments (triamcinolone acetonide) in 21 patients with psoriasis, who had no endocrine disorders. In the pretreatment phase there were typical circadian fluctuations of the plasma cortisol concentrations. Already after two days of treatment a significant suppression of adrenal function could be detected. This disfunction increased during continuous treatment. In comparison with a fluorimetric method, the radioimmunoassay allowed a better differentiation. This could be due to a lack of specificity and to susceptibility to erroneous measurement of the fluorimetric method. We could also confirm that the distribution of plasma cortisol levels is not a linear but a logarithmic one. Considering the log-normal distribution different mean values and variances are obtained.

  13. Plasma carnitine levels in patients receiving home parenteral nutrition.

    Science.gov (United States)

    Bowyer, B A; Fleming, C R; Ilstrup, D; Nelson, J; Reek, S; Burnes, J

    1986-01-01

    Patients on long-term home parenteral nutrition (HPN) are known to frequently develop hepatic steatosis or steatohepatitis. The etiology of this steatosis or steatohepatitis is unknown, but carnitine deficiency has been one of the postulated mechanisms. The importance of L-carnitine in hepatic fatty acid oxidation and the steatosis observed in primary and acquired carnitine deficiencies prompted us to determine plasma carnitine levels in 37 patients receiving long-term HPN. Thirteen patients (35%) had low total and free plasma carnitine levels. Fifteen of the 37 HPN patients were matched for age and sex with 15 patients with Crohn's disease who did not require HPN. Mean total and free plasma carnitine values were significantly lower (p less than 0.001) in these 15 HPN patients (32.2 +/- 11.9 and 28.4 +/- 10.8) when compared to Crohn's patients not requiring HPN (49.1 +/- 10.9 and 46.4 +/- 11.5). Associations were not detected between plasma carnitine and clinical or biochemical parameters that might have explained the low values.

  14. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation.

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    Jochen Wöhrle

    Full Text Available It is not known whether biomarkers of hemodynamic stress, myocardial necrosis, and renal function might predict adverse outcome in patients undergoing percutaneous repair of severe mitral valve insufficiency. Thus, we aimed to assess the predictive value of various established and emerging biomarkers for major adverse cardiovascular events (MACE in these patients.Thirty-four patients with symptomatic severe mitral valve insufficiency with a mean STS-Score for mortality of 12.6% and a mean logistic EuroSCORE of 19.7% undergoing MitraClip therapy were prospectively included in this study. Plasma concentrations of mid regional-proatrial natriuretic peptide (MR-proANP, Cystatin C, high-sensitive C-reactive protein (hsCRP, high-sensitive troponin T (hsTnT, N-terminal B-type natriuretic peptide (NT-proBNP, galectin-3, and soluble ST-2 (interleukin 1 receptor-like 1 were measured directly before procedure. MACE was defined as cardiovascular death and hospitalization for heart failure (HF.During a median follow-up of 211 days (interquartile range 133 to 333 days, 9 patients (26.5% experienced MACE (death: 7 patients, rehospitalization for HF: 2 patients. Thirty day MACE-rate was 5.9% (death: 2 patients, no rehospitalization for HF. Baseline concentrations of hsTnT (Median 92.6 vs 25.2 ng/L, NT-proBNP (Median 11251 vs 1974 pg/mL and MR-proANP (Median 755.6 vs 318.3 pmol/L, all p<0.001 were clearly higher in those experiencing an event vs event-free patients, while other clinical variables including STS-Score and logistic EuroSCORE did not differ significantly. In Kaplan-Meier analyses, NT-proBNP and in particular hsTnT and MR-proANP above the median discriminated between those experiencing an event vs event-free patients. This was further corroborated by C-statistics where areas under the ROC curve for prediction of MACE using the respective median values were 0.960 for MR-proANP, 0.907 for NT-proBNP, and 0.822 for hsTnT.MR-proANP and hsTnT strongly

  15. Discovery of new biomarkers for atrial fibrillation using a custom-made proteomics chip.

    Science.gov (United States)

    Lind, Lars; Sundström, Johan; Stenemo, Markus; Hagström, Emil; Ärnlöv, Johan

    2017-03-01

    Apart from several established clinical risk factors for atrial fibrillation (AF), a number of biomarkers have also been identified as potential risk factors for AF. None of these have so far been adopted in clinical practice. To use a novel custom-made proteomics chip to discover new prognostic biomarkers for AF risk. In two independent community-based cohorts (Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (978 participants without AF, mean age 70.1 years, 50% women, median follow-up 10.0 years) and Uppsala Longitudinal Study of Adult Men (ULSAM) (n=725, mean age 77.5 years, median follow-up 7.9 years)), ninety-two plasma proteins were assessed at baseline by a proximity extension assay (PEA) chip. Of those, 85 proteins showed a call rate >70% in both cohorts. Thirteen proteins were related to incident AF in PIVUS (148 events) using a false discovery rate of 5%. Of those, five were replicated in ULSAM at nominal multivariable p value (123 events, N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), fibroblast growth factor 23 (FGF-23), fatty acid-binding protein 4 (FABP4), growth differentiation factor 15 (GDF-15) and interleukin-6 (IL-6)). Of those, NT-pro-BNP and FGF-23 were also associated with AF after adjusting for established AF risk factors. In a prespecified secondary analysis pooling the two data sets, T-cell immunoglobulin and mucin domain 1 (TIM-1) and adrenomedullin (AM) were also significantly related to incident AF in addition to the aforementioned five proteins (Bonferroni-adjustment). The addition of NT-pro-BNP to a model with established risk factors increased the C-statistic from 0.605 to 0.676 (p<0.0001). Using a novel proteomics approach, we confirmed the previously reported association between NT-pro-BNP, FGF-23, GDF-15 and incident AF, and also discovered four proteins (FABP4, IL-6, TIM-1 and AM) that could be of importance in the development of AF. Published by the BMJ Publishing Group Limited. For

  16. Influence of co-existing atrial fibrillation on the efficacy of atorvastatin treatment in patients with dilated cardiomyopathy: a pilot study

    Directory of Open Access Journals (Sweden)

    Desai Ravi

    2010-02-01

    Full Text Available Abstract Introduction The aim of the study was to assess the influence of co-existing atrial fibrillation (AF on inflammatory condition factors, left ventricular function, clinical course and the efficacy of statin treatment of congestive heart failure in the course of dilated cardiomyopathy (DCM. Material and methods In a prospective, randomized, open-label study, 69 patients with DCM and left ventricular ejection fraction (LVEF ≤40% were divided into two groups, with and without AF, who were treated according to the recommended standards. 68% of patients from the group with AF and 59% of patients from the group without AF were administered atorvastatin 40 mg daily for 8 weeks and 10 mg for next 4 months. Clinical examination with the assessment of body mass index (BMI and waist size were followed by routine laboratory tests, measurement of concentration of tumor necrosis factor (TNF-α, interleukin-6 (IL-6, and IL-10 in blood plasma, N-terminal pro-brain natriuretic peptide (NT-proBNP concentration in blood serum, echocardiographic examination, and the assessment of exercise capacity in 6-minute walk test (6-MWT. After six months, morbidity rate and the number of heart failure hospitalizations were also observed. Results In the whole population of patients, a significantly higher concentration of NT-proBNP was observed in the AF group (2669 ± 2192 vs 1540 ± 1067, p = 0.02. After statin treatment, in patients with DCM and co-existing AF, higher values of NT-proBNP and IL-6 were observed compared to non-AF patients (1530 ± 1054 vs 1006 ± 1195, p = 0.04 and (14.16 ± 13.40 vs 6.74 ± 5.45, p = 0.02, respectively. Conclusion In patients with DCM and co-existing AF, a weaker effect of atorvastatin concerning the reduction of IL-6 and NT-proBNP concentration was observed than in patients without atrial fibrillation. Trials Registration (ClinialTrial.gov No.: NCT01015144

  17. Plasma Leptin Levels in Children Hospitalized with Cholera in Bangladesh.

    Science.gov (United States)

    Falkard, Brie; Uddin, Taher; Rahman, M Arifur; Franke, Molly F; Aktar, Amena; Uddin, Muhammad Ikhtear; Bhuiyan, Taufiqur Rahman; Leung, Daniel T; Charles, Richelle C; Larocque, Regina C; Harris, Jason B; Calderwood, Stephen B; Qadri, Firdausi; Ryan, Edward T

    2015-08-01

    Vibrio cholerae, the cause of cholera, induces both innate and adaptive immune responses in infected humans. Leptin is a hormone that plays a role in both metabolism and mediating immune responses. We characterized leptin levels in 11 children with cholera in Bangladesh, assessing leptin levels on days 2, 7, 30, and 180 following cholera. We found that patients at the acute stage of cholera had significantly lower plasma leptin levels than matched controls, and compared with levels in late convalescence. We then assessed immune responses to V. cholerae antigens in 74 children with cholera, correlating these responses to plasma leptin levels on day 2 of illness. In multivariate analysis, we found an association between day 2 leptin levels and development of later anti-cholera toxin B subunit (CtxB) responses. This finding appeared to be limited to children with better nutritional status. Interestingly, we found no association between leptin levels and antibody responses to V. cholerae lipopolysaccharide, a T cell-independent antigen. Our results suggest that leptin levels may be associated with cholera, including the development of immune responses to T cell-dependent antigens. © The American Society of Tropical Medicine and Hygiene.

  18. The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry.

    Science.gov (United States)

    Park, Jin Joo; Choi, Dong-Ju; Yoon, Chang-Hwan; Oh, Il-Young; Lee, Ju Hyun; Ahn, Soyeon; Yoo, Byung-Su; Kang, Seok-Min; Kim, Jae-Joong; Baek, Sang-Hong; Cho, Myeong-Chan; Jeon, Eun-Seok; Chae, Shung Chull; Ryu, Kyu-Hyung; Oh, Byung-Hee

    2015-06-01

    In acute heart failure (AHF) patients, pulmonary oedema and low tissue perfusion may lead to changes in the acid-base balance, which may be associated with worse outcomes. In this prospective nationwide cohort study from 24 academic hospitals, arterial blood gas (ABG) was measured in 1982 AHF patients at hospital admission. Acidosis was defined as pH 7.44. Mortality was stratified according to ABG results. Overall, 19% had acidosis, 37% had normal pH, and 44% had alkalosis. The most common type of acidosis was the mixed type (42%) followed by metabolic acidosis (40%), and the most common type of alkalosis was respiratory alkalosis (58%). At 12 months' follow-up 304 patients (15%) died. Patients with acidosis had higher mortality (acidosis 19.5%, neutral pH 13.7%, alkalosis 14.9%; P = 0.007). In the Cox proportional-hazards regression model, acidosis was a significant predictor of mortality (hazard ratio 1.93; 95% confidence intervals 1.27-2.93) along with N-terminal pro-brain type natriuretic peptide (NT-proBNP), among others. In contrast, alkalosis was not associated with increased mortality. pH had an incremental prognostic value over NT-proBNP (net reclassification improvement 30%; P analysis identified extra patients at increased risk for mortality among patients with an NT-proBNP level less than the median (12-month mortality 17.5% vs. 9.9%; P = 0.009). In high-risk AHF patients, the most common acid-base imbalance is respiratory alkalosis. Acidosis is observed in every fifth patient and is a significant predictor of mortality. pH provides an additional prognostic value and may be used to optimize risk stratification in high-risk AHF patients. © 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology.

  19. EFFICACY OF IVABRADINE AND VERAPAMIL IN PATIENTS WITH DIASTOLIC HEART FAILURE CAUSED BY LEFT VENTRICLE IMPAIRED RELAXATION

    Directory of Open Access Journals (Sweden)

    K. G. Adamyan

    2009-01-01

    Full Text Available Aim. To compare ivabradine (IB and verapamil (VP effects on left ventricle (LV diastolic function in patients with diastolic heart failure (DHF caused by left ventricle impaired relaxation.Methods. It was comparative randomized study. 238 patients (190 men, 48 women; aged 63±10 y.o. with DHF were randomized in two groups to receive IB (7,5 mg bid, n=119 or VP (240 mg o.d., n=119. Echocardiography (EchoCG indices, total ischemic burden (TIB and N-terminal fragment of pro-brain natriuretic peptide (NT-pro-BNP were evaluated initially and after 1, 3, 6 and 12 months of therapy.Results. After 3 months of therapy some EchoCG parameters (E/A, transmitral E wave deceleration time [EDT] as well as TIB improved more significantly in IB group. After 6 months in IB group in comparison with VP group additional differences appeared (midwall fractional shortening; E/Em of lateral mitral annulus – 8,6±4,7 and 12,3±4,7, respectively, p<0,05; NT-pro-BNP – 91,7±4,3 pg/ml and 128±7,6 pg/ml, respectively, p<0.01 or became stronger (TIB, E/A and EDT. The differences persisted after 12 months of follow up. Besides a number of patients required hospitalization were less in IB group in comparison with VP group (11 vs 19, respectively, p<0.05.Conclusion. Both IB and VP improved diastolic function and reduced heart rate, ischemia time, NT-pro-BNP levels and hospitalization rate in patients with DHF. However, IB compared with VP has more prominent effect on these parameters. 

  20. EFFICACY OF IVABRADINE AND VERAPAMIL IN PATIENTS WITH DIASTOLIC HEART FAILURE CAUSED BY LEFT VENTRICLE IMPAIRED RELAXATION

    Directory of Open Access Journals (Sweden)

    K. G. Adamyan

    2016-01-01

    Full Text Available Aim. To compare ivabradine (IB and verapamil (VP effects on left ventricle (LV diastolic function in patients with diastolic heart failure (DHF caused by left ventricle impaired relaxation.Methods. It was comparative randomized study. 238 patients (190 men, 48 women; aged 63±10 y.o. with DHF were randomized in two groups to receive IB (7,5 mg bid, n=119 or VP (240 mg o.d., n=119. Echocardiography (EchoCG indices, total ischemic burden (TIB and N-terminal fragment of pro-brain natriuretic peptide (NT-pro-BNP were evaluated initially and after 1, 3, 6 and 12 months of therapy.Results. After 3 months of therapy some EchoCG parameters (E/A, transmitral E wave deceleration time [EDT] as well as TIB improved more significantly in IB group. After 6 months in IB group in comparison with VP group additional differences appeared (midwall fractional shortening; E/Em of lateral mitral annulus – 8,6±4,7 and 12,3±4,7, respectively, p<0,05; NT-pro-BNP – 91,7±4,3 pg/ml and 128±7,6 pg/ml, respectively, p<0.01 or became stronger (TIB, E/A and EDT. The differences persisted after 12 months of follow up. Besides a number of patients required hospitalization were less in IB group in comparison with VP group (11 vs 19, respectively, p<0.05.Conclusion. Both IB and VP improved diastolic function and reduced heart rate, ischemia time, NT-pro-BNP levels and hospitalization rate in patients with DHF. However, IB compared with VP has more prominent effect on these parameters. 

  1. N-terminal pro brain natriuretic peptide in arterial hypertension--a marker for left ventricular dimensions and prognosis

    DEFF Research Database (Denmark)

    Hildebrandt, Per; Boesen, Mikael; Olsen, Michael

    2004-01-01

    In arterial hypertension risk factor evaluation, including LV mass measurements, and risk stratification using risk charts or programs, is generally recommended. In heart failure NT-proBNP has been shown to be a marker of LV dimensions and of prognosis. If the same diagnostic and prognostic value...... is present in arterial hypertension, risk factor evaluation would be easier. In 36 patients with arterial hypertension, electrocardiographic LV hypertrophy and preserved left ventricular function, NT-proBNP was eight-fold higher than in healthy subjects. The log NT-proBNP correlated with LV mass index (R=0...... and preserved LV function demonstrated that NT-proBNP was a very strong prognostic marker, especially combined with a history of cardiovascular disease. Patients with high NT-proBNP and known cardiovascular disease had a seven-fold increase in CV events compared to patients with low NT-proBNP and no CV disease...

  2. Natriuretic peptides for the detection of paroxysmal atrial fibrillation

    Science.gov (United States)

    Seegers, Joachim; Zabel, Markus; Grüter, Timo; Ammermann, Antje; Weber-Krüger, Mark; Edelmann, Frank; Gelbrich, Götz; Binder, Lutz; Herrmann-Lingen, Christoph; Gröschel, Klaus; Hasenfuß, Gerd; Feltgen, Nicolas; Pieske, Burkert; Wachter, Rolf

    2015-01-01

    Background and purpose Silent atrial fibrillation (AF) and tachycardia (AT) are considered precursors of ischaemic stroke. Therefore, detection of paroxysmal atrial rhythm disorders is highly relevant, but is clinically challenging. We aimed to evaluate the diagnostic value of natriuretic peptide levels in the detection of paroxysmal AT/AF in a pilot study. Methods Natriuretic peptide levels were analysed in two independent patient cohorts (162 patients with arterial hypertension or other cardiovascular risk factors and 82 patients with retinal vessel disease). N-terminal-pro-brain natriuretic peptide (NT-proBNP) and BNP were measured before the start of a 7-day Holter monitoring period carefully screened for AT/AF. Results 244 patients were included; 16 had paroxysmal AT/AF. After excluding patients with a history of AT/AF (n=5), 14 patients had newly diagnosed AT/AF (5.8%) NT-proBNP and BNP levels were higher in patients with paroxysmal AT/AF in both cohorts: (1) 154.4 (IQR 41.7; 303.6) versus 52.8 (30.4; 178.0) pg/mL and 70.0 (31.9; 142.4) versus 43.9 (16.3; 95.2) and (2) 216.9 (201.4; 277.1) versus 90.8 (42.3–141.7) and 96.0 (54.7; 108.2) versus 29.1 (12.0; 58.1). For the detection of AT/AF episodes, NT-proBNP and BNP had an area under the curve in receiver operating characteristic analysis of 0.76 (95% CI, 0.64 to 0.88; p=0.002) and 0.75 (0.61 to 0.89; p=0.004), respectively. Conclusions NT-proBNP and BNP levels are elevated in patients with silent AT/AF as compared with sinus rhythm. Thus, screening for undiagnosed paroxysmal AF using natriuretic peptide level initiated Holter monitoring may be a useful strategy in prevention of stroke or systemic embolism. PMID:26288739

  3. Prognostic usefulness of anemia and N-terminal pro-brain natriuretic peptide in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kistorp, Caroline N

    2007-01-01

    N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and anemia are predictors of outcome in systolic heart failure. It is currently unclear how these 2 markers interact in particular with regard to the prognostic information carried by each risk marker. We therefore tested the hypothesis...... that anemia (World Health Organization criteria, hemoglobin levels ... prospectively at the baseline visit to our heart failure clinic (inclusion criterion left ventricular ejection fraction anemia was 27%. In a multivariate logistic regression model, anemia (p = 0...

  4. Long-term effects with ambrisentan monotherapy in patients with pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    文莉

    2014-01-01

    Objective To investigate long-term efficacy and safety of ambrisentan monotherapy in patients with pulmonary arterial hypertension(PAH).Methods Patients with PAH who received 2.5 mg or 5 mg of ambrisentan once daily between July 10,2011 and August 30,2012for at least 6 months were enrolled.The efficacy endpoints were changes in exercise capacity,World Health Organization(WHO)functional class and N-terminal probrain natriuretic peptide(NT-pro BNP)level,echocardiographic parameters.The safety endpoint was the safety of long-term ambrisentan administration,as defined by

  5. A Prospective Study on Cardiovascular Dysfunction in Patients with Hyperthyroidism and Its Reversal After Surgical Cure.

    Science.gov (United States)

    Muthukumar, Sankaran; Sadacharan, Dhalapathy; Ravikumar, Krishnan; Mohanapriya, Gajarajan; Hussain, Zahir; Suresh, R V

    2016-03-01

    Cardiovascular dysfunction (CVD) is a major cause of mortality and morbidity in hyperthyroidism. CVD and its reversibility after total thyroidectomy (TT) are not adequately addressed. This prospective case-control study evaluates the effect of hyperthyroidism on myocardium and its reversibility after TT. Surgical candidates of new onset hyperthyroidism, Group A (n = 41, age Hyperthyroidism. Various parameters of CVD improved consistently after surgical cure. NT-proBNP levels correlated well with the severity and duration of CVD and hence can be an objective tool in monitoring of hyperthyroid cardiac dysfunction.

  6. Periodontal treatment decreases plasma oxidized LDL level and oxidative stress.

    Science.gov (United States)

    Tamaki, Naofumi; Tomofuji, Takaaki; Ekuni, Daisuke; Yamanaka, Reiko; Morita, Manabu

    2011-12-01

    Periodontitis induces excessive production of reactive oxygen species in periodontal lesions. This may impair circulating pro-oxidant/anti-oxidant balance and induce the oxidation of low-density lipoprotein (LDL) in blood. The purpose of this study was to monitor circulating oxidized LDL and oxidative stress in subjects with chronic periodontitis following non-surgical periodontal treatment. Plasma levels of oxidized LDL and oxidative stress in 22 otherwise healthy non-smokers with chronic periodontitis (mean age 44.0 years) were measured at baseline and at 1 and 2 months after non-surgical periodontal treatment. At baseline, chronic periodontitis patients had higher plasma levels of oxidized LDL and oxidative stress than healthy subjects (p surgical periodontal treatment were effective in decreasing oxLDL, which was positively associated with a reduction in circulating oxidative stress.

  7. Plasma Lactate Dehydrogenase Levels Predict Mortality in Acute Aortic Syndromes

    OpenAIRE

    Morello, Fulvio; Ravetti, Anna; Nazerian, Peiman; Liedl, Giovanni; Veglio, Maria Grazia; Battista, Stefania; Vanni, Simone; Pivetta, Emanuele; Montrucchio, Giuseppe; Mengozzi, Giulio; Rinaldi, Mauro; Moiraghi, Corrado; Lupia, Enrico

    2016-01-01

    Abstract In acute aortic syndromes (AAS), organ malperfusion represents a key event impacting both on diagnosis and outcome. Increased levels of plasma lactate dehydrogenase (LDH), a biomarker of malperfusion, have been reported in AAS, but the performance of LDH for the diagnosis of AAS and the relation of LDH with outcome in AAS have not been evaluated so far. This was a bi-centric prospective diagnostic accuracy study and a cohort outcome study. From 2008 to 2014, patients from 2 Emergency...

  8. Relationship between Plasma Leptin Level and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Anoop Shankar

    2012-01-01

    Full Text Available Background. Leptin is an adipose tissue-derived hormone shown to be related to several metabolic, inflammatory, and hemostatic factors related to chronic kidney disease. Recent animal studies have reported that infusion of recombinant leptin into normal rats for 3 weeks fosters the development of glomerulosclerosis. However, few studies have examined the association between leptin and CKD in humans. Therefore, we examined the association between plasma leptin levels and CKD in a representative sample of US adults. Methods. We examined the third National Health and Nutrition Examination Survey participants >20 years of age (n=5820, 53.6% women. Plasma leptin levels were categorized into quartiles (≤4.3 Fg/L, 4.4–8.7 Fg/L, 8.8–16.9 Fg/L, >16.9 Fg/L. CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m2 estimated from serum creatinine. Results. Higher plasma leptin levels were associated with CKD after adjusting for age, sex, race/ethnicity, education, smoking, alcohol intake, body mass index (BMI, diabetes, hypertension, and serum cholesterol. Compared to quartile 1 of leptin (referent, the odds ratio (95% confidence interval of CKD associated with quartile 4 was 3.31 (1.41 to 7.78; P-trend = 0.0135. Subgroup analyses examining the relation between leptin and CKD by gender, BMI categories, diabetes, and hypertension status also showed a consistent positive association. Conclusion. Higher plasma leptin levels are associated with CKD in a representative sample of US adults.

  9. [Preoperative digitalization. Measurement of digoxin plasma levels (author's transl)].

    Science.gov (United States)

    Geiger, H J; Rietbrock, N

    1976-09-01

    In a study of 233 patients from the department of surgery and anesthesiology taking digoxin preparations 64, per cent exhibit digoxin levels in the therapeutic range (0.6--1.5 ng/ml), 19 per cent had subtoxic concentrations ranged from 1.6--2.0 ng/ml and 7 per cent were in the toxic range (greater than 2 ng/ml). In patients treated with digoxin before admission to hospital subtherapeutic levels were most frequent. An average loading dose of digoxin 1 mg or more on one day may result in subtoxic and toxic digoxin levels on the second day, in patients receiving less than 1 mg digoxin daily an increasing frequency of plasma digoxin concentrations of 1.5 ng/ml or higher values was present on the third day. Averaged plasma digoxin concentrations were correlated with daily maintenance dose. There was, however, a wide individual variation in digoxin plasma concentrations. A low incidence of toxic digoxin plasma levels was observed in patients receiving a daily oral maintenance dose of 0.375 mg digoxin (Lanicor). For prophylactic digitalization of patients with normal renal and thyroid function the following schedules or statistical guidlines are proposed: Lanicor (bioavailability 60%): oral loading dose of 0.75 mg over two days, and then daily oral maintenance dose of 0.375 mg; Novodigal (bioavailability 80%): oral loading dose of 0.6 mg over two days and then daily oral maintenance dose of 0.3 mg; Digoxin i.v.: intravenous loading dose of 0.5 (0.4) mg over two days and then 0.25 (0.2) mg daily intravenous maintenance dose. For any patient needing treatment with digitalis glycosides therapy must be individual and dynamic. The reasons for toxic concentrations were frequently attributed to wrong dosage.

  10. Observation on the clinical effect of Shenfu injection on acute left heart failure%参附注射液治疗急性左心衰竭的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    曾艳红

    2016-01-01

    Objective:To observe the clinical effect of Shenfu injection on acute left heart failure.Methods:80 patients of acute left heart failure were divided into two groups on average.Patients in the control group were given routine treatment of Western medicine,and patients in the treatment group were treated with the intravenous infusion of shenfu injection on the basis of routine treatment of the control group.We observed the remission of clinical symptoms,the change of blood gas analysis index and pro-B-type natriuretic peptide(NT-proBNP)level.Results:Whether from clinical symptoms,blood gas analysis or NT-proBNP level,the total effective rate of the treatment group were significantly higher than those of the control group. Conclusion:Shenfu injection can significantly improve cardiac function in patients with acute left heart failure,and reduce the level of NT-proBNP.%目的:观察参附注射液治疗急性左心衰竭的临床疗效。方法:将80例急性左心衰竭患者平分成两组,对照组给予西医常规治疗,治疗组在对照组基础上加用参附注射液静脉滴注,观察两组临床症状缓解情况、血气分析指标及血浆B型利钠肽前体(NT-proBNP)水平变化。结果:无论从临床症状、血气分析还是NT-proBNP水平,治疗组总有效率明显高于对照组。结论:参附注射液可明显改善急性左心衰竭患者的心功能,降低NT-proBNP水平。

  11. Kissing reduces allergic skin wheal responses and plasma neurotrophin levels.

    Science.gov (United States)

    Kimata, Hajime

    2003-11-01

    The effect of kissing on allergen-induced skin wheal responses and plasma neurotrophin levels were studied in 30 normal subjects, 30 patients with allergic rhinitis (AR), and 30 patients with atopic dermatitis (AD). All of the patients with AR or AD are allergic to house dust mite (HDM) and Japanese cedar pollen (JCP). They are all Japanese and they do not kiss habitually. The subject kissed freely during 30 min with their lover or spouse alone in a room with closed doors while listening to soft music. Before and after kissing, skin prick tests were performed using commercial HDM allergen, JCP allergen, as well as histamine and control solution, and wheal responses were measured. Simultaneously, plasma levels of neurotrophin, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and -4 (NT-4) were measured. Kissing significantly reduced wheal responses induced by HDM and JCP, but not by histamine, and decreased plasma levels of NGF, BDNF, NT-3, and NT-4 in patients with AR or AD, while it failed to do so in normal subjects. These finding indicate that kissing have some implication in the study of neuroimmunology in allergic patients.

  12. Plasma bupivacaine levels following single dose intraarticular instillation for arthroscopy.

    Science.gov (United States)

    Meinig, R P; Holtgrewe, J L; Wiedel, J D; Christie, D B; Kestin, K J

    1988-01-01

    Arthroscopy of the knee was performed using 30 ml single dose intraarticular instillations of 0.5% or 0.25% solutions of bupivacaine (Marcaine). A total of 18 patients (mean age, 34 years), divided into two groups, participated in this study. Venous plasma levels were measured at 0, 10, 20, 30, 45, 60, 90, 120, and 240 minute intervals following a single instillation into the knee joint. All patients had suspected traumatic internal derangement of the knee. Electrocardiogram tracings, blood pressure, and neurologic assessment were monitored at each venous sampling interval or more often if clinically indicated. The type and amount of supplemental anesthesia were also recorded. None of our 18 patients required a general anesthetic because of pain although the following procedures were performed: meniscectomy, plica release, abrasion chondroplasty, loose body retrieval, and limited meniscal repair. A new methodology for the measurement of plasma bupivacaine using the gas chromatograph mass spectrometer is described. Monitoring specific molecular mass fragments allows the measurement of picogram per milliliter levels of bupivacaine. The highest peak plasma concentration occurred 20 minutes after instillation of 30 ml of 0.5% bupivacaine. The 625 +/- 225 ng/ml level was well below the 2,500 to 4,000 ng/ml reported to elicit early subjective CNS symptoms of bupivacaine toxicity. Thus, a single dose intraarticular instillation of 30 ml 0.5% or 0.25% bupivacaine is convenient, efficacious, and pharmacologically safe for routine clinical arthroscopy.

  13. Association of plasma lipid levels with atherosclerosis prevalence in psittaciformes.

    Science.gov (United States)

    Beaufrère, Hugues; Vet, Dr Med; Cray, Carolyn; Ammersbach, Mélanie; Tully, Thomas N

    2014-09-01

    The prevalence of atherosclerosis is high in the captive psittacine population and increases with age and female sex. The genera Psittacus, Amazona, and Nymphicus are predisposed to atherosclerosis, whereas the genera Cacatua and Ara are less susceptible. Plasma cholesterol and lipoprotein abnormalities have been suggested as risk factors in the development of atherosclerosis as observed in mammals. To investigate whether the psittacine genera susceptibility to atherosclerosis and the known risk factors of age and sex could be associated with differences in the lipid profile, a retrospective analysis was conducted on blood lipid values from 5625 birds. Prevalence values were obtained from a previously published, large, case-control study and were compared with identified trends in plasma lipid profiles. Genus-specific differences were identified in plasma total cholesterol values that corresponded to observed trends in the prevalence of clinically important atherosclerotic lesions, which were also highly correlated. The effect of age was significant but was mild and may not account for the dramatic increase in atherosclerosis prevalence observed with age. In addition, Quaker parrots ( Myiopsitta monachus ), which were used as experimental models for psittacine atherosclerosis and dyslipidemia, were found to have the highest values in all lipid profile parameters. The results of this study suggest that the differences observed in prevalence among species of the psittacine genera may partly be explained by differences in plasma total cholesterol levels. Results also support the use of Quaker parrots as models for studying atherosclerosis and dyslipidemia.

  14. Long-term efficacy of bosentan in inoperable chronic thromboembolic pulmonary hypertension

    Science.gov (United States)

    Post, M.C.; Plokker, H.W.M.; Kelder, J.C.; Snijder, R.J.

    2009-01-01

    Background. Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) is associated with a poor survival. Objectives. To evaluate the long-term response to a dual endothelin receptor antagonist in patients with inoperable CTEPH. Methods. All consecutive 18 patients (mean age 63±14 years) treated with bosentan for symptomatic inoperable CTEPH were included. Efficacy was evaluated by the log value of serum levels of N-terminal-pro brain natriuretic peptide (log NTpro BNP), New York Heart Association functional class (NYHA), and the six-minute walk test (6-MWT). All follow-up data (median 31 months) were compared with baseline and divided into: short-term (24 months). Results. At baseline, 15 patients were in NYHA class III and three in NYHA class IV, mean log NT-pro BNP level was 7.2±1.4 log pg/ml, and mean 6-MWT distance was 404±125 m. During short-term follow-up (n=18), the NYHA class improved (p=0.001), 6-MWT distance increased by 33 m (p=0.03), and log NT-pro BNP decreased to 6.9±1.4 log pg/ml (p=0.007). During mid-term follow-up (n=17), the NYHA class improved (p<0.001), the mean 6-MWT distance increased by 41 m (p=0.01), and log NT-pro BNP was 6.9±1.4 log pg/ml (p=0.31). During late followup (n=14) the NYHA class was still improved (p=0.03), the 6-MWT distance decreased by 9 m (p=0.73), and log NT-pro BNP was 7.1±1.5 log pg/ml (p=0.91). The overall four year survival rate was 88%. Conclusion: Bosentan seems to be effective during long-term treatment in patients with inoperable CTEPH. (Neth Heart J 2009;17:329-33.19949474) PMID:19949474

  15. FABP4 plasma levels are increased in familial combined hyperlipidemia

    Science.gov (United States)

    Cabré, Anna; Lázaro, Iolanda; Cofán, Montserrat; Jarauta, Estibaliz; Plana, Núria; Garcia-Otín, Angel L.; Ascaso, Juan F.; Ferré, Raimón; Civeira, Fernando; Ros, Emilio; Masana, Lluís

    2010-01-01

    The lipid profile of familial combined hyperlipidemia (FCHL) shares some characteristics with atherogenic dyslipidemia seen in diabetes, metabolic syndrome, and obesity. Adipocyte fatty acid-binding protein 4 (FABP4) appears to be a determinant of atherogenic dyslipidemia. We examined relationships between FABP4 plasma concentrations, dyslipidemia, and metabolic variables in patients with FCHL. We studied 273 unrelated FCHL patients and 118 control subjects. FABP4 was higher in FCHL than controls, with mean levels of 21.8 (10.1) μg/l and 19.2 (9.2) μg/l, respectively (adjusted P= 0.012). In FCHL, FABP4 correlated to body mass index (BMI), waist circumference, insulin levels, and homeostasis model assessment (HOMA) index (all P< 0.05), but not to lipid levels, whereas in obese patients, FABP4 correlated to triglyceride levels (r = 0.303, P= 0.014) and very low density lipoprotein size (r = 0.502, P = 0.001), as determined by nuclear magnetic resonance. Associations of FABP4 with BMI and waist circumference, but not with insulin levels, persisted in this subgroup. Plasma FABP4 does not influence the lipid phenotype of FCHL. In a small subgroup of obese FCHL, FABP4 levels were associated with triglyceride-rich lipoproteins independent of insulin resistance. These results support a hyperlipidemic mechanism of FCHL different from similar metabolic conditions where fat mass is strongly related to FABP4 and hypertriglyceridemia. PMID:20388924

  16. Hip Osteonecrosis Is Associated with Increased Plasma IL-33 Level

    Science.gov (United States)

    Ma, Jinhui; Guo, Wanshou; Li, Zirong; Li, Shirui; Wang, Peng

    2017-01-01

    The recently discovered IL-33 as an IL-1 cytokine family member has been proved to be specifically released from osteonecrotic bones. We aimed to investigate the potential role of IL-33 in the development of osteonecrosis of femoral head (ONFH). Forty patients diagnosed with ONFH and forty age-, sex-, and body mass index- (BMI-) matched healthy subjects were included in this prospective study between March 2016 and September 2016. A commercially available ELISA kit was used to test the level of plasma IL-33. The IL-33 levels were compared among different ARCO stages, CJFH types, and etiology groups. Plasma IL-33 levels were significantly higher in the ONFH patients than that in the control subjects. The levels of IL-33 did not differ significantly among the ONFH patients with different ARCO stages. The IL-33 levels of patients with CJFH type L3 were significantly higher than that of patients with types L1 and L2. No significant differences were observed in IL-33 levels between steroid-induced, alcohol-induced, and idiopathic patients. Our findings seem to indicate that IL-33 effects may be detrimental during ONFH, which appeared to be associated with the prognosis of ONFH. The IL-33 deserves particular attention in the pathogenesis of ONFH. PMID:28167850

  17. Plasma total antioxidant capacity is associated with dietary intake and plasma level of antioxidants in postmenopausal women.

    Science.gov (United States)

    Wang, Ying; Yang, Meng; Lee, Sang-Gil; Davis, Catherine G; Kenny, Anne; Koo, Sung I; Chun, Ock K

    2012-12-01

    Increased plasma total antioxidant capacity (TAC) has been associated with a high consumption of fruits and vegetables. However, limited information is available on whether plasma TAC reflects the dietary intake of antioxidants and the levels of individual antioxidants in plasma. By using three different assays, the study aimed to determine if plasma TAC can effectively predict dietary intake of antioxidants and plasma antioxidant status. Forty overweight and apparently healthy postmenopausal women were recruited. Seven-day food records and 12-h fasting blood samples were collected for dietary and plasma antioxidant assessments. Plasma TAC was determined by vitamin C equivalent antioxidant capacity (VCEAC), ferric-reducing ability of plasma (FRAP) and oxygen radical absorbance capacity (ORAC) assays. TAC values determined by VCEAC were highly correlated with FRAP (r=0.79, Pantioxidants and represents more closely the plasma antioxidant levels than ORAC and FRAP.

  18. 心率变异性与左心室舒张功能的关系%The relationship between heart rate variability and left ventricular diastolic function

    Institute of Scientific and Technical Information of China (English)

    田明玉; 朱桢燕; 张海锋; 夏耘; 许迪; 李新立

    2012-01-01

    June 2010 and December 2010 with mean age of (48. 1±8. 2) years and without organic heart disease. All subjects received the same questionnaires on medical history, smoking, alcohol intake and use of medications. Blood pressure and biochemical parameters were recorded. Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma concetration of N-terminal pro-brain natriuretic peptide (NT-proBNP). 2-dimensional echocardiograph'y was used to measure the indexes of left ventricular diastolic function including transmitral diastolic early peak inflow velocity (E), transmitral diastolic late peak inflow velocity(A), early diastolic velocities of mitral annulus (E) and the deceleration time of peak E(EDT). Based on the classification standard of diastolic function, the subjects were divided into 3 groups: normal diastolic function(n= 74), impaired diastolic function(n=36)and pseudonormal(n = 28). The indexes of time and frequency domain on heart rate variability were detected by 24-hour ambulatory electrocardiogram. Results With an impaired diastolic function, logNT-proBNP level was increased [(1. 8±0. 2), (1. 9 + 0. 2), (2. 0 + 0. 2) ng/L, P50 ms among all RR intervals (pNN50%) and high frequency power (HF) were all negatively correlated with A (r= - 0.210, - 0. 194, -0. 212, P<0. 05), and positively correlated with the ratio of E to A (E/A)(r=0. 189, 0. 189, 0. 175, , P<0. 05); very low frequency power(VLF) and LF were positively correlated with EDT (r=0. 265, 0. 194, P<0. 05),negatively correlated with the ratio of E to E'(E/E') (r= - 0. 174, -0. 173, P<0. 05), and logNT-proBNP level (r=-0. 315, -0. 345, P<0. 01). Stepwise multiple regression analysis showed that A was an independent influencing factor for pNN50% (β= - 0. 200, P = 0. 012), E/E' and logNT-proBNP level were independent influencing factors for LF (β=-0. 178, P = 0. 023; β= - 0. 165, P = 0. 019). E/Eand EDT were independent influencing factors for VLF (β=- 0. 170, P=0. 021; β=0. 177, P=0

  19. Effects of Canagliflozin on Cardiovascular Biomarkers in Older Adults With Type 2 Diabetes.

    Science.gov (United States)

    Januzzi, James L; Butler, Javed; Jarolim, Petr; Sattar, Naveed; Vijapurkar, Ujjwala; Desai, Mehul; Davies, Michael J

    2017-08-08

    Sodium glucose co-transporter 2 inhibitors may reduce cardiovascular and heart failure risk in patients with type 2 diabetes mellitus (T2DM). The goal of this study was to examine the effects of canagliflozin on cardiovascular biomarkers in older patients with T2DM. In 666 T2DM patients randomized to receive canagliflozin 100 or 300 mg or placebo, the study assessed the median percent change in serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI), soluble (s)ST2, and galectin-3 from baseline to 26, 52, and 104 weeks. Both serum NT-proBNP and serum hsTnI levels increased in placebo recipients, but they remained largely unchanged in those randomized to canagliflozin. Hodges-Lehmann estimates of the difference in median percent change between pooled canagliflozin and placebo were -15.0%, -16.1%, and -26.8% for NT-proBNP, and -8.3%, -11.9%, and -10.0% for hsTnI at weeks 26, 52, and 104, respectively (all p canagliflozin and placebo over 104 weeks. Serum galectin-3 modestly increased from baseline with canagliflozin versus placebo, with significant differences observed at 26 and 52 weeks but not at 104 weeks. These results remained unchanged when only patients with complete samples were assessed. Compared with placebo, treatment with canagliflozin delayed the rise in serum NT-proBNP and hsTnI for over 2 years in older T2DM patients. These cardiac biomarker data provide support for the beneficial cardiovascular effect of sodium glucose co-transporter 2 inhibitors in T2DM. (A Safety and Efficacy Study of Canagliflozin in Older Patients [55 to 80 Years of Age] With Type 2 Diabetes Mellitus; NCT01106651). Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Growth Hormone Deficiency Is Associated with Worse Cardiac Function, Physical Performance, and Outcome in Chronic Heart Failure: Insights from the T.O.S.CA. GHD Study

    Science.gov (United States)

    Giallauria, Francesco; Bossone, Eduardo; Isgaard, Jörgen; Marra, Alberto M.; Bobbio, Emanuele; Vriz, Olga; Åberg, David N.; Masarone, Daniele; De Paulis, Amato; Saldamarco, Lavinia; Vigorito, Carlo; Formisano, Pietro; Niola, Massimo; Perticone, Francesco; Bonaduce, Domenico; Saccà, Luigi; Colao, Annamaria; Cittadini, Antonio

    2017-01-01

    NT-proBNP levels. GHD is also associated with increased all-cause mortality. PMID:28095492

  1. Multi-biomarker Profiling and Recurrent Hospitalizations in Heart Failure

    Directory of Open Access Journals (Sweden)

    Antoni Bayes-Genis

    2016-10-01

    Full Text Available Background: Despite advances in pharmacologic therapy and devices, patients with heart failure (HF continue to have significant rehospitalization rates and risk prediction remains challenging. We sought to explore the value of a multi-biomarker panel (including NT-proBNP, hs-TnT, and ST2 on top of clinical assessment for long-term prediction of recurrent hospitalizations in HF.Methods and Results: NT-proBNP, hs-TnT, and ST2 levels were measured in 891 consecutive ambulatory HF patients. The independent association between the multi-biomarker panel and recurrent hospitalizations was assessed through a multivariable negative binomial regression and expressed as incidence rates ratios. McFadden pseudoR2 and goodness-of-fit measures were also used. The total number of unplanned hospitalizations (all-cause, cardiovascular CV-, and HF-related were selected as the primary endpoints. At a mean follow-up of 4.2±2.1 years, 1623 all-cause hospitalizations in 498 patients (55.9%, 710 CV-related hospitalizations in 331 patients (37.2%, and 444 HF-related hospitalizations in 214 patients (24.1% were registered. The crude incidence of all-cause, CV-, and HF-related recurrent hospitalizations was significantly higher for patients with the multi-biomarker panel above the cut-point (hs-TnT>14 ng/L, NT-proBNP>1000 ng/L, and ST2>35 ng/mL (all P<0.001. For all-cause, CV-, and HF-related recurrent hospitalizations, the McFadden R2, Akaike information criterion, and Bayesian information criterion supported the superiority of incorporating the multi-biomarker panel into a clinical predictive model.Conclusions: A multi-biomarker approach that incorporates NT-proBNP, hs-TnT, and ST2 better identifies HF patients at risk for recurrent hospitalizations. Elucidation of new biophysiological targets for recurrent hospitalizations may identify patient profiles for focused intervention.

  2. Plasma-cortisol levels in experimental heatstroke in dogs

    Science.gov (United States)

    Assia, Ehud; Epstein, Yoram; Magazanik, Avraham; Shapiro, Yair; Sohar, Ezra

    1989-06-01

    The effect of external heat-load, exercise and dehydration on dynamic changes in plasma cortisol during the development of heatstroke was investigated. Thirty-three unanesthetized dogs were tested under two sets of climatic conditions: comfort conditions and hot-dry climatic conditions, half of them while exercising. Half of the dogs in each group were rehydrated. None of the dogs that were investigated at room temperature suffered heatstroke. Of the dogs exposed to high ambient temperature, all of the exercising, as well as five out of six non-hydrated dogs and one rehydrated non-exercising dog suffered heatstroke. Significant dehydration (6% 7% of body weight), occurred only under hgh ambient temperature. Plasma cortisol levels of all dogs that suffered heatstroke rose conspicuously for at least 5 h and returned to normal levels 24 h later. Cortisol levels of dogs who did not experience heatstroke remained within the normal range. Cortisol levels correlated with the severity of the stress leading to heatstroke. High and rising levels of cortisol, several hours after body temperature returns to normal, may support the diagnosis of heatstroke.

  3. Ghrelin plasma levels and appetite in peritoneal dialysis patients.

    Science.gov (United States)

    Aguilera, Abelardo; Cirugeda, Antonio; Amair, Ruth; Sansone, Gabriela; Alegre, Laura; Codoceo, Rosa; Bajo, M Auxiliadora; del Peso, Gloria; Díez, Juan J; Sánchez-Tomero, José A; Selgas, Rafael

    2004-01-01

    Anorexia-associated malnutrition is a severe complication that increases mortality in peritoneal dialysis (PD) patients. Ghrelin is a recently-discovered orexigenic hormone with actions in brain and stomach. We analyzed, in 42 PD patients, the possible relationship between ghrelin and appetite regulation with regard to other orexigens [neuropeptide Y (NPY), NO3] and anorexigens [cholecystokinin (CCK), leptin, glucose-dependent insulinotropic peptide (GIP), tumor necrosis factor alpha (TNFalpha)]. All orexigens and anorexigens were determined in plasma. Eating motivation was evaluated using a visual analog scale (VAS). The patients were divided into three groups: those with anorexia (n = 12), those with obesity associated with high intake (n = 12), and those with no eating behavior disorders (n = 18). A control group of 10 healthy volunteers was also evaluated. Mean plasma levels of ghrelin were high (3618.6 +/- 1533 mg/mL), with 36 patients showing values above the normal range (anorexia had lower ghrelin and NPY levels and higher peptide-C, CCK, interleukin-1 (IL-1), TNFalpha, and GIP levels than did the other patients. Patients with anorexia also had an early satiety score and low desire and pleasure in eating on the VAS and diet survey. We observed significant positive linear correlations between ghrelin and albumin (r = 0.43, p anorexia show relatively lower ghrelin plasma levels than the levels seen in obese patients or in patients with normal appetite. The role of ghrelin in appetite modulation is altered in uremic PD patients, and that alteration is possibly associated with disorders in insulin and growth hormone metabolism.

  4. Increased nociceptin/orphanin FQ plasma levels in hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ferenc Szalay; Mónika B Hantos; Andrea Horvath; Peter L. Lakatos; Aniko Folhoffer; Kinga Dunkel; Dalma Hegedus; Kornélia Tekes

    2004-01-01

    AIM: The heptadecapeptide nociceptin alias orphanin FQ is the endogenous agonist of opioid receptor-like1 receptor.It is involved in modulation of pain and cognition. High blood level was reported in patients with acute and chronic pain,and in Wilson disease. An accidental observation led us to investigate nociceptin in hepatocellular carcinoma.METHODS: Plasma nociceptin level was measured by radioimmunoassay, aprotinin was used as protease inhibitor.Hepatocellular carcinoma was diagnosed by laboratory,ultrasound, other imaging, and confirmed by fine needle biopsy. Results were compared to healthy controls and patients with other chronic liver diseases.RESULTS: Although nociceptin levels were elevated in patients with Wilson disease (14.0±2.7 pg/mL, n=26),primary biliary cirrhosis (12.1±3.2 pg/mL, n=21) and liver cirrhosis (12.8±4.0 pg/mL, n=15) compared to the healthy controls (9.2±1.8 pg/mL, n=29, P<0.001 for each), in patients with hepatocellular carcinoma a ten-fold increase was found (105.9±14.4 pg/mL, n=29, P<0.0001). High plasma levels were found in each hepatocellular carcinoma patient including those with normal alpha fetoprotein and those with pain (104.9±14.9 pg/mL, n=12) and without (107.7±14.5pg/mL, n=6).CONCLUSION: A very high nociceptin plasma level seems to be an indicator for hepatocellular carcinoma. Further research is needed to clarify the mechanism and clinical significance of this novel finding.

  5. Plasma levels of catecholamines and asymmetric dimethylarginine levels as predictive values of mortality among hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Dziedzic Marcin

    2014-06-01

    Full Text Available The aim of the study was to assess plasma concentration of catecholamines and asymmetric dimethyl arginine levels and a possible relationship to predict the mortality rates among hemodialysis patients. The study population comprised 27 subjects, aged 65-70 years. Each patient underwent dialysis thrice a week. Furthermore, the median duration of hemodialysis was 3.5 years. Based on the conducted research, it can be concluded that the concentrations of adrenaline and the level of asymmetric dimethylarginine have predictive value of mortality among hemodialysis patients. Of note, lowering plasma asymmetric dimethylarginine concentration may represent therapeutic target for prevention of progressive renal damage.

  6. Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

    Directory of Open Access Journals (Sweden)

    José Roberto Tavares

    2002-08-01

    Full Text Available OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females with unstable angina and 46 control patients (19 males, paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 µmol/L than in the control group (8.7±4.4 µmol/L (p<0.05. Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 µmol/L versus 11.9±4.2 µmol/L. Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 µmol/L versus 6.4±2.9 µmol/L (p<0.05 in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 µmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.