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Variability Of NT-proBNP Plasma And Urine Levels In Stable Heart Failure Patients. A Two-Year Follow-Up Study
  1. Raquel Cortés Vergaz (raqueljerica{at}hotmail.com)
  1. Centro de Investigación. Hospital Universitario La Fe, Spain
    1. Miguel Rivera Otero (rivera_jmi{at}gva.es)
    1. Centro de Investigación. Hospital Universitario La Fe, Spain
      1. Antonio Salvador Sanz (salvador_ant{at}gva.es)
      1. Hospital Universitario La Fe, Spain
        1. Vicente Bertomeu Martínez
        1. Hospital Universitario San Juan, Spain
          1. Fernando García de Burgos
          1. Hospital General Universitario de Elche, Spain
            1. Esther Roselló-Lletí (estrolle{at}alumni.uv.es)
            1. Centro de Investigación. Hospital Universitario La Fe, Spain
              1. Manuel Portolés Sanz (portoles_man{at}gva.es)
              1. Centro de Investigación. Hospital Universitario La Fe, Spain
                1. Rafael Payá Serrano
                1. Hospital General de Valencia, Spain
                  1. Luis Martínez-Dolz
                  1. Hospital Universitario La Fe, Spain
                    1. Vicente Climent Payá
                    1. Hospital General de Alicante, Spain

                      Abstract

                      Objectives: This study examines N-terminal pro-brain natriuretic peptide (NT-proBNP) variability in plasma and urine samples of stable heart failure patients during a 24-month follow-up.

                      Design: prospective study

                      Setting: Teaching hospital based study Patients: We followed 74 clinically and functionally stable patients (NYHA class=2±0.5) out of 114 diagnosed of heart failure, measuring NT-proBNP plasma and urine levels in three stages (basal, 12 months and 24 months).

                      Results: During the follow-up we found significant differences in mean urinary levels (p<0.01), but no changes were found in plasma. Bland-Altman plots showed few variations in plasma percentages in the three intervals (stage I - basal; stage II - stage I; stage II - basal) with a coefficient of reproducibility (CR) of 22%, 21%; and 25%, respectively. Changes in NT-proBNP urinary levels had a CR of 7.1%, 6.8% and 9.4%. Finally, we found a good correlation between plasma and urinary levels (p<0.0001) and between the different NT-proBNP plasma (p<0.0001) and urine measurements (p<0.0001).

                      Conclusions: NT-proBNP plasma and urine levels show good stability in a 24-month follow-up of stable heart failure patients. As a result, assessment of urinary and plasma NT-proBNP concentrations may be a meaningful tool to monitor the follow-up of patients with heart failure. The results suggest that variations in peptide concentrations exceeding 22% in plasma and 7% in urine in a 12-month follow-up and 25% and 9% in a 24-month follow-up may be pathophysiological relevant.

                      • natriuretic peptides
                      • plasma
                      • stability
                      • urine
                      • variability

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