Clinical InvestigationB-Type Natriuretic Peptide Can Predict the Medium-Term Risk in Patients With Acute Heart Failure and Preserved Systolic Function
Section snippets
Patients
During the study period, all patients who were admitted to the Outpatient Heart Failure Unit (OHFC) for acute HF were screened for the study. To be eligible for the latter, patients had to simultaneously meet the following inclusion criteria:
- 1.
symptoms of HF, according to the criteria commonly accepted in the literature,17 namely the presence of 2 major criteria or 1 major criterion + 2 minor criteria according to the Framingham score;
- 2.
New York Heart Association (NYHA) functional class II, III, or
Study Design
This is a prospective cohort study approved by local ethics committees.
Baseline Characteristics of Population
Table 1 summarizes the baseline characteristics of the population at study entry. They were elderly patients (age 76 ± 11 years), mainly females (58%), who suffered from numerous cardiovascular comorbidities, especially hypertension (59%), ischemic heart disease (38%), atrial fibrillation (31%), diabetes mellitus (23%), and chronic obstructive pulmonary disease (22%). This distribution is similar to the epidemiologic data relating to the general population hospitalized for HF.27 This also
Prognostic Stratification of Patients Discharged With a Diagnosis of Diastolic HF
Diastolic HF is a disorder with a growing epidemiologic impact characterized by frequent episodes of decompensation, which often require hospitalisation.3 In our study, patients a low event rate was observed in during the 6-month follow-up period, probably from both to the inclusion of patients with mild decompensation (43% of patients had mild diastolic dysfunction) and to a postdischarge active follow-up program, which has been widely reported decreasing event rate.34 Studies conducted on
Acknowledgments
We wish to thank Maura Chinellato (Basic Health Services Department, San Donà di Piave). Two anonymous referees improved an earlier version of the manuscript.
References (40)
- et al.
Heart failure with preserved systolic function. A different natural history?
J Am Coll Cardiol
(2001) - et al.
Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations
Lancet
(2000) - et al.
Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure
J Am Coll Cardiol
(2001) - et al.
A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study
J Am Coll Cardiol
(2001) - et al.
Predischarge B-type natriuretic peptide assay for identifying patients at high risk of re-admission after decompensated heart failure
J Am Coll Cardiol
(2004) - et al.
Primary results of the rapid emergency department heart failure outpatient trial (REDHOT)
J Am Coll Cardiol
(2004) - et al.
N-terminal proatrial natriuretic peptide and prognosis in patients with heart failure and preserved systolic function
J Card Fail
(2000) - et al.
New Doppler echocardiographic applications for the study of diastolic function
J Am Coll Cardiol
(1998) - et al.
Utility of B-natriuretic peptide levels in identifying patients with left ventricular systolic or diastolic dysfunction
Am J Med
(2001) - et al.
Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function: comparison with tissue Doppler imaging recordings
Am Heart J
(2004)
Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction
J Am Coll Cardiol
Prognosis of congestive heart failure in patients with normal versus reduced ejection fractions: results from a cohort of 2,258 hospitalized patients
J Cardiac Fail
Multidisciplinary strategies for the management of heart failure patients at high risk for admission. A systematic review of randomized trials
J Am Coll Cardiol
Restrictive left ventricular filling pattern in dilated cardiomiopathy assessed by Doppler echocardiography: clinical, echocardiographic and emodynamic correlations and prognostic inplications
J Am Cardiol
A rapid test for B-type natriuretic peptide (BNP) correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study
J Card Failure
B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea
Ann Emerg Med
Epidemiology, aetiology, and prognosis of heart failure
Heart
Burden of systolic and diastolic ventricular dysfunction in the community
JAMA
B-type natriuretic peptide levels: diagnostic and prognostic in congestive heart failure. What's next?
Circulation
Diagnostic accuracy and prognostic relevance of the measurement of cardiac natriuretic peptides: a review
Clin Chem
Cited by (52)
The Canadian Women's Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women — Chapter 6: Sex- and Gender-Specific Diagnosis and Treatment
2022, CJC OpenCitation Excerpt :Up to 93% of individuals with acute HF have increased high-sensitivity cTn concentrations27; however, sex-specific reference values are lacking.28 The NT-proBNP level appears to differ by sex,28 increase with age,29 and vary by HF phenotype (ie, is lower in patients with HF with preserved ejection fraction [HFpEF], compared with that in patients with HF with reduced injection fraction [HFrEF]).30-32 NT-proBNP sex-specific cutoffs are also not recommended.28
Acute systolic heart failure with normal admission BNP: clinical features and outcomes
2017, International Journal of CardiologyOngoing myocardial damage in patients with heart failure and preserved ejection fraction
2012, Journal of CardiologyAn update on utilising brain natriuretic peptide for risk stratification, monitoring and guiding therapy in heart failure
2023, Expert Review of Molecular Diagnostics