Clinical relevance of biomarkers in heart failure and cardiorenal syndrome: the role of natriuretic peptides and troponin

2013 ◽  
Vol 19 (2) ◽  
pp. 267-284 ◽  
Author(s):  
Alberto Palazzuoli ◽  
Serge Masson ◽  
Claudio Ronco ◽  
Alan Maisel
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptides ◽  
Clinical Relevance ◽  
Cardiorenal Syndrome

Natriuretic Peptides – Addressing the Dilemma of Heart Failure Management

2011 ◽  
Vol 7 (2) ◽  
pp. 104
Author(s):  
Kenneth McDonald ◽  
Ulf Dahlström ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Physical Examination ◽  
Natriuretic Peptides ◽  
Normal Values ◽  
Outpatient Setting ◽  
Heart Failure Management ◽  
Effective Screening ◽  
Specific Symptoms ◽  
Objective Marker

Heart failure (HF) is characterised by non-specific symptoms and unremarkable physical examination; therefore, the need exists for an available objective marker of HF status. Natriuretic peptides (NPs) are a marker that can aid the dilemmas in present-day HF management. More effective screening for clinical deterioration would include changes in brain natriuretic peptide (BNP) levels. Normal values for BNP, <50–100 pg/ml, have excellent negative predictive value (NPV) in excluding HF as a diagnosis. BNP values that are significantly elevated, e.g. >500 pg/ml, make the diagnosis of HF more likely. There are now established and emerging uses for NPs in managing HF in the community. These include the role of NPs at the time of possible new presentation of HF, its role in prognostication and, finally, the increasing interest in using NPs to guide therapy in the outpatient setting.

scholarly journals Effects of levosimendan in patients with acute heart failure and cardiorenal syndrome

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Ribeiro Da Silva ◽  
G Santos Silva ◽  
D Caeiro ◽  
M Passos Silva ◽  
C Guerreiro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Natriuretic Peptides ◽  
Angiotensin Receptor Blockers ◽  
Cardiorenal Syndrome ◽  
Baseline Serum ◽  
Beneficial Effects ◽  
Funding Sources ◽  
Tertiary Center ◽  
Short Term Mortality

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiorenal syndrome (CRS) is common in patients with acute heart failure (AHF) and is associated with poor prognosis. Levosimendan (LVS) is an inodilator used in AHF and has beneficial effects on renal function (RF). However, its effects on RF in CRS patients are not established. Purpose To evaluate whether LVS could improve RF in AHF patients with or without CRS. Methods Retrospective study that included patients with AHF treated with LVS in a cardiac intensive care unit of a tertiary center, between January 2015 and June 2018. Baseline serum creatinine (SCr) was recorded and SCr and glomerular filtration rate (GFR) were accessed before and within 5 days after LSV use. CRS was defined as an increase in SCr &gt; 0,3 mg/dL over baseline (before LVS use). RF improvement was defined as a decrease in SCr after LVS use. We evaluate outcomes at 1-year. Results 61 patients were included, 84% males, mean age 65 years, ejection fraction ≤40% in 87%. INTERMACS 4 and hemodynamic profile C were the most frequent presentation. LSV was administered in 24h, without bolus, in most patients. CRS was present in 44,3% of patients. Basal characteristics were similar between CRS and no-CRS patients, including prevalence of chronic kidney disease, baseline SCr or natriuretic peptides (p&gt; 0,05 for all). CRS patients had a significant improvement in RF after LVS use (SCr 2,08 to 1,65 mg/dL, p&lt; 0,001 and GFR 40,4 to 54,6 mL/min/m2, p&lt; 0,001), while no-CRS patients had no significant improvement in RF (SCr 1,33 to 1,32 mg/dL and GFR 64,1 to 64,5 mL/min/m2, p&gt; 0,05 for all). Also, there was a significant decrease in natriuretic peptides after LVS in CRS patients (NT-proBNP 13527,5 to 10708,8 pg/mL, p= 0,006), without significant differences in no-CRS patients. It is noteworthy that at discharge, CRS patients were more likely to titrate HF optimal medical therapy (OMT) compared with no-CRS patients (p= 0,039). There was a lower tendency to suspend angiotensin-converting enzyme (ACE-I) and angiotensin receptor blockers (ARB) in CRS patients (p= 0,05). At discharge CRS patients received more furosemide than at admission (77,2 mg/day to 97,1 mg/day, p= 0,019) compared with no-CRS patients (89,6 mg/day to 97,0 mg/day, p= 0,469), receiving similar doses at discharge. In CRS patients, RF improvement was associated with a decrease in intra-hospital mortality (p= 0,043) and a tendency to decrease 30-day mortality (p= 0,060), but without differences in one-year mortality. Conclusion In CRS patients, LVS improved RF and NT-proBNP, allowed to titrate OMT and decreased the need to suspend ACE-I or ARB and was associated to a decrease in short-term mortality.

scholarly journals The Role of Ultrafiltration in Patients with Decompensated Heart Failure

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Sandeep A. Kamath
Keyword(s):  
Heart Failure ◽  
Decompensated Heart Failure ◽  
Cardiorenal Syndrome ◽  
Loop Diuretics ◽  
Inpatient Setting ◽  
Effective Volume ◽  
Primary Driver ◽  
High Doses

Congestion, due in large part to hypervolemia, is the primary driver of heart failure (HF) admissions. Relief of congestion has been traditionally achieved through the use of loop diuretics, but there is increasing concern that these agents, particularly at high doses, may be deleterious in the inpatient setting. In addition, patients with HF and the cardiorenal syndrome (CRS) have diminished response to loop diuretics, making these agents less effective at relieving congestion. Ultrafiltration, a mechanical volume removal strategy, has demonstrated promise in achieving safe and effective volume removal in patients with cardiorenal syndrome and diuretic refractoriness. This paper outlines the rationale for ultrafiltration in CRS and the available evidence regarding its use in patients with HF. At present, the utility of ultrafiltration is restricted to selected populations, but a greater understanding of how this technology impacts HF and CRS may expand its use.

The role of natriuretic peptides in heart failure

2008 ◽  
Vol 5 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Daniel D. Correa de Sa ◽  
Horng H. Chen
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptides

Cardiorenal Syndrome and the Role of Ultrafiltration in Heart Failure

2013 ◽  
Vol 10 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Jason Prosek ◽  
Anil Agarwal ◽  
Samir V. Parikh
Keyword(s):  
Heart Failure ◽  
Cardiorenal Syndrome

scholarly journals Cardiorenal Syndrome: An Unsolved Clinical Problem

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Paula Martínez-Santos ◽  
Isidre Vilacosta
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Renal Impairment ◽  
Clinical Relevance ◽  
Treatment Strategies ◽  
Clinical Problem ◽  
Cardiorenal Syndrome ◽  
Current Treatment ◽  
Kidney Dysfunction ◽  
Optimal Approach

The clinical relevance of the bidirectional cross-talk between heart and kidney is increasingly recognized. However, the optimal approach to the management of kidney dysfunction in heart failure remains unclear. The purpose of this article is to outline the most plausible pathophysiologic theories that attempt to explain the renal impairment in acute and chronic heart failure, and to review the current treatment strategies for these situations.

scholarly journals Influence of heart failure on malnutrition in patients with acquired heart disease

2018 ◽  
Vol 16 (1) ◽  
pp. 61
Author(s):  
A. I. Subbotovskaya ◽  
L. G. Knyazkova ◽  
V. V. Lomivorotov ◽  
A. N. Shilova ◽  
A. P. Subbotovskiy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Serum Albumin ◽  
Natriuretic Peptides ◽  
Plasma Levels ◽  
Acquired Heart Disease ◽  
Absolute Lymphocyte Counts ◽  
Correlation Level

The focus of this study was placed on the role of heart failure in forming disorders of the nutritional status in patients undergoing surgical correction of acquired heart disease. A negative correlation level of natriuretic peptides in plasma levels of serum albumin and absolute lymphocyte counts was established. The development of chronic heart failure accompanied by an increase in plasma levels of natriuretic peptides in patients with AHD is one of the reasons for the decrease of serum albumin levels and the formation of malnutrition.

The Role of Natriuretic Peptides and Highly Sensitive Troponin T in Heart Failure

2011 ◽  
Vol 17 (9) ◽  
pp. S129
Author(s):  
Masaaki Miyata ◽  
Atsushi Kusumoto ◽  
Chuwa Tei
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptides ◽  
Troponin T ◽  
Highly Sensitive ◽  
Highly Sensitive Troponin
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