scholarly journals Activation of a novel natriuretic endocrine system in humans with heart failure

2009 ◽  
Vol 118 (5) ◽  
pp. 367-374 ◽  
Author(s):  
Hafid Narayan ◽  
Noor Mohammed ◽  
Paulene A. Quinn ◽  
Iain B. Squire ◽  
Joan E. Davies ◽  
...  

Proguanylin and prouroguanylin are the inactive precursors of guanylin and uroguanylin, natriuretic peptides involved in the regulation of sodium balance. Urinary uroguanylin levels have been found previously to be elevated in patients with HF (heart failure). The aim of the present study was to investigate whether plasma proguanylin and prouroguanylin levels are increased in patients with HF and to evaluate their relationship with cardiac and renal function. In this prospective observational study, we recruited 243 patients with HF (151 men) and 72 healthy controls. In patients with HF, plasma levels of proguanylin [median, 7.2 (range, 0.9–79.0) μg/l] and prouroguanylin [8.3 (1.7–53.0 μg/l)] were both significantly (P<0.0005) higher compared with levels in healthy controls [5.5 (0.4–22.3 μg/l) for proguanylin and 6.3 (2.5–16.9) μg/l for prouroguanylin]. In patients with HF, increased age, a history of hypertension, diabetes and atrial fibrillation, use of diuretics, a higher NYHA (New York Heart Association) class and a lower eGFR (estimated glomerular filtration rate) were significant univariate predictors of proguanylin and prouroguanylin levels. In multivariate analysis, a history of hypertension and low eGFR both had strong independent associations with proguanylin and prouroguanylin levels. Proguanylin and prouroguanylin varied significantly between NYHA class with a trend of increasing plasma concentrations with worsening severity of symptoms. In conclusion, plasma proguanylin and prouroguanylin are elevated in patients with HF. Elevated plasma proguanylin and prouroguanylin levels are associated with hypertension, renal impairment and increasing severity of HF. This novel endocrine system may contribute to the pathophysiology of HF.

2021 ◽  
Vol 7 ◽  
Author(s):  
Aniket S Rali ◽  
Lynne W Stevenson ◽  
Sandip K Zalawadiya

A 57-year-old woman with New York Heart Association Class III heart failure requiring multiple hospitalisations over the previous year presented for CardioMEMS implantation. Because of the patient’s allergy history of anaphylaxis to iodine-based contrast agent she underwent the device implantation with gadolinium-based contrast agent (Magnevist), which was successful.


2021 ◽  
Vol 2 (3) ◽  
pp. 25-30
Author(s):  
Yusuf Arifin ◽  
Mohammad Saifur Rohman ◽  
Cholid Tri Tjahjono ◽  
Djanggan Sargowo ◽  
Anna Fuji Rahimah

Background: Heart Failure prevalence was raising as one of the most Objective: to find the correlation of New York Heart Association Functional Class in heart failure patient with Depression Method: This cross-sectional study recruited 342 patients diagnosed with HF with previously for more than 3 months, at dr. Saiful Anwar General Hospital during December 2016 to March 2021. Each patient was interviewed for their demography data, and their clinical data, and assessed for their depression with Montgomery-Asberg Depression Rating Scale for Indonesian version. We used Spearman coefficients (rs) to evaluate the correlations between variables. Results: Baseline characteristic among depression and non-depression group demonstrated no significant difference (p>0.05), but for marital status. Populations was predominantly male, with ACE-i/ARB and Beta-blockers treatment. Non predominant treatment was MRAs, Diuretics, Digoxin. Baseline age was 22 years old until 87 years old. Baseline LVEF was 50.4±12.9%. (p >0.05). There were significant correlations between NYHA Class and marital status (p < 0.05), while the other baseline was not significantly different. We performed log regression for the confounding. The result was NYHA Class significantly correlated with and effects the depression. Conclusion: In heart failure patients, NYHA Class was significantly correlated with depression.


2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Arslan Gürcan

Dyspnea is one of the reasons why many heart failure patients present to the emergency department. A 75 year-old female presented to a cardiologist with prominent dyspnea and orthopnea. Her heart failure was diagnosed by doctors as New York Heart Association (NYHA) Class III. Progressive increase in episodic shortness of breath forthe past 3 weeks. The patient had been in her normal state of health until 3 weeks ago that she had difficulty catching her breath while walking.The patient got 7 points from the first Borg Dyspnea Scale. The study is a case-report study. Personal Data Form (PDF), Borg Clinical Rating for Dyspnea (Borg CR-10) was evaluated by researcher. Classic foot massage was applied to each foot for a total of 30 minutes, up to 15 minutes, once a day for seven days. Dyspnea was measured after the massage following 10 min of resting. Foot massage was applied by the researcher. Distribution of dyspnea level first and seventh is given in Table 1. Dyspnea level of the patient intervention foot massage decreased to 5.00 from 7.00 at the end of seventh session. Foot massage which is an easy and safe method may be preferably used as a supportive treatment for elevated dyspnea. However, more studies are needed to examine the effect of foot massage on dyspnea level in heart failure patients.


2007 ◽  
Vol 53 (11) ◽  
pp. 1886-1890 ◽  
Author(s):  
Cristina Vassalle ◽  
Maria Grazia Andreassi ◽  
Concetta Prontera ◽  
Marianna Fontana ◽  
Luc Zyw ◽  
...  

Abstract Background: Genetic variants related to the natriuretic peptide (NP) system [ScaI mutated allele (A1) of the atrial NP (ANP) gene and the C variant of the natriuretic peptide clearance receptor (NPRC) gene] have been identified as independent risk factors for cardiovascular morbidity and mortality. Despite the importance of NPs in heart failure (HF), the role of these polymorphisms in HF has not been evaluated. Methods: We screened 124 HF patients [mean (SD), age 66 (12) years, 100 men, ejection fraction 32% (10%), New York Heart Association (NYHA) class I–II 65, III–IV 59] for NP concentrations [ANP, brain NP (BNP) and amino-terminal pro-BNP (NT-proBNP)] and for the ScaI and NPRC variants. Results: ScaI polymorphism had no effect on NP concentration in the NYHA I–II subgroup. Conversely, in severe HF, A1 carriers had higher ANP (P ≤0.05), BNP (P &lt;0.01), and NT-proBNP (P &lt;0.01) than A2A2 patients. After multivariate adjustment, A1 presence remained an independent predictor for increased NP. Regarding NPRC polymorphism in mild HF, higher ANP (P &lt;0.05) and BNP (P &lt;0.05) were observed in CC than A allele carriers. After multivariate adjustment, however, this association did not remain significant. In severe HF, the NPRC polymorphism had no effect on NP. Conclusions: The ScaI polymorphism of the ANP gene might be an important additive genetic factor influencing neurohormonal activation and disease progression in severe HF. The NPRC polymorphism is not an independent determinant of NP concentration in HF.


2016 ◽  
Vol 19 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Rebecca L. Dekker ◽  
Terry A. Lennie ◽  
Debra K. Moser ◽  
Craig S. Miller ◽  
Jeffrey L. Ebersole ◽  
...  

Aims: To describe correlations and agreement between salivary and serum B-type natriuretic peptide (BNP), C-reactive protein (CRP), interleukin (IL)-6, and IL-10 and determine which biomarkers predict worse functional class in patients with heart failure (HF). Methods: Serum and saliva were collected from 75 hospitalized patients with HF (57 ± 12 years, 43% female, New York Heart Association [NYHA] Classes I [4%], II [43%], and III [53%]). Oral inflammation was rated as good, fair, or poor. Spearman’s ρ and Bland–Altman were used to determine correlations and agreement of the salivary and serum forms of each biomarker. Logistic regressions were used to determine which biomarkers predicted worse NYHA functional class, controlling for depression, body mass index, smoking, and oral inflammation. Results: Median biomarker concentrations were as follows: BNP (serum 361 pg/ml, saliva 9 pg/ml), CRP (serum 13 ng/ml, saliva 25.6 ng/ml), IL-6 (serum 19.3 pg/ml, saliva 10.5 pg/ml), and IL-10 (serum 64.1 pg/ml, saliva 4.7 pg/ml). There was a moderate-to-strong correlation for serum–salivary CRP, weak correlation for serum–salivary IL-6, and no correlations for serum–salivary BNP and IL-10. The Bland–Altman test showed good salivary–serum agreement for all biomarkers, but as serum concentrations rose, salivary measures underestimated serum levels. Visible oral inflammation was the only predictor of worse NYHA class.


2021 ◽  
Vol 12 ◽  
Author(s):  
Alejandra García-Torre ◽  
Eva Bueno-García ◽  
Rocío López-Martínez ◽  
Beatriz Rioseras ◽  
Beatriz Díaz-Molina ◽  
...  

High levels of inflammation play an important role in chronic heart failure (CHF). Patients with CHF have elevated levels of pro-inflammatory cytokines circulating systemically, mainly TNF and IL-6. However, there are almost no studies that relate these levels to the functional status of patients in CHF, much less to their CMV serostatus. In this study, patients with CHF (n=40; age=54.9 ± 6.3; New York Heart Association functional classification (NYHA, I-III) and healthy controls (n=40; age=53.5 ± 7.1) were analyzed. The serum concentrations of nine pro- and anti-inflammatory cytokines were measured by Luminex® xMap Technology and the basal level of mRNA expression of some immune molecules was quantified by TaqMan™ Array in CD4+ T-lymphocytes. The concentration of these cytokines in culture supernatants in response to anti-CD3 and LPS was also measured. The percentage of CD28null T-cells was determined, as well as the antibody titer against CMV. We found a higher concentration of all cytokines studied in CHF serum compared to healthy controls, as well as a direct correlation between functional status in CHF patients and levels of inflammatory cytokines. Moreover, the highest cytokine concentrations were found in patients with higher concentrations of lymphocytes lacking CD28 molecule. The cytokine production was much higher in CMV+ patients, and the production of these cytokines was found mainly in the T-lymphocytes of CMV+ patients in response to anti-CD3. Anti-CMV antibody levels were positively correlated with cytokine levels. The baseline expression of specific mRNA of the main molecules involved in the Th1 response, as well as molecules related to the CD4+CD28 null subset was higher in CMV+ patients. The cytokine concentrations are higher in CHF CMV+ patients and these concentrations are related to the production of antibodies against CMV. These high levels of cytokines are also associated with the more differentiated CD28null lymphocyte populations. All this, together with the dynamics of the pathology itself, makes CMV+ patients present a worse functional status and possibly a worse evolution of the pathology.


e-CliniC ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Patricia Ratna Sari ◽  
Starry H. Rampengan ◽  
Agnes Lucia Panda

Abstract: The functional status of patients with chronic heart failure (CHF) has been standardized by the classification of NYHA [New York Heart Association] class I-IV. One of the parameters to assess the ability of the heart function is the ejection fraction (LVEF) were assessed using echocardiography parameters. The purpose of this study was to determine the relationship of NYHA class with ejection fraction in patients with chronic heart failure in the BLU/Prof. Dr. R. D. Kandou Manado. Methodology: This research method is analytic cross sectional study approach. The sample was CHF patients in BLU/Prof. Dr. R. D. Manado Kandou 30 people held during November-December 2012. Results: The distribution of patients according to NYHA class most are in NYHA II (43%), while the lowest are in NYHA IV (7%). Distribution according to the ejection fraction is at most 30-39% LVEF is 12 and there are at least LVEF <30%, is 6 people. The results obtained using the Spearman test (p = 0.177), indicating that there was no statistically significant association between NYHA class with ejection fraction in patients with chronic heart failure in the BLU/Prof. Dr. R. D. Kandou Manado.Conclusion: No significant relationship was found between NYHA class with ejection fraction. Keywords: Chronic Heart Failure, ejection fraction, NYHA class   Abstrak: Status fungsional penderita gagal jantung kronik (GJK) ini telah dibakukan berdasarkan klasifikasi NYHA [New York Heart Association] kelas I-IV. Salah satu parameter untuk menilai kemampuan fungsi jantung adalah fraksi ejeksi (LVEF) yang dinilai menggunakan parameter ekokardiografi. Tujuan penelitian ini adalah untuk mengetahui hubungan kelas NYHA dengan fraksi ejeksi pada penderita gagal jantung kronik di BLU/RSUP Prof. Dr. R. D. Kandou Manado. Metodologi: Metode penelitian ini bersifat analitik dengan pendekatan studi cross sectional.  Sampel penelitian ini adalah pasien GJK  di BLU/RSUP. Prof. Dr. R. D. Kandou Manado sebanyak 30 orang yang berlangsung selama bulan November – Desember 2012. Hasil : Distribusi pasien GJK menurut kelas NYHA terbanyak berada pada NYHA II (43%), sedangkan yang paling rendah berada pada NYHA IV (7%). Distribusi  menurut Fraksi Ejeksi terbanyak berada pada LVEF 30-39 % yaitu 12 orang dan paling rendah terdapat pada LVEF <30 % yaitu 6 orang. Hasil penelitian ini menggunakan uji Spearman diperoleh (p= 0,177), menunjukkan bahwa secara statistik tidak terdapat hubungan bermakna antara NYHA kelas dengan fraksi ejeksi pada pasien gagal jantung kronik di BLU/RSUP Prof. Dr. R. D. Kandou Manado. Kesimpulan:Tidak ditemukan hubungan yang signifikan antara kelas NYHA dengan fraksi ejeksi. Kata kunci : Fraksi ejeksI, Gagal Jantung Kronik, Kelas NYHA [New York Heart Association]


2015 ◽  
Vol 69 (1-2) ◽  
pp. 32-37
Author(s):  
K. Kh. Zahidova

Aim: to study correlation between concentration of pathological cytokines and erythropoietin in patients with chronic heart failure with anemic syndrome and also to prove importance of this communication for need of appointment erythropoietin excitants. Patients and methods: 94 patients with chronic heart failure of New York Heart Association (NYHA) class ІІІ–ІV a left ventricular ejection fraction of 40% or less with anemia w ere included in investigation (58 males, 36 females). Anemia was detected when hemoglobin (Hb) was less than 120 g/l in males and less than 110 g/l in females. 46 patients received traditional treatment of CHF (І group) and 48 patients were treated additionally with erythropoietin (EPO) (ІІ group). Percutaneous EPO 50 IU monthly to patients without iron deficiency for a period of 6 months. Echocardiography parameters, plasma NT and pro-BNP, cytokines, EPO, ferritin and 6-minute walking test were assessed at baseline and after treatment. Results: in patients with CHF and anemia in ІІ group erythropoietin treatment increased Hb levels by 22,4% (p IL 6 by 54,3% (p α by 48,3% (p increase of LVEF by 19,04% (p Conclusions: Correction of anemia in patients with chronic heart failure with percutaneous erythropoietin injections 50 IU monthly for 6 month period to improve erythropoietin deficit and cytokines aggression and associated anemia, symptoms and quality of life.


2017 ◽  
Vol 31 (2) ◽  
pp. 230-233 ◽  
Author(s):  
Pritpal Singh

Background: Anagrelide is an established treatment option for essential thrombocythemia (ET). Cardiovascular adverse events can occur with its use including heart failure and cardiomyopathy. Case Report: A 52-year-old African American male with ET presented with chest pain, shortness of breath, and dyspnea on exertion. His ET was managed with hydroxyurea 1500 mg by mouth twice a day and anagrelide 1 mg by mouth 3 times a day. The patient was receiving anagrelide for approximately 2 years prior to presentation. The patient’s platelet count was 2.07 × 105 cells/mm3. Transthoracic echocardiography revealed decreased left systolic dysfunction. Also, cardiac magnetic resonance imaging showed an increased left ventricle cavity size with severely depressed systolic dysfunction and an ejection fraction (EF) of 18%. Anagrelide therapy was discontinued and the patient was maintained on hydroxyurea for ET. Three months later, following treatment by a heart failure clinic, the patient’s EF was 55%. Five months after discontinuation, the patient improved from New York Heart Association (NYHA) class II to NYHA class I. Conclusion: A 52-year-old man with ET presented with an EF of 18% after 2 years of anagrelide therapy. His EF increased from 18% to 55% 3 months after discontinuation of anagrelide.


Sign in / Sign up

Export Citation Format

Share Document