Prognostic Implications of Procalcitonin and NT-ProBNP in Neutropenic Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4743-4743
Author(s):  
Sun Young Kim ◽  
Hye Young Han ◽  
Dae-Chul Jeong
Keyword(s):  
Heart Failure ◽  
Conflicts Of Interest ◽  
Neutropenic Patient ◽  
Inflammatory Marker ◽  
Systemic Infection ◽  
University Hospital ◽  
Cardiac Events ◽  
National University ◽  
Neutropenic Patients

Abstract Abstract 4743 Background Procalcitonin (PCT) has been increasingly used as an inflammatory marker to identify patients with systemic infection. N-terminal pro brain natriuretic peptide (NT-proBNP) elevation can be used to predict future cardiac events and survival. The aim of this study was to evaluate the role of PCT and NT-proBNP measurements in febrile neutropenic patients in terms predicting outcomes in these patients. Methods Neutropenia was defined as neutrophil count of 500 cells/mm3 or less or a count of < 1,000 cells/mm3 with a predicted decrease to < 500 cells/mm3. Fever in a neutropenic patient is defined as a single measurement of oral temperature of more than 38.3 °C or a temperature of 38.0 °C for 1 hr. From July 2008 and May 2009, immunocompromized patients with neutropenia were screened for PCT, NT-proBNP at the time of diagnosis, 3 days later and 3 days after fever subsided. Results A total of 32 patients aged between 2.5 and 13.5 years (17 boys and 15 girls) were admitted because of neutropenic fever at the Chungnam National University Hospital. PCT levels were not significantly different among 3 different times of measurements, but NT-proBNP was significantly higher at 3 days after admission compared with those of at diagnosis and after fever was subsided. PCT and NT-proBNP levels at the time of diagnosis were significantly correlated with each other. Three patients with higher NT-proBNP showed symptoms of heart failure and arrhythmia but PCT was not significantly elevated in these patients. Conclusion PCT and NT-proBNP at the time of diagnosis were correlated with each other. PCT levels were not significantly changed among 3 different times of measurements but NT-proBNP was significant index of heart failure especially 3 days after fever developed. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Increased Interleukin-11 Levels Are Correlated with Cardiac Events in Patients with Chronic Heart Failure

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Jing Ye ◽  
Zhen Wang ◽  
Di Ye ◽  
Yuan Wang ◽  
Menglong Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Plasma Concentrations ◽  
Heart Association ◽  
Functional Class ◽  
Control Group ◽  
Class Iii ◽  
Cardiac Events ◽  
Nyha Functional Class ◽  
Interleukin 11

Background. Interleukin-11 (IL-11) is an important inflammatory cytokine and has been demonstrated to participate in cardiovascular diseases. However, there have been no studies about the role of IL-11 in heart failure (HF). The present study is aimed at investigating whether IL-11 levels are associated with the cardiac prognosis in patients with HF. Methods. The plasma concentrations of IL-11 were measured in 240 patients with chronic HF (CHF) and 80 control subjects without signs of significant heart disease. In addition, we prospectively followed these CHF patients to endpoints of cardiac events. Results. Compared with the control group, the plasma IL-11 concentrations were significantly increased in the CHF patients and gradually increased in the New York Heart Association (NYHA) functional class II group, the NYHA functional class III group, and the NYHA functional class IV group. The receiver operating characteristic (ROC) curve revealed that the predictive role of IL-11 in HF is not as good as N-terminal B-type natriuretic peptide (BNP), although IL-11 has a certain value in predicting cardiac events. In addition, the CHF patients were divided into 3 groups according to the plasma IL-11 concentration category (low, T1; middle, T2; and high, T3). The multivariate Cox hazard analysis showed that the high plasma IL-11 concentrations were independently associated with the presence of cardiac events after adjustment for confounding factors. Furthermore, the CHF patients were divided into two groups based on the median plasma IL-11 concentrations. The Kaplan-Meier analysis revealed that the patients with high IL-11 concentrations had a higher risk of cardiac events compared with those with low IL-11 concentrations. Conclusions. Higher plasma IL-11 levels significantly increase the presence of cardiac events and suggest a poor outcome; although the diagnostic value of IL-11 in CHF is not as good as BNP, there is a certain value in predicting cardiac events in CHF.

Significance of Laminar Air Flow Room for the Reverse Isolation in Neutropenic Cancer Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5503-5503
Author(s):  
Ji Hye Lee ◽  
Hae Sook Kim ◽  
Hwi-Joong Yoon ◽  
Kun Soo Lee
Keyword(s):  
Cancer Patients ◽  
Sexual Difference ◽  
Air Flow ◽  
Underlying Disease ◽  
University Hospital ◽  
Care Group ◽  
Reverse Isolation ◽  
National University ◽  
Neutropenic Patients ◽  
Laminar Air Flow

Abstract Infection is one of the most important causes of death in cancer patients. So many physicians make every effort to control the infection, especially in neutropenic cancer patients. The aim of this study is to find out the role of HEPA filter equipped laminar air flow room reverse isolation for the management of chemotherapy induced febrile neutropenic children with cancer. We evaluated febrile neutropenic patients following chemotherapy from January 2003 to April 2006 at the Department of Pediatrics, Kyungpook National University Hospital, Daegu, Korea. They were promptly managed by antibiotics and antifungal agents and if possible, they were isolated in the aseptic room. They were allocated to three groups of standard ward care, isolation after onset of fever and isolation before onset of fever. Profiles of infection, clinical courses and survival rate were compared among three groups. One hundred and nine episodes of febrile neutropenia from thirty eight cancer patients were observed. Twenty nine were boys and nine were girls with their median age were 5.5 years. The diagnoses included acute leukemia (36.8%), malignant lymphoma (15.8%), and other solid tumor (47.4%). Fifty five episodes were included to standard ward care, forty four episodes to isolation after onset of fever and thirteen episodes to isolation before onset of fever. We found out that one in thirteen episodes of isolation before onset of fever (8%) and twenty six in ninety six episodes in other groups (27%) were microbiologically or clinically defined infections. Fifty six episodes recovered and only one died of infectious cause both isolation after and before onset of fever group, especially all recovered in isolation before onset of fever group. Forty eight episodes recovered and four died in general ward care group, but there was no statistical difference among three groups (p=0.93). Age, sexual difference, underlying disease, absolute neutrophil count (ANC), duration of ANC recovery and incidence of disseminated intravascular coagulation were no difference among three groups. In early isolated group, duration of fever and antibiotics medication were significantly shorter (p=0.002, 0.009) and CRP level was lower than other two groups (p=0.04). Reverse isolation in laminar air flow room for neutropenic cancer children before onset of fever affect the durations of fever and antibiotics treatment with beneficial effect.

scholarly journals Diagnostic, clinical and prognostic aspects determine the concentration of C-reactive protein in chronic heart failure.

2018 ◽  
Vol 96 (3) ◽  
pp. 197-207
Author(s):  
Andrey A. Bobylev ◽  
S. A. Rachina ◽  
S. N. Avdeev ◽  
A. A. Petrov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Disease Severity ◽  
Cardiac Dysfunction ◽  
Inflammatory Marker ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Incident Heart Failure

A lot of mechanisms in development and progression of cardiac dysfunction are associated with changes of multiple markers and high-sensitivity C-reactive protein is one of them. The role of this inflammatory marker in heart failure pathogenesis requires further study. However, various recent reports have suggested that C-reactive protein assessment may be used for prediction of incident heart failure, its prognosis and estimation of the disease severity.

Telemonitoring in Patients with Heart Failure – Lessons from Recent Randomised Multicentre Trials

2012 ◽  
Vol 8 (2) ◽  
pp. 84 ◽  
Author(s):  
Andrea Mortara ◽  
Keyword(s):  
Heart Failure ◽  
Cardiac Events ◽  
Negative Results ◽  
Home Telemonitoring ◽  
Patients With Heart Failure ◽  
Multicentre Trials ◽  
Effective System ◽  
Meta Analyses ◽  
Positive Effect

Home telemonitoring (TLM) has been proposed as an effective tool to reduce cardiac events in patients with chronic heart failure (HF). In contrast to older and more recent meta-analyses, large randomised multicentre trials have failed to demonstrate any positive effect of TLM on HF rehospitalisation and all-cause mortality. However, these negative results do not preclude the potential role of TLM as an effective system for managing patients with HF. In this article, possible explanations for these negative results are presented and discussed, and a new model of TLM, with investments in technology but above all in personnel and organisation, is suggested.

Prognostic Significance of Gelsolin and MMP12 in Langerhans Cell Histiocytosis.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4431-4431
Author(s):  
Sun Young Kim ◽  
Hee Jin Kim ◽  
Keun Wook Bae ◽  
Ho Joon Im ◽  
Ji Yoon Kim ◽  
...  
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Prognostic Significance ◽  
Langerhans Cell ◽  
University Hospital ◽  
Cellular Mechanisms ◽  
System Disease ◽  
National University ◽  
Paraffin Block

Abstract Abstract 4431 Background Langerhans cell histiocytosis (LCH) pathogenesis is hypothesized a genetic change may have a significant effect on the cellular mechanisms controlling proliferation and apoptosis of LCs. In LCH, the expression of MMP12 was observed most abundantly in multi-system disease, which has the poor prognosis, and high expression of GSN was reported but the clinical significance of GSN was unveiled until now. We will investigate the association between these proteins and clinical outcomes in patients diagnosed with LCH. Methods Archival paraffin block were retrieved from children diagnosed with LCH and followed up at Asan medical center and Chungnam National University Hospital between 1998 and 2008. Available formalin-fixed, paraffin-embedded specimens from these patients will be used for GSN, MMP12 immunohistochemistry. We will analyze the correlations between protein expression states and clinical features. Results The medical records of the patients with LCH was analyzed for the factors that affect relapse and overall survival. The specimens from 49 patients were available for immunohistochemistry. Of these, 2 slides were not suitable because the quality of staining was not good for evaluation or the tumor cells are too difficult to be differentiated. The median age of 49 patients was 9.5 years, range 5 months to 22 years with a definite diagnosis of LCH based on CD1a positivity. The gelsolin and MMP12 were expressed in various degrees except eight specimens and overexpression had a tendency of correlation with multisystem and risk organ involvement. Conclusion Gelsoin and MMP12 might be associated with the pathogenesis of LCH and the high expressions in LCH have a possibility of playing a role in the progression of LCH. Disclosures: No relevant conflicts of interest to declare.

The Varicella Zoster Virus Immunoglobulin G and the Varicella Zoster Virus Infection in Children with Cancer Under Chemotherapy.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1648-1648
Author(s):  
Ye Jee Shim ◽  
Kun Soo Lee ◽  
Yong-Mook Choi
Keyword(s):  
Varicella Zoster Virus ◽  
Immunoglobulin G ◽  
Conflicts Of Interest ◽  
University Hospital ◽  
Varicella Zoster Virus Infection ◽  
Negative Group ◽  
Children With Cancer ◽  
Varicella Zoster ◽  
Intravenous Acyclovir ◽  
National University

Abstract Abstract 1648 Poster Board I-674 Purpose The varicella zoster virus (VZV) is known to be fatal especially for immunocompromised patients receiving chemotherapy for childhood cancer. So we investigated the change of varicella zoster virus immunoglobulin G (VZV IgG) before and during chemotherapy in patients who suffered from chicken pox (CP) or herpes zoster (HZ) to find the relationship between them. Methods We reviewed the transition of VZV IgG through medical records in children with cancer who experienced CP or HS during chemotherapy from 1998 to 2008 in Kyungpook National University Hospital, Daegu, South Korea. Results We checked VZV IgG not only when they were diagnosed as cancer but also when they were receiving chemotherapy for 66 patients (VZV IgG (+) : VZV IgG (-) = 40 : 26). Among initial VZV IgG positive group, 28 patients showed sustained positive IgG during chemotherapy, and 6 patients underwent the disease (CP : HZ = 1 : 5). On the other hand, 12 patients showed negative IgG while chemotherapy and 8 patients experienced the disease (CP : HZ = 4 : 4). The seronegative group after chemotherapy showed higher morbidity of CP or HZ compare to seropositive group (p=0.011). In the case of VZV IgG negative group at diagnosis, 8 patients presented seroconsersion to positive IgG and they had no disease of VZV. Among them, 18 patients who showed still negative IgG developed 4 (CP : HZ = 2 : 2). All together, the seronegative group revealed the tendency of higher morbidity (p=0.034). We treated them using intravenous acyclovir, and no mortality was observed. Conclusion Because of higher frequency of CP or HZ in VZV IgG negative group during chemotherapy, it is important to decide when and for whom to carry out VZV vaccination during chemotherapy through regular VZV IgG checking. Disclosures No relevant conflicts of interest to declare.

scholarly journals P332 is 3D analysis of longitudinal strain useful to predict cardiac events in patients undergoing mitral valve repair?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Volpato ◽  
V Mantegazza ◽  
L Manfredonia ◽  
P Gripari ◽  
L Fusini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Longitudinal Strain ◽  
Lv Function ◽  
3D Analysis ◽  
Prognostic Role ◽  
Cardiac Events ◽  
Clinical Events ◽  
Twist Rate

Abstract Background The presence of abnormal 3D left ventricular (LV) strain values in patients diagnosed with mitral valve prolapse (MVP) and significant mitral regurgitation (MR) has been described previously. Recently, some studies showed an addictive prognostic role of Global Longitudinal Strain (GLS) in patients with severe aortic regurgitation. Few data are available about the prognostic role of LV strain in patients diagnosed with severe MR secondary to Myxomatous or fibroelastic deficiency (FED) MVP, undergoing MV repair. Purpose The aim of the study was to determinate whether LV GLS, strain rate, twist rate and left atrial strain (LAS) may identify a subgroup of patients with MVP and severe MR at higher risk of clinical events after surgical repair in both Myxomatous and FED disease. Methods We retrospectively studied 100 patients diagnosed with MVP and severe MR due to Myxomatous or FED disease, eligible for MV surgery between 2012 and 2015. Only patients with normal LV function who underwent a 3D transthoracic echocardiographic examination were included. 3D LV GLS, strain rate, twist rate and LAS were measured using 3D analysis software. Clinical data were recorded during a median follow-up of 48 months. Clinical events included cardiac death, arrhythmia and cardiac hospitalization for heart failure or arrhythmic events. Results 65 patients were diagnosed with Myxomatous and 35 with FED disease. A total of 13 events were recorded during the follow-up, including 1 death, 2 hospitalizations for heart failure and 10 minor arrhythmic events, mostly isolated premature ventricular complex. The number of events was not statistically different between the two groups. In both groups no significant correlation was found between clinical events and each of the echocardiographic parameters measured. Conclusion In patients with MVP and severe MR but normal LV function, undergoing MV repair, LV strain analysis was not able to predict long term cardiac events., regardless of the etiology.

scholarly journals Low-Level Elevations of Procalcitonin Are Associated with Increased Mortality in Acute Heart Failure Patients, Independent of Concomitant Infection

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1429
Author(s):  
Fabrice F. Darche ◽  
Moritz Biener ◽  
Matthias Müller-Hennessen ◽  
Rasmus Rivinius ◽  
Kiril M. Stoyanov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Mortality Prediction ◽  
University Hospital ◽  
Operating Characteristics ◽  
Cutoff Value ◽  
Low Level ◽  
Kaplan Meier ◽  
Receiver Operating Characteristics Curve

We aimed to evaluate the prognostic value of procalcitonin (PCT) in acute heart failure (AHF) patients, especially in those without underlying infection. We enrolled patients presenting with acute dyspnea to the emergency department (ED) of Heidelberg University Hospital and studied the prognostic role of PCT on all-cause death. Of 312 patients, AHF was diagnosed in 139 patients. Of these, 125 patients had AHF without signs of infection, and 14 had AHF complicated by respiratory or other infection. The optimal prognostic PCT cutoff value for mortality prediction was calculated by a receiver operating characteristics curve. In patients with AHF, the prognostic PCT cutoff value was 0.08 ng/mL. The Kaplan–Meier survival analysis showed that AHF patients with PCT values > 0.08 ng/mL had a higher all-cause mortality at 120 days than those with PCT values ≤ 0.08 ng/mL (log-rank p = 0.0123). Similar results could be obtained after subdivision into AHF patients with and without signs of overt infection. In both cases, mortality was higher in patients with PCT levels above the prognostic PCT cutoff than in those with values ranging below this threshold. Moreover, we show that the prognostic PCT cutoff values for mortality prediction ranged below the established PCT cutoff for the guidance of antibiotic therapy. In conclusion, the data of our study revealed that low-level elevations of PCT were associated with an increased mortality in patients with AHF, irrespective of concomitant respiratory or other infection. PCT should thus be further used as a marker in the risk stratification of AHF.

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