scholarly journals High Intraindividual Variation of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in Patients with Stable Chronic Heart Failure

2004 ◽  
Vol 50 (11) ◽  
pp. 2052-2058 ◽  
Author(s):  
Sanne Bruins ◽  
M Rebecca Fokkema ◽  
Jeroen W P Römer ◽  
Mike J L DeJongste ◽  
Fey P L van der Dijs ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Natriuretic Peptide ◽  
Heart Association ◽  
Failure Diagnosis ◽  
Treatment Optimization ◽  
Intraindividual Variation ◽  
Amino Terminal ◽  
Heart Failure Diagnosis

Abstract Background: Plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are promising markers for heart failure diagnosis, prognosis, and treatment. Insufficient data on the intraindividual biological variation (CVi) of BNP and NT-proBNP hamper interpretation of changes in concentration on disease progression or treatment optimization. We therefore investigated CVi values in stable heart failure patients. Methods: We recruited 43 patients with stable chronic heart failure living in Curaçao (22 males, 21 females; median age, 63 years; range, 20–86 years; New York Heart Association classes I–III). Samples were collected for within-day CVi (n = 6; every 2 h starting at 0800), day-to-day CVi (n = 5; samples collected between 0800 and 1000 on 5 consecutive days), and week-to-week CVi (n = 6; samples collected between 0800 and 1000 on the same day of the week for 6 consecutive weeks). NT-proBNP (Roche) and BNP (Abbott) were measured by immunoassay. Results: Median (range) concentrations were 134 (0–1630) ng/L (BNP) and 570 (17–5048) ng/L (NT-proBNP). Analytical variation, week-to-week CVi, and reference change values were 8.4%, 40%, and 113% (BNP), and 3.0%, 35%, and 98% (NT-proBNP). Week-to week CVis were inversely related to median BNP concentrations. Week-to week CVis for BNP were 44% (BNP ≤350 ng/L) and 30% (BNP >350 ng/L). Both BNP and NT-proBNP increased between 0800 and 1000. Median NT-proBNP/BNP ratios were inversely related to median BNP concentrations. Conclusions: The high CVis hamper interpretation of changes in BNP and NT-proBNP concentrations and may partly explain their poor diagnostic values in chronic heart failure. Easily modifiable determinants to lower CVi have not been identified. The value of BNP and NT-proBNP for chronic heart failure diagnosis, and especially for follow-up and treatment optimization of individuals, remains largely to be established.

Chronic heart failure diagnosis: biomarkers

ESC CardioMed ◽  
2018 ◽  
pp. 1778-1781
Author(s):  
Christian Mueller
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Point Of Care ◽  
Failure Diagnosis ◽  
Central Laboratory ◽  
Important Advance ◽  
Cardiac Stress ◽  
Heart Failure Diagnosis

Natriuretic peptides including B-type natriuretic peptide (BNP), N-terminal (NT)-proBNP, and midregional pro-atrial natriuretic peptide (MR-proANP) are the biomarkers of choice in the diagnosis of heart failure. Assays measuring either BNP, NT-proBNP, or MR-proANP are widely available and run on large analysers operating in the central laboratory or as point-of-care options. Natriuretic peptides are considered quantitative markers of haemodynamic cardiac stress and therefore quantitative markers of heart failure itself. The clinical introduction of natriuretic peptides constitutes the most important advance in the diagnosis of heart failure in the last decade.

Chronic heart failure diagnosis: biomarkers

ESC CardioMed ◽  
2018 ◽  
pp. 1778-1781
Author(s):  
Christian Mueller
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Point Of Care ◽  
Failure Diagnosis ◽  
Central Laboratory ◽  
Important Advance ◽  
Cardiac Stress ◽  
Heart Failure Diagnosis

Natriuretic peptides including B-type natriuretic peptide (BNP), N-terminal (NT)-proBNP, and midregional pro-atrial natriuretic peptide (MR-proANP) are the biomarkers of choice in the diagnosis of heart failure. Assays measuring either BNP, NT-proBNP, or MR-proANP are widely available and run on large analysers operating in the central laboratory or as point-of-care options. Natriuretic peptides are considered quantitative markers of haemodynamic cardiac stress and therefore quantitative markers of heart failure itself. The clinical introduction of natriuretic peptides constitutes the most important advance in the diagnosis of heart failure in the last decade.

Chronic heart failure diagnosis: biomarkers

ESC CardioMed ◽  
2018 ◽  
pp. 1778-1781
Author(s):  
Christian Mueller
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Point Of Care ◽  
Failure Diagnosis ◽  
Central Laboratory ◽  
Important Advance ◽  
Cardiac Stress ◽  
Heart Failure Diagnosis

Natriuretic peptides including B-type natriuretic peptide (BNP), N-terminal (NT)-proBNP, and midregional pro-atrial natriuretic peptide (MR-proANP) are the biomarkers of choice in the diagnosis of heart failure. Assays measuring either BNP, NT-proBNP, or MR-proANP are widely available and run on large analysers operating in the central laboratory or as point-of-care options. Natriuretic peptides are considered quantitative markers of haemodynamic cardiac stress and therefore quantitative markers of heart failure itself. The clinical introduction of natriuretic peptides constitutes the most important advance in the diagnosis of heart failure in the last decade.

scholarly journals Influence of ScaI and Natriuretic Peptide (NP) Clearance Receptor Polymorphisms of the NP System on NP Concentration in Chronic Heart Failure

2007 ◽  
Vol 53 (11) ◽  
pp. 1886-1890 ◽  
Author(s):  
Cristina Vassalle ◽  
Maria Grazia Andreassi ◽  
Concetta Prontera ◽  
Marianna Fontana ◽  
Luc Zyw ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Natriuretic Peptide ◽  
Nyha Class ◽  
Heart Association ◽  
Amino Terminal ◽  
Multivariate Adjustment ◽  
Cardiovascular Morbidity And Mortality ◽  
New York Heart Association ◽  
Clearance Receptor

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 <0.01), and NT-proBNP (P <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 <0.05) and BNP (P <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.

scholarly journals Plasma amino-terminal pro-brain natriuretic peptide and accuracy of heart-failure diagnosis in primary care

2003 ◽  
Vol 42 (10) ◽  
pp. 1793-1800 ◽  
Author(s):  
Susan P. Wright ◽  
Robert N. Doughty ◽  
Ann Pearl ◽  
Greg D. Gamble ◽  
Gillian A. Whalley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Failure Diagnosis ◽  
Amino Terminal ◽  
Heart Failure Diagnosis

scholarly journals Association between ventilatory efficiency, oxygen uptake, and Glittre-ADL test results in patients with chronic heart failure: a preliminary study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Hebert Olímpio Júnior ◽  
Agnaldo José Lopes ◽  
Fernando Silva Guimarães ◽  
Sergio Luiz Soares Marcos da Cunha Chermont ◽  
Sara Lúcia Silveira de Menezes
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Functional Capacity ◽  
Treatment Plan ◽  
Minute Ventilation ◽  
Heart Association ◽  
Gas Analysis ◽  
Ventilatory Efficiency ◽  
Scale Scores

Abstract Objective The Glittre-ADL test (GA-T) is a functional capacity test that stands out for encompassing multiple tasks similar to activities of daily living. As ventilatory efficiency is one of the variables valued in the prognosis of chronic heart failure (CHF), this study aimed to evaluate associations between functional capacity and ventilatory variables in patients with CHF during the GA-T. Results Eight patients with CHF and New York Heart Association (NYHA) functional classification II–III underwent the GA-T coupled with metabolic gas analysis to obtain data by means of telemetry. The median total GA-T time was 00:04:39 (00:03:29–00:05:53). Borg dyspnoea scale scores before and after the GA-T were 2 (0–9) and 3 (1–10), respectively (P = 0.011). The relationship between the regression slope relating minute ventilation to carbon dioxide output (VE/VCO2 slope) was correlated with the total GA-T time (rs = 0.714, P = 0.047) and Borg dyspnoea score (rs = 0.761, P = 0.028). The other ventilatory variables showed no significant correlations. Our results suggest that the total GA-T time can be applied to estimate the ventilatory efficiency of patients with CHF. Future studies may use the GA-T in conjunction with other functional capacity tests to guide the treatment plan and evaluate the prognosis.

scholarly journals Remote monitoring of chronic heart failure patients: invasive versus non-invasive tools for optimising patient management

2019 ◽  
Vol 28 (1) ◽  
pp. 3-13 ◽  
Author(s):  
J. F. Veenis ◽  
J. J. Brugts
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Remote Monitoring ◽  
Heart Association ◽  
The United States ◽  
Pharmacological Therapy ◽  
Functional Class ◽  
Class Iii ◽  
Additional Tool

AbstractExacerbations of chronic heart failure (HF) with the necessity for hospitalisation impact hospital resources significantly. Despite all of the achievements in medical management and non-pharmacological therapy that improve the outcome in HF, new strategies are needed to prevent HF-related hospitalisations by keeping stable HF patients out of the hospital and focusing resources on unstable HF patients. Remote monitoring of these patients could provide the physicians with an additional tool to intervene adequately and promptly. Results of telemonitoring to date are inconsistent, especially those of telemonitoring with traditional non-haemodynamic parameters. Recently, the CardioMEMS device (Abbott Inc., Atlanta, GA, USA), an implantable haemodynamic remote monitoring sensor, has shown promising results in preventing HF-related hospitalisations in chronic HF patients hospitalised in the previous year and in New York Heart Association functional class III in the United States. This review provides an overview of the available evidence on remote monitoring in chronic HF patients and future perspectives for the efficacy and cost-effectiveness of these strategies.

Abstract 2848: Medication Knowledge And Assistance In Older Chronic Heart Failure Patients.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robyn Gallagher ◽  
Judith Donoghue ◽  
Lynn Chenoweth ◽  
Jane Stein-Parbury
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Self Efficacy ◽  
Heart Association ◽  
Post Discharge ◽  
Medication Knowledge ◽  
Moderate Heart Failure ◽  
Association Class ◽  
New York Heart Association

Medication knowledge and assistance in older chronic heart failure (CHF) patients. Medication adherence is central to the optimal management of CHF. Little is known about older patients’ knowledge of their medications or the factors that contribute to this knowledge. Aim: To describe and identify the predictors of medication knowledge in older CHF patients. Method: Subjects ( n = 62) aged over 55 years with moderate heart failure (New York Heart Association Class II and III) who identified as self-managing were recruited from hospital or rehabilitation. Interviews occurred at home four weeks post-discharge using a medication checklist and the Self-Efficacy in Chronic Illness Scale (Lorig et al, 2001). Multiple regression analysis determined the predictors of medication knowledge. Results: Patients were aged mean 78.4 years (sd 8.54 years), mostly male (57%) and had an average 8 (median, range 3–22) medications to take daily, of which 6 (median, range 3–14) were for CHF. Most managed their own medications (54%) but more than a quarter (28%) were assisted by reminding, dispensing and supervision. Compliance with medications was high (84%), although only half (53%) knew the name, main purpose and side effect of their medications. Patients with better self-efficacy (β = 2.88) and no help with medication (β = -21.05) had better medication knowledge (model F = 13.6, p = .000, R = .61, r 2 = .37). Conclusion: Older CHF patients have poor knowledge of their medications, which may be improved by promoting overall self-efficacy for disease management. Less knowledgeable patients received appropriate assistance with medications, but the consequence may be less knowledge and thus warrants further investigation.

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