scholarly journals Brain natriuretic peptide in differentiating cardiogenic and non- cardiogenic dyspnoea in patients with renal dysfunction: a single centre study

2021 ◽  
Vol 9 (5) ◽  
pp. 1434
Author(s):  
Sruthi Meenaxshi Subbiah Renganathan ◽  
Madhukar Rai ◽  
Tiwari J. P. ◽  
Tej Bali Singh
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Renal Function ◽  
Brain Natriuretic Peptide ◽  
Renal Dysfunction ◽  
Natriuretic Peptide ◽  
Characteristic Curve ◽  
Final Diagnosis ◽  
Prognostic Indicators ◽  
Acute Dyspnoea

Background: Both BNP (Brain Natriuretic Peptide) and renal function are prognostic indicators of survival in patients with congestive heart failure. However, relationship between BNP, renal function and heart failure as an emergency diagnosis are unknown. The usefulness of BNP as a diagnostic tool in patients with renal dysfunction is thus explored in this study.Methods: The present study was prospectively designed diagnostic test evaluation study conducted in Banaras Hindu University, Varanasi. Out of 166 participants with renal dysfunction defined as creatinine >1.5mg/dl who presented with acute dyspnoea, clinical history, BNP, 2D Echo and baseline estimated glomerular filtration rate were assessed. Patients with severe anaemia, eGFR less than 15 ml/min/1.73 m2 and those on dialysis therapy were excluded from the study. The final diagnosis was adjudicated by cardiologist who was blinded to BNP values.Results: The final diagnosis of CHF was in 104 (62.7%). The correlation between BNP and eGFR values were r=-0.49 for those with CHF (p<0.001) and r=-0.279 (p<0.028) for those without CHF. Median BNP in patients with renal dysfunction with CHF was 1206 pg/ml and without CHF was 186 pg/ml. The area under the receiver operating characteristic curve and optimal cutpoints for EGFR categories 59-30 ml /min/1.73 m2 and EGFR less than 30 ml/min/1.73m2 were 0.992 and 491.5 pg/ml (sensitivity 97% and specificity 95%) and 1.000 and 512pg/ml (sensitivity 100% and specificity  95.5%) respectively.Conclusions: Renal function weakly correlates with BNP in patients without CHF (congestive heart failure). BNP is an important bed side tool for distinguishing cardiogenic and non-cardiogenic dyspnoea in patients with renal dysfunction requiring higher diagnostic cut points. Thus the present study emphasises BNP is the strong and independent predictor of CHF even after taking renal function into considerations. 

scholarly journals Renal Function, Congestive Heart Failure, and Amino-Terminal Pro-Brain Natriuretic Peptide Measurement

2006 ◽  
Vol 47 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Saif Anwaruddin ◽  
Donald M. Lloyd-Jones ◽  
Aaron Baggish ◽  
Annabel Chen ◽  
Daniel Krauser ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Renal Function ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Amino Terminal

scholarly journals Augmenting renal function in experimental congestive heart failure by brain natriuretic peptide and lasix

2003 ◽  
Vol 41 (6) ◽  
pp. 193-194
Author(s):  
Alessandro Cataliotti ◽  
Horng H. Chen ◽  
Giodo Boerrigter ◽  
Lisa C. Costello-Boerrigter ◽  
Toshihiro Tsuruda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Renal Function ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide

Abstract 4951: Serum N-Terminal Pro-Brain Natriuretic Peptide Reflects the Grade of Congestive Heart Failure in Children

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Masaya Sugimoto ◽  
Hiroki Kajino ◽  
Hiromi Manabe ◽  
Kazutomo Goh ◽  
Kenji Fujieda
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Characteristic Curve ◽  
Heart Association ◽  
Blood Levels ◽  
Healthy Children ◽  
Specificity And Sensitivity ◽  
Grade Ii

Background: The N-terminal pro-brain natriuretic peptide (NTproBNP) has a longer serum half-life than the brain natriuretic peptide (BNP), and it is reported to be advantageous in the accurate detection of congestive heart failure (CHF) in adults. However, it has not been sufficiently examined in children. Therefore, we investigated which of the 2 peptides is more beneficial and identified their cut-off levels at the CHF grades in children. Methods: Plasma BNP and serum NTproBNP levels were determined in 252 healthy children (median age, 3.5 years) and in 142 children with congenital heart disease (median age, 2.6 years). CHF severity was assessed by using the modified Ross score to classify the severity into 4 grades (I–IV). The BNP and NTproBNP levels were analyzed and compared with the CHF grade. Results: Both BNP and NTproBNP levels increased significantly with the CHF grades (Fig. 1 ). The change in the NTproBNP level was more remarkable in each CHF grade than in BNP. Furthermore, at CHF grades of II or higher, the area under the receiver operating characteristic curve was larger with NTproBNP than with BNP (Fig. 2 ). The cut-off levels of BNP and NTproBNP were 47.3 and 333.4 pg/mL, respectively, in CHF grade II and higher; 101.4 and 2415.5 pg/mL, respectively, in CHF grade III and higher; and 320.0 and 3617.0 pg/mL, respectively, in CHF grade IV. Conclusions: Our study clearly demonstrated that blood levels of BNP and NTproBNP reflected the severity of CHF in the children. Of these, NTproBNP showed better specificity and sensitivity for the evaluation of CHF severity in children. Therefore, we concluded that NTproBNP is beneficial as a biomarker for assessing CHF in children. This research has received full or partial funding support from the American Heart Association, AHA National Center. Fig. 1 Fig. 2

scholarly journals Evaluation of Atrial Natriuretic Peptide and Brain Natriuretic Peptide in Atrial Granules of Rats with Experimental Congestive Heart Failure

2001 ◽  
Vol 49 (10) ◽  
pp. 1293-1300 ◽  
Author(s):  
Gad M. Bialik ◽  
Zaid A. Abassi ◽  
Ilan Hammel ◽  
Joseph Winaver ◽  
Dina Lewinson
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Atrial Natriuretic Peptide ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Aortocaval Fistula ◽  
Granule Formation ◽  
Gold Particles ◽  
The Mean ◽  
Atrial Natriuretic

The natriuretic peptides are believed to play an important role in the pathophysiology of congestive heart failure (CHF). We utilized a quantitative cytomorphometric method, using double immunocytochemical labeling, to assess the characteristics of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in atrial granules in an experimental model of rats with CHF induced by aortocaval fistula. Rats with CHF were further divided into decompensated (sodium-retaining) and compensated (sodium-excreting) subgroups and compared with a sham-operated control group. A total of 947 granules in myocytes in the right atrium were analyzed, using electron microscopy and a computerized analysis system. Decompensated CHF was associated with alterations in the modal nature of granule content packing, as depicted by moving bin analysis, and in the granule density of both peptides. In control rats, the mean density of gold particles attached to both peptides was 347.0 ± 103.6 and 306.3 ± 89.9 gold particles/μm2 for ANP and BNP, respectively. Similar mean density was revealed in the compensated rats (390.6 ± 81.0 and 351.3 ± 62.1 gold particles/μm2 for ANP and BNP, respectively). However, in rats with decompensated CHF, a significant decrease in the mean density of gold particles was observed (141.6 ± 67.3 and 158.0 ± 71.2 gold particles/μm2 for ANP and BNP, respectively; p < 0.05 compared with compensated rats, for both ANP and BNP). The ANP:BNP ratio did not differ between groups. These findings indicate that the development of decompensated CHF in rats with aortocaval fistula is associated with a marked decrease in the density of both peptides in atrial granules, as well as in alterations in the quantal nature of granule formation. The data further suggest that both peptides, ANP and BNP, may be regulated in the atrium by a common secretory mechanism in CHF.

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