scholarly journals The Relationship Between Brain Natriuretic Peptide (NT-proBNP) Levels and Diastolic Heart Failure in Patients With COVID-19

Author(s):  
Naghmeh Ziaie ◽  
Khadijeh Ezoji ◽  
Seyedeh Golnaz Ziaei ◽  
Mohammad Chehrazi ◽  
Parviz Amri Maleh ◽  
...  

Abstract Background: Diastolic dysfunction has been reported in patients with COVID-19. Due to the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the diagnosis of heart failure, this study investigated the relationship between serum NT-proBNP levels and diastolic heart failure in COVID-19 patients.Methods: This descriptive-analytical study was performed at Ayatollah Rouhani Hospital in Babol. Fifty-four patients with confirmed COVID-19 diagnosis who were admitted to the ICU were included in the study. The primary outcome was the relationship and predictive role of NT-proBNP and diastolic heart failure in patients with severe SARS-COV-2 infection. Patients with pro BNP >125 pg/mL underwent echocardiography and the relationship between echocardiographic indices and NT-proBNP was assessed as a secondary outcome.Results: Our study showed that plasma NT-proBNP levels in patients with increased diastolic dysfunction were associated with disease severity. It was also found that the cut-off point of NT-proBNP = 799 pg/mL could be a predictor of diastolic dysfunction grades two and three. In this study, patients with a serum NT-proBNP level equal or above 799 had 37 times higher chance of having diastolic dysfunction than those with a serum NT-proBNP level below 799. Patients with NT-proBNP above 556 had RV_EA> 2 in echocardiography, indicating increased right-sided filling pressures.Conclusion: Despite the confounding factors in the interpretation of the pro BNP level in COVID-19, its level can be used to estimate the presence of high-grade diastolic heart failure on the left and right sides of the heart and the presence of high filling pressures. Lower levels of NT-proBNP are associated with right-sided diastolic failure.

Author(s):  
Kelley C. Stewart ◽  
Rahul Kumar ◽  
John J. Charonko ◽  
Pavlos P. Vlachos ◽  
William C. Little

Left ventricular diastolic dysfunction (LVDD) and diastolic heart failure are conditions that affect the filling dynamics of the heart and affect 36% of patients diagnosed with congestive heart failure [1]. Although this condition is very prevalent, it currently remains difficult to diagnose due to inherent atrio-ventricular compensatory mechanisms including increased heart rate, increased left ventricular (LV) contractility, and increased left atrial pressure (LA). A greater comprehension of the governing flow physics in the left ventricle throughout the introduction of the heart’s compensatory mechanisms has great potential to substantially increase the understanding of the progression of diastolic dysfunction and in turn advance the diagnostic techniques.


2009 ◽  
Vol 103 (8) ◽  
pp. 1128-1133 ◽  
Author(s):  
Sven Linzbach ◽  
Azat Samigullin ◽  
Sezayi Yilmaz ◽  
Maria Tsioga ◽  
Andreas M. Zeiher ◽  
...  

2009 ◽  
Vol 150 (45) ◽  
pp. 2060-2067 ◽  
Author(s):  
András Nagy ◽  
Zsuzsanna Cserép

Diabetes mellitus, a disease that has been reaching epidemic proportions, is an important risk factor to the development of cardiovascular complication. The left ventricular diastolic dysfunction represents the earliest pre-clinical manifestation of diabetic cardiomyopathy, preceding systolic dysfunction and being able to evolve to symptomatic heart failure. In early stages, these changes appear reversible with tight metabolic control, but as pathologic processes become organized, the changes are irreversible and contribute to an excess risk of heart failure among diabetic patients. Doppler echocardiography provides reliable data in the stages of diastolic function, as well as for systolic function. Combination of pulsed tissue Doppler study of mitral annulus with transmitral inflow may be clinically valuable for obtaining information about left ventricular filling pressure and unmasking Doppler inflow pseudonormal pattern, a hinge point for the progression toward advanced heart failure. Subsequently we give an overview about diabetes and its complications, their clinical relevance and the role of echocardiography in detection of diastolic heart failure in diabetes.


2019 ◽  
Vol 45 (4) ◽  
Author(s):  
Evrim Eylem Akpınar ◽  
Derya Hoşgün ◽  
Serdar Akpınar ◽  
Can Ateş ◽  
Ayşe Baha ◽  
...  

ABSTRACT Objective: Pneumonia is a leading cause of mortality worldwide, especially in the elderly. The use of clinical risk scores to determine prognosis is complex and therefore leads to errors in clinical practice. Pneumonia can cause increases in the levels of cardiac biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP). The prognostic role of the NT-proBNP level in community acquired pneumonia (CAP) remains unclear. The aim of this study was to evaluate the prognostic role of the NT-proBNP level in patients with CAP, as well as its correlation with clinical risk scores. Methods: Consecutive inpatients with CAP were enrolled in the study. At hospital admission, venous blood samples were collected for the evaluation of NT-proBNP levels. The Pneumonia Severity Index (PSI) and the Confusion, Urea, Respiratory rate, Blood pressure, and age ≥ 65 years (CURB-65) score were calculated. The primary outcome of interest was all-cause mortality within the first 30 days after hospital admission, and a secondary outcome was ICU admission. Results: The NT-proBNP level was one of the best predictors of 30-day mortality, with an area under the curve (AUC) of 0.735 (95% CI: 0.642-0.828; p < 0.001), as was the PSI, which had an AUC of 0.739 (95% CI: 0.634-0.843; p < 0.001), whereas the CURB-65 had an AUC of only 0.659 (95% CI: 0.556-0.763; p = 0.006). The NT-proBNP cut-off level found to be the best predictor of ICU admission and 30-day mortality was 1,434.5 pg/mL. Conclusions: The NT-proBNP level appears to be a good predictor of ICU admission and 30-day mortality among inpatients with CAP, with a predictive value for mortality comparable to that of the PSI and better than that of the CURB-65 score.


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