BACKGROUND: Brain natriuretic peptide (BNP) is increasingly used in the management of patients with heart failure (HF). It is still unclear how to use serial BNP measurement in HF. AIM: To evaluate the usefulness of three consecutive measurements of BNP in patients (pts) hospitalized for acute HF. METHODS: Clinical evaluation, BNP levels and echocardiography were assessed in 150 pts (67% males, age: 69+/-12 years; left ventricular ejection fraction: 34+/-14%) admitted for severe HF (NYHA class III-IV: 146/150). BNP measurements were obtained: at admission (basal, T0), at discharge (T1) and at first ambulatory control (T2), after optimization of medical therapy in those with discharge BNP level >250 pg/mL. End-points were death and hospital readmission during 6-month follow-up. RESULTS: According to BNP levels 3 groups of patients were identified: Group 1 (62 pts, 41%), in whom discharge (T1) BNP was high and persisted elevated at T2 despite aggressive medical therapy; at 6-month follow-up 72% died or were hospitalized for HF. Group 2 (36 pts, 24%), in whom discharge (T1) BNP was high but decreased after medical therapy (T2); death and HF-readmission were observed in 8 pts (26%). Group 3 (52 pts, 35%), in whom discharge (T1) BNP levels were <250 pg/mL and persisted below this value at T2; death and HF-hospital readmission were observed in 6 pts (12%). Event rate differences among groups were statistically significant (p<0.001). At Cox-analysis discharge BNP cutoff of 250 pg/mL was the only parameter predictive of a worse outcome. CONCLUSION: These data suggest that 3 BNP measurements, at admission, at discharge and few weeks later can allow to identify HF pts whom, despite a further potentiation of medical therapy, will present a worsening or even will die during short-term follow-up. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
BACKGROUND:Brain natriuretic peptide (BNP) is increasingly used in the management of patients with heart failure (HF). It is still unclear how to use serial BNP measurement in HF. AIM: To evaluate the usefulness of three consecutive measurements of BNP in patients (pts) hospitalized for acute HF. METHODS: Clinical evaluation, BNP levels and echocardiography were assessed in 150 pts (67% males, age: 69+/-12 years; left ventricular ejection fraction: 34+/-14%) admitted for severe HF (NYHA class III-IV: 146/150). BNP measurements were obtained: at admission (basal, T0), at discharge (T1) and at first ambulatory control (T2), after optimization of medical therapy in those with discharge BNP level >250 pg/mL. End-points were death and hospital readmission during 6-month follow-up. RESULTS: According to BNP levels 3 groups of patients were identified: Group 1 (62 pts, 41%), in whom discharge (T1) BNP was high and persisted elevated at T2 despite aggressive medical therapy; at 6-month follow-up 72% died or were hospitalized for HF. Group 2 (36 pts, 24%), in whom discharge (T1) BNP was high but decreased after medical therapy (T2); death and HF-readmission were observed in 8 pts (26%). Group 3 (52 pts, 35%), in whom discharge (T1) BNP levels were <250 pg/mL and persisted below this value at T2; death and HF-hospital readmission were observed in 6 pts (12%). Event rate differences among groups were statistically significant (p<0.001). At Cox-analysis discharge BNP cutoff of 250 pg/mL was the only parameter predictive of a worse outcome. CONCLUSION: These data suggest that 3 BNP measurements, at admission, at discharge and few weeks later can allow to identify HF pts whom, despite a further potentiation of medical therapy, will present a worsening or even will die during short-term follow-up. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
Authors: Pasqualina L Santaguida; Andrew C Don-Wauchope; Mark Oremus; Robert McKelvie; Usman Ali; Stephen A Hill; Cynthia Balion; Ronald A Booth; Judy A Brown; Amy Bustamam; Nazmul Sohel; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214
Authors: Salvatore Di Somma; Laura Magrini; Valerio Pittoni; Rossella Marino; Antonella Mastrantuono; Enrico Ferri; Paola Ballarino; Andrea Semplicini; Giuliano Bertazzoni; Giuseppe Carpinteri; Paolo Mulè; Maria Pazzaglia; Kevin Shah; Alan Maisel; Paul Clopton Journal: Crit Care Date: 2010-06-16 Impact factor: 9.097
Authors: Rudolf A de Boer; Dirk J A Lok; Tiny Jaarsma; Peter van der Meer; Adriaan A Voors; Hans L Hillege; Dirk J van Veldhuisen Journal: Ann Med Date: 2010-12-28 Impact factor: 4.709
Authors: Franck Desmoulin; Michel Galinier; Charlotte Trouillet; Matthieu Berry; Clément Delmas; Annie Turkieh; Pierre Massabuau; Heinrich Taegtmeyer; Fatima Smih; Philippe Rouet Journal: PLoS One Date: 2013-04-03 Impact factor: 3.240