Xin-Yi Liu1, Ya-Ting Huang2, Min-Yu Lai3, John Chen4, Tung-Wei Chu5, Pei-Kwei Tsay6, Chih-Chung Shiao7. 1. Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan, ROC. 2. Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan, ROC; Department of Nursing, Saint Mary's Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan, ROC. 3. Department of Nursing, Saint Mary's Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan, ROC. 4. Division of Cardiovascular Medicine, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan, ROC. 5. Division of Cardiovascular Surgery, Department of Surgery, Saint Mary's Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan, ROC. 6. Department of Public Health and Center of Biostatistics, College of Medicine, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan, ROC; Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, No. 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan, ROC. 7. Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan, ROC; Saint Mary's Junior College of Medicine, Nursing and Management, No.100, Ln. 265, Sec. 2, Sanxing Rd., Sanxing Township, Yilan County 266, Taiwan, ROC. Electronic address: chungyy2001@yahoo.com.tw.
Abstract
BACKGROUND: Cardiogenic pulmonary edema (CPE) is a life-threatening emergency necessitating aggressive management. We conducted this study to test the hypothesis that a combination of N-terminal pro-b-type natriuretic peptide (NT-pro-BNP) and some relevant clinical factors may provide better predictability for CPE in heart failure (HF) patients. METHODS: This retrospective study enrolled adult HF patients hospitalized during January 2011 to December 2013. After determining the independent predictors for the occurrence of CPE, a novel NT-pro BNP-based diagnostic score for predicting CPE was established. RESULTS: A total of 269 patients (mean age, 74.5 ± 13.6 years; female, 53.9%) were enrolled, and categorized into CPE group (n = 80, 29.7%) and non-CPE group (n = 189, 70.3%). Several factors such as "Serum NT-pro-BNP level > 6980 mg/dl," "systemic blood pressure > 170 mm Hg," "heart rate > 120 bpm," "with rales in breathing sound," "with jugular vein engorgement," "with NYHA Fc III/IV," "with chronic lung disease" and "with angiotensin converting enzyme inhibitors/angiotensin receptor blocker" were found to be associated with the existence of CPE. A novel NT-pro BNP based scoring system containing these risk factors was proposed and proven excellent in predicting CPE. CONCLUSIONS: The NT-pro-BNP scoring system could predict CPE in HF patients.
BACKGROUND:Cardiogenic pulmonary edema (CPE) is a life-threatening emergency necessitating aggressive management. We conducted this study to test the hypothesis that a combination of N-terminal pro-b-type natriuretic peptide (NT-pro-BNP) and some relevant clinical factors may provide better predictability for CPE in heart failure (HF) patients. METHODS: This retrospective study enrolled adult HF patients hospitalized during January 2011 to December 2013. After determining the independent predictors for the occurrence of CPE, a novel NT-pro BNP-based diagnostic score for predicting CPE was established. RESULTS: A total of 269 patients (mean age, 74.5 ± 13.6 years; female, 53.9%) were enrolled, and categorized into CPE group (n = 80, 29.7%) and non-CPE group (n = 189, 70.3%). Several factors such as "Serum NT-pro-BNP level > 6980 mg/dl," "systemic blood pressure > 170 mm Hg," "heart rate > 120 bpm," "with rales in breathing sound," "with jugular vein engorgement," "with NYHA Fc III/IV," "with chronic lung disease" and "with angiotensin converting enzyme inhibitors/angiotensin receptor blocker" were found to be associated with the existence of CPE. A novel NT-pro BNP based scoring system containing these risk factors was proposed and proven excellent in predicting CPE. CONCLUSIONS: The NT-pro-BNP scoring system could predict CPE in HF patients.
Authors: Alejandro O Luquetti; Dayse Elisabeth Campos de Oliveira; Suelene Brito do Nascimento Tavares; Enio Chaves de Oliveira Journal: Am J Trop Med Hyg Date: 2022-03-28 Impact factor: 3.707