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Erschienen in: Irish Journal of Medical Science (1971 -) 2/2011

01.06.2011 | Original Article

Profiling B-type natriuretic peptide in a stable heart failure population: a valuable adjunct to care

verfasst von: A. Jan, N. F. Murphy, C. O’Loughlin, M. Ledwidge, K. McDonald

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2011

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Abstract

Aim

To examine the prognostic importance of absolute values and change in values of BNP in patients with stable heart failure (HF).

Methods

Five-hundred and fifty-nine patients attending a disease management programme were categorized into tertiles of BNP (group 1; ≤95 pg/ml, group 2; 96–249 pg/ml and group 3; ≥250 pg/ml). A change in BNP between two stable visits was recorded. Patients were followed up for 1 year for death and a composite morbidity measure of HF hospitalization, all-cause hospitalization, unscheduled visits for clinical deterioration(UC) of HF using survival analysis.

Results

The risk of the combined morbidity outcome increased with increasing tertiles of BNP (Log rank = 17.8 (2), p < 0.001). Furthermore, a 50 and 25% increase in BNP predicted morbidity in stable HF patients with an initial BNP > 200 pg/ml (p = 0.02) and >450 pg/ml (p = 0.03), respectively.

Conclusion

In a stable community HF population, an elevated BNP or an increase in BNP predicts an adverse prognosis thereby potentially identifying a population in need of closer clinical follow-up.
Literatur
2.
Zurück zum Zitat Logeart D, Thabut G, Jourdain P et al (2004) Predischarge B-type natriuretic peptide assay for identifying patients at high risk of re-admission after decompensated heart failure. J Am Coll Cardiol 43:635–641PubMedCrossRef Logeart D, Thabut G, Jourdain P et al (2004) Predischarge B-type natriuretic peptide assay for identifying patients at high risk of re-admission after decompensated heart failure. J Am Coll Cardiol 43:635–641PubMedCrossRef
3.
Zurück zum Zitat Fonarow GC, Peacock WF, Phillips CO, Givertz MM, Lopatin M (2007) Admission B-type natriuretic peptide levels and in-hospital mortality in acute decompensated heart failure. J Am Coll Cardiol 49:1943–1950PubMedCrossRef Fonarow GC, Peacock WF, Phillips CO, Givertz MM, Lopatin M (2007) Admission B-type natriuretic peptide levels and in-hospital mortality in acute decompensated heart failure. J Am Coll Cardiol 49:1943–1950PubMedCrossRef
4.
Zurück zum Zitat Yu CM, Sanderson JE (1999) Plasma brain natriuretic peptide-an independent predictor of cardiovascular mortality in acute heart failure. Eur J Heart Fail 1:59–65PubMedCrossRef Yu CM, Sanderson JE (1999) Plasma brain natriuretic peptide-an independent predictor of cardiovascular mortality in acute heart failure. Eur J Heart Fail 1:59–65PubMedCrossRef
5.
Zurück zum Zitat Ishii J, Nomura M, Nakamura Y et al (2002) Risk stratification using a combination of cardiac troponin T and brain natriuretic peptide in patients hospitalized for worsening chronic heart failure. Am J Cardiol 89:691–695PubMedCrossRef Ishii J, Nomura M, Nakamura Y et al (2002) Risk stratification using a combination of cardiac troponin T and brain natriuretic peptide in patients hospitalized for worsening chronic heart failure. Am J Cardiol 89:691–695PubMedCrossRef
6.
Zurück zum Zitat Cournot M, Leprince P, Destrac S, Ferrieres J (2007) Usefulness of in-hospital change in B-type natriuretic peptide levels in predicting long-term outcome in elderly patients admitted for decompensated heart failure. Am J Geriatr Cardiol 16:8–14PubMedCrossRef Cournot M, Leprince P, Destrac S, Ferrieres J (2007) Usefulness of in-hospital change in B-type natriuretic peptide levels in predicting long-term outcome in elderly patients admitted for decompensated heart failure. Am J Geriatr Cardiol 16:8–14PubMedCrossRef
7.
Zurück zum Zitat Koglin J, Pehlivanli S, Schwaiblmair M, Vogeser M, Cremer P, vonScheidt W (2001) Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure. J Am Coll Cardiol 38:1934–1941PubMedCrossRef Koglin J, Pehlivanli S, Schwaiblmair M, Vogeser M, Cremer P, vonScheidt W (2001) Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure. J Am Coll Cardiol 38:1934–1941PubMedCrossRef
8.
Zurück zum Zitat de Groote P, Dagorn J, Soudan B, Lamblin N, McFadden E, Bauters C (2004) B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure. J Am Coll Cardiol 43:1584–1589PubMedCrossRef de Groote P, Dagorn J, Soudan B, Lamblin N, McFadden E, Bauters C (2004) B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure. J Am Coll Cardiol 43:1584–1589PubMedCrossRef
9.
Zurück zum Zitat Doust JA, Pietrzak E, Dobson A, Glasziou P (2005) How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ 330:625PubMedCrossRef Doust JA, Pietrzak E, Dobson A, Glasziou P (2005) How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ 330:625PubMedCrossRef
10.
Zurück zum Zitat Jourdain P, Jondeau G, Funck F et al (2007) Plasma brain natriuretic peptide guided therapy to improve outcome in heart failure: the STARS-BNP Multicenter Study. J Am Coll Cardiol 49:1733–1739PubMedCrossRef Jourdain P, Jondeau G, Funck F et al (2007) Plasma brain natriuretic peptide guided therapy to improve outcome in heart failure: the STARS-BNP Multicenter Study. J Am Coll Cardiol 49:1733–1739PubMedCrossRef
11.
Zurück zum Zitat Troughton RW, Frampton CM, Yandle TG, Espiner EA, Nicholls MG, Richards AM (2000) Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. Lancet 355:1126–1130PubMedCrossRef Troughton RW, Frampton CM, Yandle TG, Espiner EA, Nicholls MG, Richards AM (2000) Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. Lancet 355:1126–1130PubMedCrossRef
12.
Zurück zum Zitat Castellanos LR, Bhalla V, Isakson S, et al (2008) B-type Natriuretic peptide and impedance cardiography at the time of routine echocardiography predict subsequent heart failure events. J Card Fail (article in press) Castellanos LR, Bhalla V, Isakson S, et al (2008) B-type Natriuretic peptide and impedance cardiography at the time of routine echocardiography predict subsequent heart failure events. J Card Fail (article in press)
13.
Zurück zum Zitat O’Hanlon R, O’Shea P, Ledwidge M et al (2007) The biologic variability of B type natriuretic peptide and N-terminal pro-B-type natriuretic peptide in stable heart failure patients. J Card Fail 13:50–55PubMedCrossRef O’Hanlon R, O’Shea P, Ledwidge M et al (2007) The biologic variability of B type natriuretic peptide and N-terminal pro-B-type natriuretic peptide in stable heart failure patients. J Card Fail 13:50–55PubMedCrossRef
14.
Zurück zum Zitat Schou M, Gustafsson F, Nielsen PH, Madsen LH, Kjaer A, Hildebrandt PR (2007) Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state. Eur J Heart Fail 9:68–74PubMedCrossRef Schou M, Gustafsson F, Nielsen PH, Madsen LH, Kjaer A, Hildebrandt PR (2007) Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state. Eur J Heart Fail 9:68–74PubMedCrossRef
15.
Zurück zum Zitat Moertl D, Berger R, Hammer A et al (2009) B-type natriuretic peptide predicts benefit from a home-based nurse care in chronic heart failure. J Card Fail 15:233–240PubMedCrossRef Moertl D, Berger R, Hammer A et al (2009) B-type natriuretic peptide predicts benefit from a home-based nurse care in chronic heart failure. J Card Fail 15:233–240PubMedCrossRef
16.
Zurück zum Zitat Wei T, Zeng C, Chen L et al (2005) Systolic and diastolic heart failure are associated with different plasma levels of B-type natriuretic peptide. Int J Clin Pract 59:891–894PubMedCrossRef Wei T, Zeng C, Chen L et al (2005) Systolic and diastolic heart failure are associated with different plasma levels of B-type natriuretic peptide. Int J Clin Pract 59:891–894PubMedCrossRef
17.
Zurück zum Zitat McDonald K, Ledwidge M, Cahill J et al (2002) Heart failure management: multidisciplinary care has intrinsic benefit above the optimization of medical care. J Card Fail 8:142–148PubMedCrossRef McDonald K, Ledwidge M, Cahill J et al (2002) Heart failure management: multidisciplinary care has intrinsic benefit above the optimization of medical care. J Card Fail 8:142–148PubMedCrossRef
18.
Zurück zum Zitat Ledwidge M, Ryan E, O’Loughlin C et al (2005) Heart failure care in a hospital unit: a comparison of standard 3-month and extended 6-month programs. Eur J Heart Fail 7:385–391PubMedCrossRef Ledwidge M, Ryan E, O’Loughlin C et al (2005) Heart failure care in a hospital unit: a comparison of standard 3-month and extended 6-month programs. Eur J Heart Fail 7:385–391PubMedCrossRef
19.
Zurück zum Zitat Nieminen MS, Böhm M, Cowie MR et al (2005) Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J 26:384–416 Nieminen MS, Böhm M, Cowie MR et al (2005) Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J 26:384–416
20.
Zurück zum Zitat Cheng V, Kazanagra R, Garcia A et al (2001) A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study. J Am Coll Cardiol 37:386–391PubMedCrossRef Cheng V, Kazanagra R, Garcia A et al (2001) A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study. J Am Coll Cardiol 37:386–391PubMedCrossRef
21.
Zurück zum Zitat Hosmer D, Lemeshow S (1999) Applied survival analysis: regression modeling of time to event data. John Wiley & Sons, Inc, New York Hosmer D, Lemeshow S (1999) Applied survival analysis: regression modeling of time to event data. John Wiley & Sons, Inc, New York
22.
Zurück zum Zitat Maeda K, Tsutamoto T, Wada A et al (2000) High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure. J Am Coll Cardiol 36:1587–1593PubMedCrossRef Maeda K, Tsutamoto T, Wada A et al (2000) High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure. J Am Coll Cardiol 36:1587–1593PubMedCrossRef
23.
Zurück zum Zitat Rienstra M, Van GI, Van den Berg MP, Boomsma F, van Veldhuisen DJ (2006) Natriuretic peptides in patients with atrial fibrillation and advanced chronic heart failure: determinants and prognostic value of (NT-) ANP and (NT-pro) BNP. Europace 8:482–487PubMedCrossRef Rienstra M, Van GI, Van den Berg MP, Boomsma F, van Veldhuisen DJ (2006) Natriuretic peptides in patients with atrial fibrillation and advanced chronic heart failure: determinants and prognostic value of (NT-) ANP and (NT-pro) BNP. Europace 8:482–487PubMedCrossRef
24.
Zurück zum Zitat Watanabe J, Shiba N, Shinozaki T et al (2005) Prognostic value of plasma brain natriuretic peptide combined with left ventricular dimensions in predicting sudden death of patients with chronic heart failure. J Card Fail 11:50–55PubMedCrossRef Watanabe J, Shiba N, Shinozaki T et al (2005) Prognostic value of plasma brain natriuretic peptide combined with left ventricular dimensions in predicting sudden death of patients with chronic heart failure. J Card Fail 11:50–55PubMedCrossRef
25.
Zurück zum Zitat Berger R, Huelsman M, Strecker K et al (2002) B-type natriuretic peptide predicts sudden death in patients with chronic heart failure. Circulation 105:2392–2397PubMedCrossRef Berger R, Huelsman M, Strecker K et al (2002) B-type natriuretic peptide predicts sudden death in patients with chronic heart failure. Circulation 105:2392–2397PubMedCrossRef
26.
Zurück zum Zitat Valle R, Aspromonte N, Feola M et al (2005) B-type natriuretic peptide can predict the medium-term risk in patients with acute heart failure and preserved systolic function. J Card Fail 11:498–503PubMedCrossRef Valle R, Aspromonte N, Feola M et al (2005) B-type natriuretic peptide can predict the medium-term risk in patients with acute heart failure and preserved systolic function. J Card Fail 11:498–503PubMedCrossRef
27.
Zurück zum Zitat Aspromonte N, Feola M, Milli M et al (2007) Prognostic role of B-type natriuretic peptide in patients with diabetes and acute decompensated heart failure. Diabet Med 24:124–130PubMedCrossRef Aspromonte N, Feola M, Milli M et al (2007) Prognostic role of B-type natriuretic peptide in patients with diabetes and acute decompensated heart failure. Diabet Med 24:124–130PubMedCrossRef
28.
Zurück zum Zitat Verdiani V, Nozzoli C, Bacci F et al (2005) Pre-discharge B-type natriuretic peptide predicts early recurrence of decompensated heart failure in patients admitted to a general medical unit. Eur J Heart Fail 7:566–571PubMedCrossRef Verdiani V, Nozzoli C, Bacci F et al (2005) Pre-discharge B-type natriuretic peptide predicts early recurrence of decompensated heart failure in patients admitted to a general medical unit. Eur J Heart Fail 7:566–571PubMedCrossRef
29.
Zurück zum Zitat Christ M, Laule-Kilian K, Hochholzer W et al (2006) Gender-specific risk stratification with B-type natriuretic peptide levels in patients with acute dyspnea: insights from the B-type natriuretic peptide for acute shortness of breath evaluation study. J Am Coll Cardiol 48:1808–1812PubMedCrossRef Christ M, Laule-Kilian K, Hochholzer W et al (2006) Gender-specific risk stratification with B-type natriuretic peptide levels in patients with acute dyspnea: insights from the B-type natriuretic peptide for acute shortness of breath evaluation study. J Am Coll Cardiol 48:1808–1812PubMedCrossRef
30.
Zurück zum Zitat Harrison A, Morrison LK, Krishnaswamy P et al (2002) B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea. Ann Emerg Med 39:131–138PubMedCrossRef Harrison A, Morrison LK, Krishnaswamy P et al (2002) B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea. Ann Emerg Med 39:131–138PubMedCrossRef
31.
Zurück zum Zitat Anand IS, Fisher LD, Chiang YT et al (2003) Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT). Circulation 107:1278–1283PubMedCrossRef Anand IS, Fisher LD, Chiang YT et al (2003) Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT). Circulation 107:1278–1283PubMedCrossRef
32.
Zurück zum Zitat Wijeysundera HC, Hansen MS, Stanton E et al (2003) Neurohormones and oxidative stress in nonischemic cardiomyopathy: relationship to survival and the effect of treatment with amlodipine. Am Heart J 146:291–297PubMedCrossRef Wijeysundera HC, Hansen MS, Stanton E et al (2003) Neurohormones and oxidative stress in nonischemic cardiomyopathy: relationship to survival and the effect of treatment with amlodipine. Am Heart J 146:291–297PubMedCrossRef
33.
Zurück zum Zitat Ryder M, Murphy NF, McCaffrey D, O’Loughlin C, Ledwidge M, McDonald K (2008) Outpatient intravenous diuretic therapy; potential for marked reduction in hospitalisations for acute decompensated heart failure. Eur J Heart Fail 10:267–272PubMedCrossRef Ryder M, Murphy NF, McCaffrey D, O’Loughlin C, Ledwidge M, McDonald K (2008) Outpatient intravenous diuretic therapy; potential for marked reduction in hospitalisations for acute decompensated heart failure. Eur J Heart Fail 10:267–272PubMedCrossRef
34.
Zurück zum Zitat Conlon C, O’Loughlin C, Ledwidge M, McDonald K (2006) Community Direct Access Service for Early Detection and Treatment of Clinical Deterioration: Effectiveness and Impact on the Workload Pattern of a Hospital-Based Heart Failure Unit. Dis Manage Health Outcomes 14:185–190CrossRef Conlon C, O’Loughlin C, Ledwidge M, McDonald K (2006) Community Direct Access Service for Early Detection and Treatment of Clinical Deterioration: Effectiveness and Impact on the Workload Pattern of a Hospital-Based Heart Failure Unit. Dis Manage Health Outcomes 14:185–190CrossRef
35.
Zurück zum Zitat Miller WL, Hartman KA, Burritt MF et al (2007) Serial biomarker measurements in ambulatory patients with chronic heart failure: the importance of change over time. Circulation 116:249–257PubMedCrossRef Miller WL, Hartman KA, Burritt MF et al (2007) Serial biomarker measurements in ambulatory patients with chronic heart failure: the importance of change over time. Circulation 116:249–257PubMedCrossRef
36.
Zurück zum Zitat Bettencourt P, Frioes F, Azevedo A et al (2004) Prognostic information provided by serial measurements of brain natriuretic peptide in heart failure. Int J Cardiol 93:45–48PubMedCrossRef Bettencourt P, Frioes F, Azevedo A et al (2004) Prognostic information provided by serial measurements of brain natriuretic peptide in heart failure. Int J Cardiol 93:45–48PubMedCrossRef
37.
Zurück zum Zitat Masson S, Latini R, Anand IS et al (2008) Prognostic value of changes in N-terminal pro-brain natriuretic peptide in Val-HeFT (Valsartan Heart Failure Trial). J Am Coll Cardiol 52:997–1003PubMedCrossRef Masson S, Latini R, Anand IS et al (2008) Prognostic value of changes in N-terminal pro-brain natriuretic peptide in Val-HeFT (Valsartan Heart Failure Trial). J Am Coll Cardiol 52:997–1003PubMedCrossRef
38.
Zurück zum Zitat Maeder MT, Hack D, Rickli H et al (2008) Relevance of short-term variation of B-type natriuretic peptide in patients with clinically stable heart failure. Wien Klin Wochenschr 120:672–678PubMedCrossRef Maeder MT, Hack D, Rickli H et al (2008) Relevance of short-term variation of B-type natriuretic peptide in patients with clinically stable heart failure. Wien Klin Wochenschr 120:672–678PubMedCrossRef
39.
Zurück zum Zitat Pfisterer M, Buser P, Rickli H et al (2009) BNP-Guided vs Symptom-Guided Heart Failure Therapy The Trial of Intensified vs Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) Randomized Trial. JAMA 301:383–392PubMedCrossRef Pfisterer M, Buser P, Rickli H et al (2009) BNP-Guided vs Symptom-Guided Heart Failure Therapy The Trial of Intensified vs Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) Randomized Trial. JAMA 301:383–392PubMedCrossRef
Metadaten
Titel
Profiling B-type natriuretic peptide in a stable heart failure population: a valuable adjunct to care
verfasst von
A. Jan
N. F. Murphy
C. O’Loughlin
M. Ledwidge
K. McDonald
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 2/2011
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-011-0689-1

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