High Intraindividual Variation of N-Terminal Pro–B-Type Natriuretic Peptide in Urine of Patients with Stable Chronic Heart Failure: Comparison with Plasma
| Autor: | Rick N. Steward, Anneliene M. Schimmel, Frits A. J. Muskiet, Jeroen W.P. Römer, Maaike Barents, Mike J.L. de Jongste |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Plasma samples business.industry Biochemistry (medical) Clinical Biochemistry Prohormone Significant difference Pulsatile flow Urine 030204 cardiovascular system & hematology Brain natriuretic peptide medicine.disease 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Endocrinology Heart failure Internal medicine medicine Cardiology N terminal pro b type natriuretic peptide business medicine.drug |
| Zdroj: | Clinical Chemistry, 62(2), 407-408. AMER ASSOC CLINICAL CHEMISTRY |
| ISSN: | 1530-8561 0009-9147 |
| DOI: | 10.1373/clinchem.2015.242909 |
| Popis: | Metaanalyses have revealed that natriuretic peptide–guided therapy is superior to symptom-guided therapy in groups of patients with chronic heart failure (HF)1 (1). However, the large intraindividual CV (CVi) of plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNPp) precludes its applicability for guided therapy optimization in the individual chronic HF patient (2). Natriuretic peptides are secreted in a pulsatile manner (3). These pulses may attenuate by measuring NT-proBNP in urine (NT-proBNPu). A statistically significant difference between pre- and posttreatment NT-proBNP requires comparison with the reference change value (RCV), usually calculated from 2.8 × the total variation (CVt). For NT-proBNPp, CVt mostly comprises CVi and less analytical variation (CVa) (2). CVi reflects natural fluctuations of NT-proBNP in a stable situation. We collected corresponding plasma samples and urine portions according to within-day, day-to-day, and week-to-week protocols similar to those previously described (2). To study whether measurement of NT-proBNPu is superior to that of NT-proBNPp for treatment optimization in individual chronic HF patients, we compared RCVs of NT-proBNP in urine and plasma from stable chronic HF patients living in Curacao. The Medical Ethics Committee of the St. Elisabeth Hospital in Curacao approved the study, which also conformed to … |
| Databáze: | OpenAIRE |
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