NT-proBNP Concentration and Early Cardiac Dysfunction in Patients Receiving Dialysis: A Prospective Cohort Study

Autor:	Elaine M. Pascoe, Yeoungjee Cho, Magid Fahim, Wen-ling Yang, Carmel M. Hawley, David W. Johnson
Rok vydání:	2020
Předmět:	Cardiac function curve medicine.medical_specialty medicine.drug_class Urology medicine.medical_treatment 030232 urology & nephrology 030204 cardiovascular system & hematology Cohort Studies Ventricular Dysfunction Left 03 medical and health sciences 0302 clinical medicine Renal Dialysis Internal medicine Natriuretic Peptide Brain medicine Natriuretic peptide Humans Prospective Studies cardiovascular diseases Prospective cohort study Dialysis Ejection fraction business.industry medicine.disease Peptide Fragments Confidence interval Heart failure Cardiology Cardiology and Cardiovascular Medicine business Cohort study
Zdroj:	Cardiorenal Medicine. 10:323-332
ISSN:	1664-5502 1664-3828
DOI:	10.1159/000507388
Popis:	Introduction: The significance of N-terminal pro-B type natriuretic peptide (NT-proBNP) to detect heart failure in patients with end-stage kidney diseases on dialysis is controversial. Objective: To assess whether serial measurements of NT-proBNP can predict worsening cardiac function in dialysis patients. Methods: In this prospective, longitudinal, observational cohort study, the relationship between changes in monthly plasma NT-proBNP concentrations and changes in echocardiographic indices (left ventricular global longitudinal strain [GLS] and ejection fraction [LVEF]) were analyzed in dialysis patients without symptoms of heart failure over 24 months using multilevel mixed effects models. Results: The study included 40 dialysis patients who were followed for a median period of 24 months. Logarithmically transformed baseline plasma NT-proBNP levels were correlated positively with GLS (r = 0.48, p = 0.002) and negatively with LVEF (r = –0.44, p = 0.005). Time-averaged and maximum NT-proBNP values during the echocardiogram intervals were significantly correlated with GLS and LVEF over time. Every 1-unit increase in average NT-proBNP level during the echocardiogram interval was associated with a 0.99 (95% confidence interval, 0.41–1.56) higher GLS (%) and 2.90 (1.22–4.57) lower LVEF (%). Every 1-unit increase in maximum NT-proBNP level was associated with a 0.90 (0.35–1.45) higher GLS (%) and 2.67 (1.03–4.30) lower LVEF (%). This increase in GLS indicates a reduction in systolic performance. Conclusions: Our cohort study demonstrated that serial plasma NT-proBNP concentrations may be useful for early identification of individuals with worsening cardiac function over time.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc0982632e1a50c2e646b04bff2ba412 https://doi.org/10.1159/000507388 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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