Relative Change in NT-proBNP Level: An Important Risk Predictor of Cardiovascular Congestion in Haemodialysis Patients.

Nephron Extra Pub Date : 2012-01-01 Epub Date: 2012-12-12 DOI:10.1159/000343897

M Pastural-Thaunat, R Ecochard, N Boumendjel, E Abdullah, C Cardozo, A Lenz, I M'pio, J C Szelag, D Fouque, A Walid, M Laville

{"title":"Relative Change in NT-proBNP Level: An Important Risk Predictor of Cardiovascular Congestion in Haemodialysis Patients.","authors":"M Pastural-Thaunat, R Ecochard, N Boumendjel, E Abdullah, C Cardozo, A Lenz, I M'pio, J C Szelag, D Fouque, A Walid, M Laville","doi":"10.1159/000343897","DOIUrl":null,"url":null,"abstract":"Background: Cross-sectional studies have shown that B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) are predictive of cardiovascular death in haemodialysis (HD) patients. In the present study, we tested the hypothesis that monitoring NT-proBNP measurements adds further prognostic information, i.e. predicts congestive heart failure (CHF) events.Methods: In a prospective cohort of 236 HD patients, NT-proBNP levels were measured monthly during 18 months. Patients were divided according to the occurrence of CHF events. In a nested case-control study, we assessed the evolution of NT-proBNP levels.Results: On average, the 236 HD patients were followed up for 12.5 months, a period during which 44 patients developed a CHF event (half requiring hospitalisation). At baseline, patients who developed a CHF event had significantly more dilated cardiomyopathy and/or altered left ventricular ejection fraction and higher NT-proBNP levels compared with patients who did not develop a CHF event. During follow-up, we observed a significant increase in NT-proBNP levels preceding the CHF event. At a 20% relative increase of NT-proBNP, the sensitivity of NT-proBNP as a predictor of CHF events was 0.57 and the specificity 0.77.Conclusion: The relative change in NT-proBNP levels is a significant risk predictor of a CHF event.","PeriodicalId":56356,"journal":{"name":"Nephron Extra","volume":"2 1","pages":"311-8"},"PeriodicalIF":0.0000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000343897","citationCount":"7","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nephron Extra","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000343897","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2012/12/12 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 7

Abstract

Background: Cross-sectional studies have shown that B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) are predictive of cardiovascular death in haemodialysis (HD) patients. In the present study, we tested the hypothesis that monitoring NT-proBNP measurements adds further prognostic information, i.e. predicts congestive heart failure (CHF) events.

Methods: In a prospective cohort of 236 HD patients, NT-proBNP levels were measured monthly during 18 months. Patients were divided according to the occurrence of CHF events. In a nested case-control study, we assessed the evolution of NT-proBNP levels.

Results: On average, the 236 HD patients were followed up for 12.5 months, a period during which 44 patients developed a CHF event (half requiring hospitalisation). At baseline, patients who developed a CHF event had significantly more dilated cardiomyopathy and/or altered left ventricular ejection fraction and higher NT-proBNP levels compared with patients who did not develop a CHF event. During follow-up, we observed a significant increase in NT-proBNP levels preceding the CHF event. At a 20% relative increase of NT-proBNP, the sensitivity of NT-proBNP as a predictor of CHF events was 0.57 and the specificity 0.77.

Conclusion: The relative change in NT-proBNP levels is a significant risk predictor of a CHF event.

Abstract Image

查看原文本刊更多论文

NT-proBNP水平的相对变化:血液透析患者心血管充血的重要风险预测因子。

背景:横断面研究表明，b型利钠肽(BNP)及其n端片段(NT-proBNP)可预测血液透析(HD)患者的心血管死亡。在本研究中，我们检验了这样一个假设，即监测NT-proBNP测量增加了进一步的预后信息，即预测充血性心力衰竭(CHF)事件。方法:在236例HD患者的前瞻性队列中，在18个月内每月测量NT-proBNP水平。根据CHF事件的发生情况对患者进行分组。在一项巢式病例对照研究中，我们评估了NT-proBNP水平的演变。结果:236例HD患者平均随访12.5个月，在此期间44例患者发生了CHF事件(一半需要住院治疗)。在基线时，与未发生CHF事件的患者相比，发生CHF事件的患者有明显更多的扩张性心肌病和/或左心室射血分数改变，NT-proBNP水平更高。在随访期间，我们观察到在CHF事件发生前NT-proBNP水平显著升高。NT-proBNP相对增加20%时，NT-proBNP作为CHF事件预测因子的敏感性为0.57，特异性为0.77。结论:NT-proBNP水平的相对变化是CHF事件的重要风险预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nephron Extra

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： An open-access subjournal to Nephron. ''Nephron EXTRA'' publishes additional high-quality articles that cannot be published in the main journal ''Nephron'' due to space limitations.