B-type natriuretic hormone – the diagnostic and prognostic cardiovascular biomarker

2007 ◽  
Vol 148 (5) ◽  
pp. 217-221 ◽  
Author(s):  
Mária Lengyel
Keyword(s):  
Heart Failure ◽  
Hormone Level ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Therapeutic Modality ◽  
Natriuretic Hormone ◽  
High Brain ◽  
Cardiovascular Biomarker ◽  
Near Future ◽  
Rule Out

Brain natriuretic hormone and N-terminal-probrain natriuretic hormone are equally important cardiovascular biomarkers. Moderately increased brain natriuretic hormone level is a reliable predictor of preclinical, asymptomatic left ventricular dysfunction. Low brain natriuretic hormone levels are extensively used to rule out acute heart failure. Increased brain natriuretic hormone is associated to age, left ventricular hypertrophy, left atrial volume, atrial fibrillation, myocardial ischemia, renal failure, pulmonary hypertension, acute pulmonary embolism and progressive aortic stenosis. In chronic heart failure only high brain natriuretic hormone values support the diagnosis. High brain natriuretic hormone level, however, is an important overall cardiovascular prognostic biomarker. In the near future brain natriuretic hormone appears to be an interesting new therapeutic modality.

scholarly journals Features of the relationship between the parameters of left ventricular mechanics and the level of biomarkers of heart failure in patients with epicardial obesity

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
O Gritsenko ◽  
GA Chumakova
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Speckle Tracking ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Serum Biomarker ◽  
Volume Index ◽  
Time To Peak ◽  
Ventricular Mechanics ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: None. Currently, there is no serum biomarker that is a marker of the presence of heart failure (HF) at an early stage. It is also shown that the traditional indicators used for the diagnosis diastolic dysfunction (DD) of left ventricular (LV) using echocardiography (ECG) are not informative enough. Thus, it is currently relevant to study new serum biomarkers of DD, such as sST2, as well as to study the mechanics of LV. Objective to study the relationship between mechanics of LV and the level of sST2 (bioamarker of HF) in patients with epicardial obesity (EO). Materials and methods The study included 110 men with general obesity. According to the results of echocardiography (ECG), patients were divided into 2 groups: EO (+) with epicardial fat thickness (tEAT) ≥7 mm (n = 70); EO (-) with tEAT <7 mm (n = 40) without diastolic dysfunction according to the results of ECG. All patients were assessed for sST2 and NT-pro-BNP levels using enzyme immunoassay. Using speckle-tracking ECG, the mechanics of LV were studied (twist LV, peak twist ratio LV, time to peak twist of LV, peak untwist ratio LV, time to peak untwist of LV). The exclusion criteria were the presence of coronary pathology, arterial hypertension, and type 2 diabetes mellitus. Results In the group patients with EO ( + ) a statistically significant increase in the level of sST2 was revealed in comparison with the group of EO (-) [21,55 ng/ml (26,52; 15,40) and 9.89 ng/ml (11.12; 7.95); p = 0.001, respectively], while the levels of NT-pro-BNP in both groups were not statistically different [211.36 pg / ml (254.0; 156.0) and 204.81 pg / ml (268.0; 157.0), respectively, p = 0.85]. When determining the parameters of DD LV by ECG, there were no statistical differences between the EO (+) and EO (-) groups [e ", cm / sec 0.09 (0.11; 0.09) and 0.09 (0.11; 0.09), respectively, p = 0.63; E/e " , units, 7.80 (8.90; 6.55) in the EO (+) and 8.53 (9.70; 7.20) in the EO group ( - ), p = 0.08; left atrial volume index, ml / sq2, in the EO group (+) 28.39 (31.25; 24.17) and in the EO group(-) 27,82 (30,21; 25,66), p = 0.55; in the EO group ( + ), the maximum speed of tricuspid regurgitation, m / sec, is 2.78 (2.9; 2.58) in the EO group(-) 2,67 (2,87; 2,41), p = 0.13]. According to the results of speckle-tracking ECG in the EO (+) group, an increase peak untwist ratio LV to -128.31 (-142.0; -118.0) deg/s-1 (p = 0.002) and an increase time to peak untwist of LV of 476.44 (510.0; 411.0) msec was determined in comparison with the EO ( - ) group (p = 0.03). A significant relationship between peak untwist ratio LV and sST2 was revealed (r = 0.37; p = 0.02). Conclusion Thus, it can be assumed that patients with EO have DD LV at the preclinical stage, which is not diagnosed using traditional ECG indicators. The serum biomarker sST2 is an early marker of the presence of HF.

P624The prognostic value of myocardial deformation in patients with congenital aortic stenosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R W J Van Grootel ◽  
A T Van Den Hoven ◽  
D Bowen ◽  
T Ris ◽  
J W Roos-Hesselink ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Prognostic Value ◽  
Nyha Class ◽  
Global Longitudinal Strain ◽  
Multivariable Analysis ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Congenital Aortic Stenosis

Abstract Background Congenital aortic stenosis (AoS) is associated with significant mortality and morbidity but predictors for clinical outcome are scarce. Strain analysis provides a robust and reproducible method for early detection of left ventricular (LV) dysfunction, which might be of prognostic value. Therefore we aimed to assess the prognostic value of LV global longitudinal strain (GLS) and global longitudinal early diastolic strain rate (GLSre) with regard to cardiovascular events. Methods This prospective study, included clinically stable patients with congenital AoS between 2011–2013. LV GLS and GLSre was performed in the apical 4, 3 and 2-chamber views using Tomtec software. The endpoint was a composite of death, heart failure, hospitalization, arrhythmia, thrombo-embolic events and re-intervention. Results In total 138 patients were included (33 [26–43] years, 86 (62%) male), NYHA class I: 134 (97%). Mean LV GLS was −15.3±3.2%, GLSre 0.66±0.18 s–1. Both correlated with NT-proBNP, LV volumes and ejection fraction (strongest LV GLS with LV EF: r −0.539, p<0.001, strongest LV GLSre with age: r −0.376 p<0.001). During median follow-up of 5.9 [5.5–6.2] years, the endpoint occurred in 53 (38%) patients: 4 patients died, 9 developed heart failure, 22 arrhythmias, 8 thrombo-embolic events and 35 re-interventions. Both LV GLS (standardized HR (sHR 0.62 (95% CI 0.47–0.81) and GLSre (sHR 0.62 (95% CI 0.47–0.83) were associated with the endpoint. Additional multivariable analysis showed that both GLS and GLSre were associated independent of left atrial volume, NT-proBNP and prior re-interventions. Figure 1 Conclusion Left ventricular GLS and GLSre are reduced in adult patients with congenital AoS. Both markers are associated with adverse cardiac events and have clear clinical relevance Acknowledgement/Funding Erasmus Thorax Foundation

scholarly journals Chloroquine Decreases Cardiomyocyte Autophagy and Improves Cardiac Function in a Mouse Model of Duchenne Muscular Dystrophy

2021 ◽  
Author(s):  
Takaya Hirata ◽  
Shiro Baba ◽  
Kentaro Akagi ◽  
Daisuke Yoshinaga ◽  
Katsutsugu Umeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Left Ventricular ◽  
Muscle Disease ◽  
Therapeutic Modality ◽  
Cardiomyocyte Autophagy ◽  
And Function ◽  
Ventricle Size

Abstract Background: Duchenne muscular dystrophy (DMD), a severe degenerative skeletal and cardiac muscle disease, has a poor prognosis, and no curative treatments are available. Because autophagy has been reported to contribute to skeletal muscle degeneration, therapies targeting autophagy are expected to improve skeletal muscle hypofunction. However, the role of this regulatory mechanism has not been evaluated clearly in DMD cardiomyocytes. Methods: In the present study, we demonstrated that autophagy was enhanced in the cardiomyocytes of mdx mice, a model of DMD, and that increased autophagy contributed to the development of cardiomyopathy in this context. Results: As assessed by GFP-mRFP-LC3 transfection, autophagosomes were more abundant in cardiomyocytes of mdx mice compared with control wild-type (WT) mice. The number of autophagosomes was significantly enhanced by isoproterenol-induced cardiac stress (4 weeks) in cardiomyocytes of mdx but not WT mice. Simultaneously, isoproterenol increased cardiomyocyte fibrosis in mdx but not WT mice. Administration of chloroquine, an autophagy inhibitor, significantly decreased cardiomyocyte autophagy and fibrosis in mdx mice, even after isoproterenol treatment. Left ventricle size and function were evaluated by echocardiography. Left ventricular contraction was decreased in mdx mice after isoproterenol treatment compared with control mice, which was alleviated by chloroquine administration.Conclusions: These findings suggested that heart failure of DMD could be associated with autophagy. Therefore, autophagy inhibitors, such as chloroquine, are a potential therapeutic modality for heart failure in DMD patients.

Percutaneous catheter ablation of atrial fibrillation in heart failure

2018 ◽  
Vol 3 (48) ◽  
pp. 8-11
Author(s):  
Monika Kozieł ◽  
Patrycja Pruszkowska ◽  
Jakub Gumprecht ◽  
Oskar Kowalski ◽  
Zbigniew Kalarus
Keyword(s):  
Heart Failure ◽  
Catheter Ablation ◽  
Ejection Fraction ◽  
Complication Rate ◽  
Left Ventricular ◽  
Therapeutic Modality ◽  
Left Ventricular Ejection ◽  
Level Of Evidence ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction

Catheter ablation of AF has transformed from a specialized, experimental procedure into a common treatment to prevent recurrent AF. AF ablation appears to be more effective than AAD in maintaining sinus rhythm, and the complication rate is comparable to the complication rate of AAD. According to the European Society of Cardiology catheter ablation of symptomatic paroxysmal AF is recommended to decrease AF symptoms in patients who have symptomatic recurrences of AF on AAD and who prefer further rhythm control strategy (I class of recommendation, level of evidence A). Catheter ablation, compared with AAD significantly decreases recurrent AF in AF patients with heart failure with reduced ejection fraction. Some trials suggest reduced hospitalizations and mortality. However, indications for catheter ablation in HF patients should be wisely balanced and the procedures performed in experiences centers. Beyond AF recurrence, catheter ablation of AF in HF tends to be associated with improvement in left ventricular ejection fraction, exercise performance and quality of life. The method mentioned above appears to be increasingly employed as a therapeutic modality in patients with HF and AF.

The Effect of Angiotensin Receptor Inhibitors and Neprilysin on Aortic Stiffness in Patients with Heart Failure and Reduced Ejection Fraction

2021 ◽  
Vol 76 (3) ◽  
pp. 298-306
Author(s):  
Alexey S. Ryazanov ◽  
Evgenia V. Shikh ◽  
Konstantin I. Kapitonov ◽  
Mariya V. Makarovskaya ◽  
Alexey A. Kudryavtsev
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Aortic Stiffness ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Atrial Volume Index ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

Background. Compared with enalapril, sacubitril/valsartan reduces mortality from cardiovascular diseases and the number of hospitalizations for heart failure in patients with heart failure and reduced ejection fraction (HFrEF). These benefits may be related to effects on hemodynamics and cardiac remodeling. The aim of the study is to determine the effect of sacubitril/valsartan on aortic stiffness and cardiac remodeling compared with enalapril in HFrEF. Materials and methods. In this long-term outpatient study, 100 patients with HFrEF received sacubitril/valsartan or enalapril. The primary endpoint was the change in arterial impedance (aortic stiffness characteristic) over a 12-month follow-up. Secondary endpoints included changes in N-terminal cerebral natriuretic propeptide (NT-proBNP), ejection fraction, left atrial volume index, E/e index, left ventricular end-systolic and end-diastolic volumes; left ventricular-arterial index (Ea/Ees). Results. During 12 months of follow-up, 100 patients showed significant differences between the groups with respect to changes in arterial impedance, which decreased from 224.0 to 207.9 dynes s/ cm5 in the sacubitrile/valsartan group and increased from 213.5 to 214.1 dyne s/cm5 in the enalapril group (difference between groups: 9.3 dynes s/ cm5; 95% CI: from 16.9 to 12.8 dynes s/cm5; p = 0.69). Also, there were intergroup differences in the change in left ventricular ejection fraction and Ea/Ees index. NT-proBNP level, left ventricular end-diastolic and systolic volume index, left atrial volume index, E/e index were reduced in the sacubitril/valsartan group. Conclusions. Treatment with sacubitril/valsartan compared with enalapril resulted in a significant reduction in aortic stiffness in HFrEF.

scholarly journals Reduced left ventricular dimension and normalized atrial natriuretic hormone level after repair of aortic coarctation in an adult

1999 ◽  
Vol 22 (3) ◽  
pp. 233-235 ◽  
Author(s):  
Daniel F. Pauly ◽  
Sydney E. Morss ◽  
Jennifer W. Tanio ◽  
Kaikobad Irani ◽  
Duke E. Cameron ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Hormone Level ◽  
Left Ventricular ◽  
Natriuretic Hormone ◽  
Left Ventricular Dimension ◽  
Atrial Natriuretic Hormone ◽  
Ventricular Dimension ◽  
Atrial Natriuretic
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