scholarly journals C-Reactive Protein and N-Terminal Pro-brain Natriuretic Peptide Levels Correlate With Impaired Cardiorespiratory Fitness in Patients With Heart Failure Across a Wide Range of Ejection Fraction

2018 ◽  
Vol 5 ◽  
Author(s):  
Jessie van Wezenbeek ◽  
Justin M. Canada ◽  
Krishna Ravindra ◽  
Salvatore Carbone ◽  
Cory R. Trankle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiorespiratory Fitness ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Wide Range ◽  
Patients With Heart Failure

Abstract 12849: Changes in N-terminal Pro Brain Natriuretic Peptide Levels Predicts Mortality and Heart Failure Hospitalization in Patients With Heart Failure and Preserved Ejection Fraction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Gianluigi Savarese ◽  
Camilla Hage ◽  
Ulf Dahlström ◽  
Pasquale Perrone-Filardi ◽  
Lars H Lund
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Total Mortality ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Impact

Introduction: Changes in N-terminal pro brain natriuretic peptide (NT-proBNP) have been demonstrated to correlate with outcomes in patients with heart failure (HF) and reduced ejection fraction (EF). However the prognostic value of a change in NT-proBNP in patients with heart failure and preserved ejection fraction (HFPEF) is unknown. Hypothesis: To assess the impact of changes in NT-proBNP on all-cause mortality, HF hospitalization and their composite in an unselected population of patients with HFPEF. Methods: 643 outpatients (age 72+12 years; 41% females) with HFPEF (ejection fraction ≥40%) enrolled in the Swedish Heart Failure Registry between 2005 and 2012 and reporting NT-proBNP levels assessment at initial registration and at follow-up were prospectively studied. Patients were divided into 2 groups according the median value of NT-proBNP absolute change that was 0 pg/ml. Median follow-up from first measurement was 2.25 years (IQR: 1.43 to 3.81). Adjusted Cox’s regression models were performed using total mortality, HF hospitalization (with censoring at death) and their composite as outcomes. Results: After adjustments for 19 baseline variables including baseline NT-proBNP, as compared with an increase in NT-proBNP levels at 6 months (NT-proBNP change>0 pg/ml), a reduction in NT-proBNP levels (NT-proBNP change<0 pg/ml) was associated with a 45.2% reduction in risk of all-cause death (HR: 0.548; 95% CI: 0.378 to 0.796; p:0.002), a 50.1% reduction in risk of HF hospitalization (HR: 0.49; 95% CI: 0.362 to 0.689; p<0.001) and a 42.6% reduction in risk of the composite outcome (HR: 0.574; 95% CI: 0.435 to 0.758; p<0.001)(Figure). Conclusions: Reductions in NT-proBNP levels over time are independently associated with an improved prognosis in HFPEF patients. Changes in NT-proBNP could represent a surrogate outcome in phase 2 HFPEF trials.

scholarly journals Comparative efficacy of enalapril and valsartan in heart failure with mid-range ejection fraction

2021 ◽  
Vol 102 (5) ◽  
pp. 614-620
Author(s):  
T. A. Glebova ◽  
P. Yu Galin
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Natriuretic Peptide Level ◽  
Patients With Heart Failure ◽  
Peptide Level ◽  
Minute Walk

Aim. To compare the effectiveness of the angiotensin-converting enzyme inhibitor enalapril and the angiotensin II receptor antagonist valsartan in patients with heart failure with mid-range ejection fraction (HFmrEF) from the standpoint of the effect on the clinical picture, echocardiographic parameters and the level of the N-terminal fragment of the prohormone brain-type sodium (NT-proBNP). Methods. 110 patients with heart failure with mid-range ejection fraction were included in the study based on the City Clinical Hospital named after N.I. Pirogov of Orenburg between 2018 and 2020. All patients were divided into two randomized groups. Patients of the first group (n=55) were prescribed enalapril, the second group (n=55) valsartan. Each patient was followed up for 1 year. The six-minute walk test, NT-pro-brain natriuretic peptide level, echocardiography parameters were assessed in dynamics. Statistical analysis was performed by using Statistica 10.0 software, ShapiroWilk, MannWhitney, Wilcoxon tests. Results. During the year of observation in both groups, there was a significant decrease in the functional class of chronic heart failure (p 0.005) without a statistical difference between the groups (p=0.251). The distance during the six-minute walk test increased from 350 (310400) m to 490 (420530) m (p 0.001) in the first group, from 360 (330400) m to 510 (450520) m (p 0.001) in the second group, also without significant differences (p=0.361). The NT-pro-brain natriuretic peptide level decreased from 491 (410610) pg/ml to 286 (187350) pg/ml (p 0.001) in the first group, and from 446 (376534) pg/ml to 210 (143343) pg/ml (p 0.001) in the second, with a more significant change in the second group (p=0.020). The dynamics of echocardiography parameters were comparable in the groups (p 0.05), while ejection fraction normalized in 89.1% of patients received enalapril and 92.7% of patients received valsartan. Conclusion. The efficacy of enalapril and valsartan in heart failure with mid-range ejection fraction is comparable in its effect on the clinical picture and echocardiography parameters with a more pronounced decrease in NT-pro-brain natriuretic peptide when taking valsartan during a year of follow up.

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