ABSTRACT
INTRODUCTION AND OBJECTIVES: NT-proBNP is useful in the diagnosis of heart failure and ventricular dysfunction. Left atrioventricular plane displacement (AVPD) is a consolidated index of ventricular function. Our objective was to carry out a multicenter population-based study to establish the relationship between plasma NT-proBNP levels with AVPD values. PATIENTS AND METHOD: We studied 215 subjects (age 66 9 years; 57.7% women) chosen from a random sample of 432 people from the Community of Valencia, who previously reported suffering from some degree of dyspnea. Doppler echocardiography was done, AVPD was calculated and plasma NT-proBNP concentrations were determined. All studies were completed in 194 patients. RESULTS: For the whole population NT-proBNP was 88 (0-2,586) pg/ml and AVPD was 11.9 1.6 mm. NT-proBNP concentration correlated well with AVPD (r = 0.44; p < 0.00001), and higher peptide levels were obtained in AVPD quartiles that indicated less displacement (p < 0.05). When NT-proBNP values were grouped according to their association with AVPD lower or higher than the 50th percentile AVPD, the difference was significant at p < 0.01. When AVPD values lower and higher than 10 mm were compared, NT-proBNP values were higher in persons with AVPD lower than 10 mm (p < 0.05). CONCLUSIONS: This population study found higher NT-proBNP concentrations in subjects with lower AVPD, and illustrates the potential diagnostic usefulness of NT-proBNP in clinical practice.
Subject(s)
Heart Failure/blood , Nerve Tissue Proteins/blood , Peptide Fragments/blood , Protein Precursors/blood , Ventricular Dysfunction, Left/blood , Aged , Cross-Sectional Studies , Echocardiography, Doppler, Color , Female , Heart Failure/diagnostic imaging , Humans , Male , Natriuretic Peptide, Brain , Reproducibility of Results , Sensitivity and Specificity , Ventricular Dysfunction, Left/diagnostic imagingABSTRACT
Introducción y objetivos. El N-terminal propéptido natriurético cerebral (NT-proBNP) es útil en el diagnóstico de la insuficiencia cardíaca y la disfunción ventricular. El desplazamiento del plano auriculoventricular (DPAV) es un índice consolidado de la función ventricular. Nuestro objetivo es relacionar en un estudio multicéntrico poblacional los valores plasmáticos del NT-proBNP y los valores del DPAV. Pacientes y método. Estudiamos a 215 sujetos (edad, 66 ñ 9 años; un 57,7 por ciento, mujeres) obtenidos de una muestra aleatoria de 432 personas de la Comunidad Valenciana que previamente declararon sufrir algún grado de disnea. Se realizó un estudio con eco-Doppler, se midió el DPAV y se determinó el valor plasmático de NTproBNP. El estudio se completó en 194 pacientes. Resultados. Para toda la población, el valor de NTproBNP fue de 88 pg/ml (rango, 0-2.586 pg/ml) y el valor del DPAV fue de 11,9 ñ 1,6 mm. Las concentraciones del péptido natriurético muestran una correlación con los valores del DPAV (r = 0,44; p < 0,00001) y su valores más elevados se observan en los cuartiles del DPAV con menor desplazamiento (p < 0,05). Cuando agrupamos los valores del NT-proBNP en menor o mayor del percentil 50 del DPAV, obtuvimos un valor de p < 0,01. Si dividimos el DPAV en mayor o menor de 10 mm, los valores de NT-proBNP son más elevados en los sujetos con DPAV menor de 10 mm (p < 0,05).Conclusiones. Este estudio poblacional muestra valores más altos de NT-proBNP en sujetos con un desplazamiento menor del plano auriculoventricular, y pone de manifiesto su potencial diagnóstico en la práctica clínica (AU)
Subject(s)
Aged , Male , Female , Humans , Sensitivity and Specificity , Reproducibility of Results , Ventricular Dysfunction, Left , Echocardiography, Doppler, Color , Peptide Fragments , Nerve Tissue Proteins , Protein Precursors , Cross-Sectional Studies , Heart FailureABSTRACT
AIMS: Proinflammatory cytokines are important mediators for the development of heart failure and increased plasma levels of these cytokines have been reported in patients with this condition. The purpose of the study was to investigate whether urine, a non-invasively obtained biological sample, was an appropriate medium in which to measure the concentration of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in patients in the advanced stages of the disease. METHODS AND RESULTS: Thirty consecutive patients who had severe congestive heart failure (NYHA classes III and IV) and 30 matched healthy control subjects were enrolled. Plasma and the first urine of the day were collected and TNF-alpha and IL-6 were quantitatively analyzed by enzyme-linked immunosorbent assays. For every subject there were no differences in the amount of cytokine determined in plasma and urine. Both urine and plasma levels of IL-6 and TNF-alpha were greater in heart failure patients than in controls. CONCLUSION: Our results show that plasmatic and urinary levels of proinflammatory cytokines did not differ significantly. Thus, urine may be a good milieu in which to study these cytokines and may have diagnostic, prognostic and therapeutic implications.
