ABSTRACT
BACKGROUND: Brain natriuretic peptide (BNP) is produced and released mainly from ventricles. It has several physiological actions. BNP has been shown to be useful for diagnosis and prognosis in heart failure. The aim of this study is to analyse NT-proBNP levels in chronic obstructive pulmonary disease (COPD) patients and to distinguish factors which could modify these levels. PATIENTS AND METHODS: A descriptive and prospective study was made. COPD patients admitted due to acute exacerbation of this disease at the Hospital Universitario Lozano Blesa (Zaragoza, Spain) were included from November 1st 2004 to May 1st 2007. We included 99 patients; they had not suffered heart failure and they did not present any exclusion criteria. Blood samples were taken to determine NT-proBNP concentrations. RESULTS: Mean age was 74 years and 79% of patients were men. Medium value of NT-proBNP was 1289 pg/ml. Mean body mass index (BMI) was 27.19. There were significant differences between NT-proBNP in patients with or without atrial fibrillation and depending on their age, but there were no differences between men and women nor between patients with or without renal insufficiency. CONCLUSION: COPD patients present high serum levels of NT-proBNP during acute exacerbations and these are modified with age and atrial fibrillation. NT-proBNP could be a prognostic factor identifying COPD patients at special risk, or with a worsening clinical evolution.
Subject(s)
Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Pulmonary Disease, Chronic Obstructive/blood , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Introducción. El péptido natriurético cerebral (BNP) esun péptido de producción fundamentalmente ventricular,con múltiples acciones fisiológicas, cuyo principaluso clínico es el diagnóstico y estratificación pronósticade la insuficiencia cardiaca. El presente trabajo tienepor objeto analizar las concentraciones de NT-proBNPen una población con enfermedad pulmonar obstructivacrónica (EPOC) y su correlación con algunos parámetrosque las modifican en condiciones normales.Material y métodos. Estudio descriptivo, prospectivo, enel que se incluyeron de forma consecutiva pacientes conEPOC ingresados en el servicio de Medicina Interna delH.C.U. Lozano Blesa de Zaragoza, del 1 de noviembre de2004 al 1 de mayo de 2007, por una reagudización de su enfermedad,sin insuficiencia cardiaca y sin criterios de exclusión.Se incluyeron 99 pacientes, a los que se les extrajosangre en las primeras 72 horas para analizar NT-proBNP.Resultados. La edad media fue de 74 años, el 79% fueronhombres. El valor medio del NT-proBNP fue de 1.289 pg/ml. El índice de masa corporal (IMC) medio fue de 27,19.Se encontraron diferencias estadísticamente significativasen las concentraciones de NT-proBNP en relacióncon la presencia o ausencia de fibrilación auricular yla edad, pero no hubo modificaciones con relación alsexo, IMC o la presencia de insuficiencia renal.Conclusiones. Los pacientes con EPOC presentan concentracioneselevadas de NT-proBNP durante las reagudizaciones,que se modifican en función de la edad y de lacoexistencia o no de fibrilación auricular. Ello podría tenerun valor pronóstico, constituyendo una herramienta deselección de los pacientes de riesgo o con peor evolución(AU)
Background. Brain natriuretic peptide (BNP) is producedand released mainly from ventricles. It has severalphysiological actions. BNP has been shown to be usefulfor diagnosis and prognosis in heart failure. The aimof this study is to analyse NT-proBNP levels in chronicobstructive pulmonary disease (COPD) patients and todistinguish factors which could modify these levels.Patients and methods. A descriptive and prospectivestudy was made. COPD patients admitted due to acuteexacerbation of this disease at the Hospital UniversitarioLozano Blesa (Zaragoza, Spain) were included fromNovember 1st 2004 to May 1st 2007. We included 99 patients;they had not suffered heart failure and they didnot present any exclusion criteria. Blood samples weretaken to determine NT-proBNP concentrations.Results. Mean age was 74 years and 79% of patientswere men. Medium value of NT-proBNP was 1289 pg/ml. Mean body mass index (BMI) was 27.19. There weresignificant differences between NT-proBNP in patientswith or without atrial fibrillation and depending ontheir age, but there were no differences between menand women nor between patients with or without renalinsufficiency.Conclusion. COPD patients present high serum levelsof NT-proBNP during acute exacerbations and theseare modified with age and atrial fibrillation. NT-proBNPcould be a prognostic factor identifying COPD patientsat special risk, or with a worsening clinical evolution(AU)
Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/physiopathology , Natriuretic Peptide, Brain/analysis , Prospective Studies , Atrial Fibrillation/complications , Risk Factors , Heart Failure/physiopathologySubject(s)
Hernia, Diaphragmatic/diagnostic imaging , Aged , Humans , Male , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Aged , Humans , Emphysematous Cholecystitis/diagnosis , Emphysematous Cholecystitis/surgery , Lithiasis/complications , Lithiasis/pathology , Emphysematous Cholecystitis , Radiography, Abdominal , Piperacillin/administration & dosage , Piperacillin/therapeutic useABSTRACT
We report a postpericardiotomy syndrome (PS) following the implantation of endovenous pacemaker in a 78-year-old woman. Ten more single cases were reported in the medical literature since 1975. The infrequent single reports and the high complication rate are in contrast with the 4,6% occurrence and the benign course of acute pericarditis following the insertion of endovenous pacemakers in 126 consecutive patients. This sort of PS is probably underdiagnosed and the cases reported represent the more severe clinical presentations. A higher suspicion index would improve the diagnosis and management.
Subject(s)
Pacemaker, Artificial , Pericardiectomy/adverse effects , Prosthesis Implantation/adverse effects , Aged , Female , Humans , Pericardial Effusion/etiology , Pericarditis/etiologyABSTRACT
Presentamos un caso de síndrome postpericardiotomía tras la implantación de un marcapasos endovenoso (SPIV) en una mujer de 78 años y revisamos la experiencia publicada. Desde 1975 se han publicado en la literatura médica diez casos más de SPIV. La escasez de casos publicados y la alta tasa de complicaciones contrastan con la elevada prevalencia (4.6%) y el curso benigno de las pericarditis agudas tras la inserción de marcapasos endovenosos en una serie de 126 pacientes consecutivos. Esta clase de SPIV está probablemente infradiagnosticada y los casos publicados probablemente representan solo las formas clínicas más graves. Un alto índice de sospecha debería mejorar su diagnóstico y tratamiento
We report a postpericardiotomy syndrome (PS) following the implantation of endovenous pacemaker in a 78-year-old woman. Ten more single cases were reported in the medical literature since 1975. The infrequent single reports and the high complication rate are in contrast with the 4,6% occurrence and the benign course of acute pericarditis following the insertion of endovenous pacemakers in 126 consecutive patients. This sort of PS is probably underdiagnosed and the cases reported represent the more severe clinical presentations. A higher suspicion index would improve the diagnosis and management
Subject(s)
Female , Aged , Humans , Pacemaker, Artificial/adverse effects , Pericardiectomy/adverse effects , Postpericardiotomy Syndrome/diagnosis , Postoperative Complications , Postpericardiotomy Syndrome/therapy , Pericarditis/physiopathologySubject(s)
Endocarditis, Bacterial/microbiology , Heart Valve Diseases/microbiology , Pacemaker, Artificial/microbiology , Prosthesis-Related Infections/microbiology , Staphylococcal Infections/microbiology , Staphylococcus epidermidis/isolation & purification , Tricuspid Valve/microbiology , Anti-Bacterial Agents/therapeutic use , Endocarditis, Bacterial/drug therapy , Heart Valve Diseases/drug therapy , Humans , Male , Middle Aged , Prosthesis-Related Infections/drug therapy , Staphylococcal Infections/drug therapy , Treatment OutcomeABSTRACT
No disponible
