جستجوی مقالات مرتبط با کلیدواژه "nt-probnp" در نشریات گروه "پزشکی"

Tetralogy of Fallot (TOF) is the most prevalent cyanotic congenital heart defect. Pulmonary regurgitation (PR) is a common sequela following most surgical repairs for TOF. Tadalafil might reduce pulmonary vascular resistance after Tetralogy of Fallot total correction (TOFTC).

This study evaluated the efficacy of tadalafil in reducing PR volume and improving heart function among TOFTC children with severe PR, using transthoracic echocardiography, particularly focusing on changes in N-terminal pro-b-type natriuretic peptide (NT-proBNP).

The present study was conducted on TOFTC patients consecutively between September 2019 and August 2020 at Shiraz University of Medical Sciences, Shiraz, Iran. M-mode and two-dimensional (2D) Doppler echocardiography were performed, and NT-proBNP levels were measured in 20 patients before and one month after tadalafil administration. SPSS version 23.0 was utilized to analyze all results.

The patients' ages ranged from 25 to 128 months. The mean age and weight of the patients were 67.9 ± 34.5 months and 21.1 ± 6.9 kg, respectively. Tadalafil administration did not significantly improve Doppler and tissue Doppler parameters; however, it increased the pulmonary valve pressure gradient and velocity-time integral. Additionally, tadalafil had no significant effect on improving NT-proBNP levels. The Spearman correlation test did not show any significant correlation between the pulmonary valve pressure gradient and velocity-time integral with age, weight, and NT-proBNP.

Tadalafil increased the pulmonary valve pressure gradient and velocity-time integral in TOFTC patients with severe PR; however, it did not affect NT-proBNP levels or tissue Doppler parameters.

Cardiovascular disease (CVD) is the most considerable long-term outcome of rheumatoid arthritis (RA) and the leading cause of premature death in RA patients. The pathogenesis of CVD in RA is largely determined by persistent systemic inflammation and its underlying factors, including chemokines. In this regard, C-X-C motif chemokine ligand 12 (CXCL12) has a crucial role in the CVD and RA pathogenesis. For the first time, plasma CXCL12 was related to conventional CV risk and well-established cardiac biomarkers in RA patients.

This study was conducted on 30 RA patients who have been newly diagnosed, 30 under-treatment RA patients, and 30 healthy subjects. The plasma levels of CXCL12 and N-terminal pro-B-type natriuretic peptide (NT-ProBNP) were measured using the enzyme-linked immunosorbent assay (ELISA) technique. The high sensitivity C-reactive protein (HS-CRP) concentration was evaluated in plasma samples using the ADVIA 1800 Clinical Chemistry System based on the latex-enhanced immunoturbidimetric assay. The CVD risk was measured by calculating the Framingham risk score (FRS) and systematic coronary risk evaluation (SCORE).

The mean FRS and plasma concentration of high-density lipid (HDL), NT-proBNP, and HS-CRP were significantly different between the three groups (P = 0.029, P < 0.001, P = 0.016, P < 0.001, respectively). A significant positive correlation was found between CXCL12 with disease activity score-28 (DAS-28) (P = 0.024, r = 0.293) and NT-proBNP (P < 0.0001, r = 0.570) in the patients’ group.

Based on the results, there was a significant relationship between the inflammatory mediator CXCL12 and a well-known cardiac biomarker, NT-proBNP

Diagnosis and early treatment of the cardiac causes of chest pain are of particular importance. This study aimed to investigate the association between NT-pro-BNP levels as a cardiac marker and the prognosis of patients with chest pain.

All patients visiting the emergency department of a tertiary cardiovascular center with chest pain between October 2016 and March 2017 were evaluated for eligibility. Demographic data, proBNP levels, final diagnosis on angiography, echocardiography, and other symptoms were recorded.

A total of 222 patients at a mean age of 59.0±14.8 years were studied. Totally, 127 patients (57.2%) were male. A significant inverse relationship was found between proBNP levels and the left ventricular ejection fraction (r= -0.316; P<0.001). NT-proBNP levels showed a significant elevation in patients with abnormal size and function of the right ventricle, with regional wall motion abnormalities, and with valvular heart diseases (P<0.05). The BNP level in patients with abnormal angiographic results was 1148.5 (405.3–3214.0), significantly higher than that in patients with normal results (545.0: 90.3–2807.8; P=0.009). The level of this marker in patients with obstructive coronary artery disease (1192.0: 438.8–3233.0) was significantly higher than that in patients with non-obstructive coronary artery disease (620.0: 108.0–2792.0; P=0.001). BNP>841 pg/mL had a sensitivity of 92.9% and a specificity of 47.9% in identifying cases at risk of complications.

NT-proBNP could be a good diagnostic and prognostic marker for patients with chest pain complaints. Measuring this marker upon arrival can help identify patients with cardiac diseases. It is recommended to evaluate patients with elevated levels of this marker for earlier diagnosis and treatment. 

Soluble ST2 (sST2) is a member of the interleukin-1 receptor family and is considered a novel biomarker of inflammation, fibrosis, and cardiac stress. Additionally, sST2 is accepted by guidelines as a measure of risk stratification in patients with heart failure.
 
Our study enrolled 53 subjects: 23 patients who were followed up for pulmonary arterial hypertension (PAH) and were prescribed different medications and 30 healthy children admitted to the pediatric cardiology outpatient clinic with chest pain or innocent murmurs as the control group. The plasma concentration of NT-proBNP was analyzed via the electrochemiluminescence method, and the sST2 level was analyzed via the ELISA method.
 
The mean age was 13.9 years (5.5–18 y) in the case group and 9.6 years (3–17 y) in the control group. The mean NT-proBNP level was significantly higher in the patient group than in the control group (763.73±2432.67 pg/mL vs 51.71± 30.08 pg/mL; P<0.01). The mean sST2 level was 1469.26±510.9 pg/mL in the patient group and 1151.30±655.99 pg/mL in the control group (P>0.05).
 
Our results suggest that sST2 could be a significant indicator of right heart failure and cardiovascular mortality in children, as well as a novel biomarker of PAH. However, we found that the serum sST2 level was not as useful as the serum NT-proBNP level in this regard. Further studies with larger patient series are needed to evaluate sST2 as a biomarker in patients with PAH. (Iranian Heart Journal 2022; 23(4): 46-51)

The objective of the present research was to evaluate the possible association between the N-terminal pro-brain type natriuretic peptide (NT-proBNP) levels and in-hospital mortality in coronavirus disease 2019 (COVID-19) pneumonia patients who did not have pre-existing heart failure (HF).

A total of 137 consecutive patients without pre-existing HF and hospitalized due to COVID-19 pneumonia were enrolled into the current research. The main outcome of the research was the in-hospital death. The independent parameters linked with the in-hospital death were determined by multivariable analysis.

A total of 26 deaths with an in-hospital mortality rate of 18.9% was noted. Those who died were older with an increased frequency of co-morbidities such as hypertension, chronic kidney disease, coronary artery disease, stroke and dementia. They had also increased white blood cell (WBC) counts and had elevated glucose, creatinine, troponin I, and NT-pro-BNP levels but had decreased levels of hemoglobin. By multivariable analysis; age, NT-pro-BNP, WBC, troponin I, and creatinine levels were independently linked with the in-hospital mortality. After ROC evaluation, the ideal value of the NT-pro-BNP to predict the in-hospital mortality was found as 260 ng/L reflecting a sensitivity of 82% and a specificity of 93% (AUC:0.86; 95%CI:0.76-0.97).

The current research clearly shows that the NT-proBNP levels are independently linked with the in-hospital mortality rates in subjects with COVID-19 pneumonia and without HF. Thus, we believe that this biomarker can be used as a valuable prognostic parameter in such cases.

Infection with the novel coronavirus, named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), producing a clinical syndrome known as COVID-19, is a budding infectious disease that first manifested in December 2019 in China and subsequently spread worldwide.

We performed an analysis of cardiac injurymarkers to determine their usefulness as predictors of severity andmortality

In a retrospective study, we enrolled 73 patients with confirmed diagnoses of COVID-19, from March 21, 2020, to April 24, 2020. Serial tests of cardiac injury markers, including cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NTproBNP), and Lactate dehydrogenase (LDH), were considered for the analysis of potential cardiac damage.

Among 149 patients with confirmed COVID-19, data from 73 patients were studied. Of them, 58 (79.46%) patients were discharged, and 15 (20.54 %) patients died. The mean age was 58.50 (14.66) years. Patients were classified into mild (39 cases), severe (17 cases), and critical (17 cases) groups. The peak cardiac troponin I level (0.11 ng/mL [IQR: 0.33–0.20]), peak NT-pro BNP level (5840.35 pg/mL [IQR: 1609.39 – 10071.32]), and peak LDH level (578.65 UI/l[IQR: 313.40 – 843.90]) were significantly higher in the critical group, and the three cardiac injury parameters were significantly higher in the death group, suggesting that they are significantly associated with a higher risk of in-hospital mortality.

The understanding of cardiovascular system injury caused by SARS-CoV-2 and its underlying mechanisms is of great importance for the early clinical management of these patients and mortality reduction.

The standard heart failure treatment in adult patients with Congenital Heart Disease (CHD) is a challenging issue. Biomarkers, such as N-Terminal pro- B-type Natriuretic Peptide (NT-proBNP), have been used, but soluble Suppression of Tumorigenicity-2 (sST2) has been able to bring prognostic value in patients with acute and chronic left heart failure.

The present study sought to evaluate the predictive value of sST2 and NTproBNP measurements in the assessment of the efficacy of treatment of adult patients with symptomatic CHD.

This case series was conducted using a before/after design on 80 consecutive adult patients with CHD who had never received treatment for symptomatic heart failure (New York Heart Association functional classes II, III). sST2 levels were measured before and six months after the standard drug regimen of cardiac dysfunction according to the American guidelines in order to assess the efficacy of the standard treatment on sST2. Cardiac function was assessed via echocardiography and functional capacity via the 6-Minute Walk Test (6MWT) and direct inquiry from the patients before and six months after the treatment. The data were entered into the SPSS 22 software and were analyzed using paired t-test, Wilcoxon, and chi-square test.

The mean age of the patients was 32 years. At the six-month follow-up, functional capacity showed a significant improvement based on the mean 6MWT compared to the pre-treatment state (P < 0.001). In addition, the standard treatment significantly decreased the sST2 level compared to the pre-treatment value (P < 0.001).

The measurement of biomarkers could help assess the efficacy of the treatment of adult patients with CHD and symptomatic heart failure.

Patients with Acute Coronary Syndrome (ACS) with preserved Left Ventricular Ejection Fraction (LVEF) have an incidence of adverse outcomes despite the previously presumed benign prognosis.

We hypothesized that NT-pro-BNP could help refine the risk stratification of these patients.

In this observational retrospective study, laboratory and clinical data were collected from 232 consecutive patients with ACS and preserved LVEF (> 50%) and no previous history of Heart Failure (HF) at hospital discharge. Associations between NT-proBNP and the composite outcome of HF hospitalization, HF diagnosis de novo, and all-cause mortality were assessed by univariate and multivariable Cox models. Statistical analyses were performed using Stata software, version 12.1 and a two-sided P-value < 0.05 was considered to be statistically significant.

The NT-proBNP median was 408 [IQR 177-853] pg/mL. Patients with increased NT-proBNP were older and were more likely to be female (P = 0.013), be non-smoker (P = 0.039), have worse renal function (P < 0.001), and have lower hemoglobin concentration (P < 0.001). They had more ST-Elevation Myocardial Infarction (STEMI) and evolved with higher Killip classes (P < 0.001). Increased NT-proBNP levels were also associated with higher peak values of Creatinine Kinase (CK) and troponin (r = 0.36, P < 0.001 and r = 0.37, P < 0.001), higher left ventricular mass (P = 0.021), larger left atria (P = 0.013), and higher prevalence of regional LV hypocontractility (P = 0.012 to P = 0.090). During the 4.2 [2.1-5.4] years of follow-up, the composite outcome occurred in 19 patients. After adjusting for age, sex, and Killip class, NT-proBNP was not associated with the composite outcome (HR = 1.18; 95% CI: 0.78 - 1.78).

Post-ACS patients with preserved LVEF and increased levels of NT-proBNP were older, had more comorbidities, and presented with a more severe myocardial infarction. However, NT-proBNP levels measured during ACS hospitalization did not predict the clinical adverse outcomes.

Allopurinol used in the treatment of gout has been shown to improve the vascular endothelial dysfunction and reduce the dysfunction of the failing heart. This study was done to evaluate the effect and safety of allopurinol in non-hyperuricemic patients with chronic severe left ventricular (LV) dysfunction.
In this study, 35 consecutive cases of non-hyperuricemic patients with chronic heart failure who had severe LV systolic dysfunction (ejection fraction of less than 35%) and were on optimal guideline directed medical therapies for at least 3 months were included. Allopurinol was administered with the dose of 300 mg po daily for 1 week and then it was up-titrated to a dose of 600 mg po daily for 3 months. Six minute walk test, strain imaging, laboratory testing were done for every patient at baseline and after 3 months treatment with allopurinol.
In this study 30 heart failure (HF) patients with a mean age of 49.3 ± 14.4 years old were evaluated. No adverse effects were reported except for one case of skin rash after 4 days treatment which was excluded from the study. Study showed significant improvement of six minute walk test of the patients from 384.5 ± 81.5 meters to 402.8 ± 89.6 meters and the global longitudinal peak strain (P Allopurinol could be of benefit in non-hyperuricemic patients with severe LV systolic dysfunction without significant adverse effects. Randomized clinical trials are needed in future to confirm the results.

In patients with systemic sclerosis, NT-proBNP is a useful diagnostic marker for pulmonary hypertension and ventricular dysfunction, with important prognostic significance. The aim of this study was to assess the relationship between the NT-proBNP levels and the presence and severity of ventricular arrhythmias in patients with scleroderma.
Forty consecutive patients with a diagnostic of systemic sclerosis according to the EULAR criteria admitted at the Rheumatology Clinic of Cluj-Napoca, Romania, from Jan 2014 to Apr 2014 were enrolled. Patients underwent a 12-lead ECG and a 24-hour Holter ECG monitoring for ventricular arrhythmias evaluation. Blood sample testing (including NT-proBNP level measurements), echocardiography, spirometry, chest X-ray and, when considered appropriate, high-resolution chest CT were performed.
Sixty percent of patients (n=24) had abnormal NT-proBNP serum levels (>125 pg/ml) and 10 patients had >100 PVC /24 h. There was a statistically significant correlation between the NT-proBNP levels and the total number of premature ventricular contractions (PVC) (r=0.445, P=0.006), total number of isolated PVC (r=0,493, P=0.002), total number of ventricular couplets (r=0.379, P=0.021) and the number of PVC morphologies (r=0.501, P=0.002). The presence of an NT-proBNP serum level >287 pg/ml had a sensitivity of 55% and a specificity of 93% in predicting the presence of complex ventricular arrhythmias on 24-hour Holter ECG monitoring.
NT-proBNP levels could become a useful ventricular arrhythmia marker for assessing the arrhythmic risk in patients with systemic sclerosis.