Clinical significance of N-terminal-probrain natriuretic peptide in hypertrophic cardiomyopathy.

N-Terminal-probrain natriuretic peptide (NT-proBNP) plasma levels are elevated in patients with congestive heart failure. Published data concerning the utility of NT-proBNP in hypertrophic cardiomyopathy (HCM) are lacking. Our aim was to evaluate the clinical significance of NT-proBNP in patients with HCM. A blood sample was collected for plasma NT-proBNP measurement from 43 consecutive patients with documented HCM. NT-proBNP was measured using a chemiluminescent immunoassay kit (Roche Diagnostics) on an Elecsys 2010 analyzer. Median value of NT-proBNP was 219 pg/ml (range 8-3 045 pg/ml) in NYHA class I patients, 698 pg/ml (125-2 463 pg/ml) in NYHA class II patients, and 2 683 pg/ml (131-11 542 pg/ml) in NYHA class III and IV patients. NT-proBNP plasma levels were significantly higher across the severity of functional limitation (i.e., NYHA class classification) (P = 0.002). NT-proBNP levels were significantly higher in female than male (P = 0.034), in referral vs nonreferral patients (P = 0.004), in symptomatic vs asymptomatic patients (P = 0.020), in patients with basal subaortic gradient >or=30 mmHg (P = 0.001) and in the patients who were on cardioactive medication (P = 0.010). In univariate analysis NT-proBNP was significantly correlated with age (P < 0.001), left ventricular maximum wall thickness (P = 0.001), left atrial size (P = 0.019), and subaortic gradient >or=30 mmHg (P < 0.001). In multivariate regression analysis, age (P < 0.001), maximum wall thickness (P = 0.007), and gradient >or=30 mmHg (P = 0.027) were independently associated with NT-proBNP levels. Our data support the idea that measurement of plasma NT-proBNP levels in HCM patients is useful to assess their clinical status, especially the severity of hypertrophy and the presence of obstruction, although age must be taken into account

Clinical significance of N-terminal-probrain natriuretic peptide in hypertrophic cardiomyopathy.

N-Terminal-probrain natriuretic peptide (NT-proBNP) plasma levels are elevated in patients with congestive heart failure. Published data concerning the utility of NT-proBNP in hypertrophic cardiomyopathy (HCM) are lacking. Our aim was to evaluate the clinical significance of NT-proBNP in patients with HCM. A blood sample was collected for plasma NT-proBNP measurement from 43 consecutive patients with documented HCM. NT-proBNP was measured using a chemiluminescent immunoassay kit (Roche Diagnostics) on an Elecsys 2010 analyzer. Median value of NT-proBNP was 219 pg/ml (range 8-3 045 pg/ml) in NYHA class I patients, 698 pg/ml (125-2 463 pg/ml) in NYHA class II patients, and 2 683 pg/ml (131-11 542 pg/ml) in NYHA class III and IV patients. NT-proBNP plasma levels were significantly higher across the severity of functional limitation (i.e., NYHA class classification) (P = 0.002). NT-proBNP levels were significantly higher in female than male (P = 0.034), in referral vs nonreferral patients (P = 0.004), in symptomatic vs asymptomatic patients (P = 0.020), in patients with basal subaortic gradient >or=30 mmHg (P = 0.001) and in the patients who were on cardioactive medication (P = 0.010). In univariate analysis NT-proBNP was significantly correlated with age (P or=30 mmHg (P or=30 mmHg (P = 0.027) were independently associated with NT-proBNP levels. Our data support the idea that measurement of plasma NT-proBNP levels in HCM patients is useful to assess their clinical status, especially the severity of hypertrophy and the presence of obstruction, although age must be taken into account

Teachers responding to cultural diversity: case studies on assessment practices, challenges and experiences in secondary schools in Austria, Ireland, Norway and Turkey

Global mobility and economic and political crises in some parts of the world have fuelled migration and brought new constellations of ‘cultural diversity’ to European classrooms (OECD 2019). This produces new challenges for teaching, but also for assessment in which cultural biases may have far-reaching consequences for the students’ further careers in education, occupation and life. After considering the concept of and current research on ‘culturally responsive assessment’, we use qualitative interview data from 115 teachers and school leaders in 20 lower secondary schools in Austria, Ireland, Norway and Turkey to explore the thinking about diversity and assessment practices of teachers in the light of increasing cultural diversity. Findings suggest that ‘proficiency in the language of instruction’ is the main dimension by which diversity in classrooms is perceived. While there is much less reference to ‘cultural differences’ in our case studies, we found many teachers in case schools trying to adapt their assessment procedures and grading in order to help students from diverse backgrounds to show their competencies and to experience success. However, these responses were, in many cases, individualistic rather than organised by the school or regional education authorities and were also strongly influenced and at times, limited by government-mandated assessment regimes that exist in each country. The paper closes with a series of recommendations to support the further development of a practicable and just practice of culturally responsive assessment in schools