6 research outputs found
N-terminal pro-b-type natriuretic peptide in patients with hypertensive heart disease
Patients with hypertensive heart disease have elevated concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP). The aim of our study was to evaluate NT-proBNP in patients with long-standing hypertension and in patients with signs of hypertensive cardiomyopathy. The study included three groups of 50 subjects: healthy persons (Control Group), patients with hypertension and normal left ventricular systolic function (Group 1) and patients with long-standing hypertension and signs of hypertensive cardiomyopathy with impaired left ventricular systolic function (Group 2). Our results show a very good correlation (Pearson's test) between NT-proBNP in Group 1 and Group 2 and C-reactive protein (Group 1: r = 0.8424; Group 2: r = 0.6650), systolic blood pressure (Group 1: r = 0.7213; Group 2: r = 0.4856), diastolic blood pressure (Group 1: r = 0.4282; Group 2: r = 0.3989) and ejection fraction (Group 1: r = -0.7390; Group 2: r = 0.9111). ROC analysis revealed that the AUC between the Control Group and Group 1 for NT-proBNP (0.912) was not significantly different (p>0.05) from the AUC for systolic (0.924) and diastolic pressure (0.937). A cut-off value for NT-proBNP of 5.89 pmol/L can be used to reliably distinguish patients of Group 1 from the Control Group, and a cut-off value of 21.67 pmol/L reliably separates patients from Group 1 and Group 2 (in both cases, the AUC is 1.000). Patients in Group 2 who belonged to the II and III New York Heart Association (NYHA) class had significantly higher levels of NT-proBNP than those in NYHA class I (ANOVA test, p=0.001). These data suggest that NT-proBNP is a useful biomarker for distinguishing patients with long-standing hypertension who are at risk of heart failure, allowing optimization and proper treatment of these patients
Correlation of N-terminal pro-B-type natriuretic peptide with clinical parameters in patients with hypertension
Background/Aim. Identification of patients with arterial hypertension and a possible onset of heart failure by determining the concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP) enables timely intensification of treatment and allows clinicians to prescribe and implement optimal and appropriate care. The aim of this study was to evaluate NT-proBNP in patients with longstanding hypertension and in patients with signs of hypertensive cardiomyopathy. Methods. The study involved 3 groups, with 50 subjects each: "healthy" persons (control group), patients with hypertension and normal left ventricular systolic function (group 1) and patients with longstanding hypertension and signs of hypertensive cardiomyopathy with impaired left ventricular systolic function (group 2). We measured levels of NT-proBNP, C-reactive protein and creatinine according to the manufacturer's instructions. All the patients were clinically examined including physical examination of the heart with blood pressure, pulse rate, electrocardiogram (ECG) and echocardiogram. Results. Our results showed that the determined parameters generally differed significantly (Student's t-test) among the groups. The mean (+/- SD) values of NT-proBNP in the control group, group 1 and group 2 were: 2.794 (+/- 1.515) pmol/L, 9.575 (+/- 5.449) pmol/L and 204.60 (84,93) pmol/L, respectively. NT-proBNP correlated significantly with the determined parameters both in the group 1 and the group 2. In the group 1, the highest correlation was obtained with C-reactive protein (r = 0.8424). In the group 2, the highest correlation was obtained with ejection fraction (r = -0.9111). NT-proBNP showed progressive increase in proportion to the New York Heart Association (NYHA) classification. The patients in the- group 2 who belonged to the II and III NYHA class had significantly higher levels of NT-proBNP than those in the NYHA class I (ANOVA test,p = 0.001). Conclusion. The obtained results suggest that NT-proBNP is a useful biomarker in the treatment of patients with longstanding hypertension who are at risk for heart failure
Some specificities in the management of hyperglycemia in patients with diabetic kidney disease
nem
Blood concentrations of B-type natriuretic peptide and N-terminal prohormone B-type natriuretic peptide as markers of left ventricle diastolic function in patients with chronic renal failure
Background/Aim. Patients with chronic renal failure (CRF) have increased
cardiovascular morbidity and mortality. It is unknown which biomarkers best
describe the degree of diastolic dysfunction in patients with CRF. The aim of
this study was to determine the correlation between B-type natriuretic
peptide (BNP), N-terminal prohormone brain natriuretic peptide (NTproBNP) and
left ventricular diastolic dysfunction (DD-LV) with the degree of CRF.
Methods. The study included 100 adult patients with CRF without major cardiac
and cerebral incidents who did not start actively treating CRF. According to
the degree of CRF, the patients were divided into two groups: G1 (moderate
degree), glomerular filtration rate (GFR) ā„ 30 mL/min/1.73 m2, and G2 (more
severe degree), GFR < 30 mL/min/1.73 m2. Blood concentrations of BNP and
NTproBNP were measured and Doppler echocardiographic measurement performed to
estimate diastolic dysfunction (DD-LV). According to the degree of DD-LV, all
the patients were divided into two groups: DD-LV1 (mild diastolic
dysfunction) and DD-LV2 (severe diastolic dysfunction). According to the
degree of CRF and DD-LV, the patients were divided into four groups: I (G1,
DD-LV1), II (G1, DD-LV2), III (G2, DD-LV1) and IV (G2, DD-LV2). Results.
There was a highly significant statistical correlation between BNP and
NTproBNP with GFR (p < 0.001), and DD-LV with BNP (p < 0.023) and NTproBNP (p
= 0.035). In patients with DD-LV2, a statistically significantly higher BNP
concentrations were registered in patients with G2 (p < 0.001). Unlike BNP in
the patients with diastolic dysfunction DD-LV1 and those with diastolic
dysfunction DD-LV2, significantly higher concentrations of NTproBNP were
registered in the patients with G2 (DD- LV1: p = 0.006; DD-LV2: p < 0.001).
Conclusion. Biomarkers BNP and NTproBNP are not the best predictors in the
assessment of diastolic dysfunction because they are correlated with the
degree of renal insufficiency
Psoriasis is the independent factor for early atherosclerosis: A prospective study of cardiometabolic risk profile
Background/Aim. Psoriasis as multisystemic inflammatory dis-ease is related with an increased cardiometabolic risk. The aim of the study was to analyze risk biomarkers, peripheral and renal arteries ultrasonography and echocardiography for subclinical atherosclerosis and metabolic disease in 106 subjects (66 psoriasis patients and 40 controls, 20 eczema patients and 20 healthy volunteers). Methods. In all exameenes following parameters were analyzed: body mass index (BMI), C-reactive protein, D-dimer, serum amyloid A (SAA), apolipoprotein (Apo) A1, ApoB, ApoB/Apo A1 index, fasting glucose, C-peptide, fasting insulinemia, homeostatic model assessment-insulin resistance (HOMA-IR), HOMA-Ī²-cell, lipid profile, serum uric acid concentration (SUAC), 24-h proteinuria and microalbuminuria. Carotid, brachial, femoral and renal arteries ultrasonography, as well as echocardiography was also performed. Results. Five of 66 (7.6%) psoriasis patients had metabolic syndrome (not present in both control groups). The following variables were increased in patients with psoriasis compared to both control groups: BMI (p = 0.012), insulinemia (p < 0.001), HOMA-IR (p = 0.003), HOMA-Ī² cell (p < 0.001), SUAC (p = 0.006), ApoB/ApoA1 ra-tio (p = 0.006) and microalbuminuria (p < 0.001). Also, increased C-peptide (p = 0.034), D-dimer (p = 0.029), triglycerides (p = 0.044), SAA (p = 0.005) and decreased ApoA1 (p = 0.014) were found in the psoriasis patients compared to healthy controls. HDL cholesterol was decreased in the psoriasis patients compared to the control group of eczema patients (p = 0.004). Common carotid (CIMT) and femoral artery intima-media thickness (FIMT) was significantly greater (p < 0.001) and the maximal flow speed (cm/s) in brachial artery significantly de-creased (p = 0.017) in the patients with psoriasis in comparison to both control groups. In multivariate logistic regression analysis, after the adjustment for confounding variables, the most important predictor of CIMT and FIMT was the diagnosis of psoriasis (p < 0.001). Conclusion. Cardiometabolic risk biomarkers and ultrasonographic signs of early atherosclerosis are correlated with the diagnosis of psoriasis, and not to generalized eczema. Psoriasis was found to be an independent risk factor for subclinical atherosclerosis