Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device
Background: B-type natriuretic peptide (BNP) is a strong predictor of prognosis in chronic heart failure. We aimed to evaluate the clinical correlates and interpretation of BNP monitoring in LVAD out-patient recipients. Methods: We performed a prospective study in 136 individuals after HeartMate II...
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Palacký University Olomouc, Faculty of Medicine and Dentistry
2017-03-01
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doaj-9674ff75f3d0411a802167c56fbac1492020-11-25T03:22:20ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212017-03-011611687410.5507/bp.2017.003bio-201701-0009Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist deviceMarketa Hegarova0Milos Kubanek1Ivan Netuka2Jiri Maly3Zora Dorazilova4Tomas Gazdic5Janka Franekova6Vera Lanska7Vojtech Melenovsky8Josef Kautzner9Ivan Malek10Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Biostatistics, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicBackground: B-type natriuretic peptide (BNP) is a strong predictor of prognosis in chronic heart failure. We aimed to evaluate the clinical correlates and interpretation of BNP monitoring in LVAD out-patient recipients. Methods: We performed a prospective study in 136 individuals after HeartMate II LVAD implantation. During follow-up they were divided into group A (severe adverse events requiring hospitalisation), group B (mild to moderate adverse events) and group C (an uneventful course). BNP was measured pre-implant, at the first out-patient visit, and then every 2 months. We identified the lowest level, and the level at the clinical event and/or the highest value in patients without clinical events (BNP peak). Results: During a median follow-up of 298 days, 8 patients (6%) died, 21 patients (15%) experienced a severe adverse event (group A) and 38 patients (28%) had other adverse event (group B). Both the absolute value of BNP peak and its percentage values relative to pre-implant, first visit and minimum BNP had similar areas under the curve (AUC) to identify individuals with adverse events (group A and B) from group C. The performance of BNP peak rose from detection of infection to diagnosis of heart failure and culminated in individuals with pump thrombosis (AUC 0.68 vs. 0.75 vs. 0.93). Conclusions: Serial measurement of BNP in outpatients with LVAD correlates with the occurrence of adverse events. Assessment of absolute values of BNP peak seems to have a similar accuracy to analysis of intra-individual variation of BNP and it is more practical.https://biomed.papers.upol.cz/artkey/bio-201701-0009_Clinical_correlates_of_B-type_natriuretic_peptide_monitoring_in_outpatients_with_left_ventricular_assist_device.phpprognosisb-type natriuretic peptideventricular assist devicesadvanced heart failure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marketa Hegarova Milos Kubanek Ivan Netuka Jiri Maly Zora Dorazilova Tomas Gazdic Janka Franekova Vera Lanska Vojtech Melenovsky Josef Kautzner Ivan Malek |
spellingShingle |
Marketa Hegarova Milos Kubanek Ivan Netuka Jiri Maly Zora Dorazilova Tomas Gazdic Janka Franekova Vera Lanska Vojtech Melenovsky Josef Kautzner Ivan Malek Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device Biomedical Papers prognosis b-type natriuretic peptide ventricular assist devices advanced heart failure |
author_facet |
Marketa Hegarova Milos Kubanek Ivan Netuka Jiri Maly Zora Dorazilova Tomas Gazdic Janka Franekova Vera Lanska Vojtech Melenovsky Josef Kautzner Ivan Malek |
author_sort |
Marketa Hegarova |
title |
Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device |
title_short |
Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device |
title_full |
Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device |
title_fullStr |
Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device |
title_full_unstemmed |
Clinical correlates of B-type natriuretic peptide monitoring in outpatients with left ventricular assist device |
title_sort |
clinical correlates of b-type natriuretic peptide monitoring in outpatients with left ventricular assist device |
publisher |
Palacký University Olomouc, Faculty of Medicine and Dentistry |
series |
Biomedical Papers |
issn |
1213-8118 1804-7521 |
publishDate |
2017-03-01 |
description |
Background: B-type natriuretic peptide (BNP) is a strong predictor of prognosis in chronic heart failure. We aimed to evaluate the clinical correlates and interpretation of BNP monitoring in LVAD out-patient recipients. Methods: We performed a prospective study in 136 individuals after HeartMate II LVAD implantation. During follow-up they were divided into group A (severe adverse events requiring hospitalisation), group B (mild to moderate adverse events) and group C (an uneventful course). BNP was measured pre-implant, at the first out-patient visit, and then every 2 months. We identified the lowest level, and the level at the clinical event and/or the highest value in patients without clinical events (BNP peak). Results: During a median follow-up of 298 days, 8 patients (6%) died, 21 patients (15%) experienced a severe adverse event (group A) and 38 patients (28%) had other adverse event (group B). Both the absolute value of BNP peak and its percentage values relative to pre-implant, first visit and minimum BNP had similar areas under the curve (AUC) to identify individuals with adverse events (group A and B) from group C. The performance of BNP peak rose from detection of infection to diagnosis of heart failure and culminated in individuals with pump thrombosis (AUC 0.68 vs. 0.75 vs. 0.93). Conclusions: Serial measurement of BNP in outpatients with LVAD correlates with the occurrence of adverse events. Assessment of absolute values of BNP peak seems to have a similar accuracy to analysis of intra-individual variation of BNP and it is more practical. |
topic |
prognosis b-type natriuretic peptide ventricular assist devices advanced heart failure |
url |
https://biomed.papers.upol.cz/artkey/bio-201701-0009_Clinical_correlates_of_B-type_natriuretic_peptide_monitoring_in_outpatients_with_left_ventricular_assist_device.php |
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