Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management
Background. Persistently elevated natriuretic peptide (NP) levels in heart failure (HF) patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in cl...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/562763 |
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| author | Aftab Jan Ian Dawkins Niamh Murphy Patrick Collier John Baugh Mark Ledwidge Kenneth McDonald Chris J. Watson |
| author_facet | Aftab Jan Ian Dawkins Niamh Murphy Patrick Collier John Baugh Mark Ledwidge Kenneth McDonald Chris J. Watson |
| author_sort | Aftab Jan |
| collection | DOAJ |
| description | Background. Persistently elevated natriuretic peptide (NP) levels in heart failure (HF) patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in clinically stable patients are persistent occult fluid overload, wall stress, inflammation, fibrosis, and ischemia. The purpose of this study was to identify associates of B-type natriuretic peptide (BNP) in a stable HF population. Methods. In a prospective observational study of 179 stable HF patients, the association between BNP and markers of collagen metabolism, inflammation, and Doppler-echocardiographic parameters including left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), and E/e prime (E/e′) was measured. Results. Univariable associates of elevated BNP were age, LVEF, LAVI, E/e′, creatinine, and markers of collagen turnover. In a multiple linear regression model, age, creatinine, and LVEF remained significant associates of BNP. E/e′ and markers of collagen turnover had a persistent impact on BNP independent of these covariates. Conclusion. Multiple variables are associated with persistently elevated BNP levels in stable HF patients. Clarification of the relative importance of NP stimuli may help refine NP-guided therapy, potentially improving outcome for this at-risk population. |
| format | Article |
| id | doaj-art-54a3a1d23641479ba2e1ed1f827295d3 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-54a3a1d23641479ba2e1ed1f827295d32025-02-03T06:44:34ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/562763562763Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted ManagementAftab Jan0Ian Dawkins1Niamh Murphy2Patrick Collier3John Baugh4Mark Ledwidge5Kenneth McDonald6Chris J. Watson7Chronic Cardiovascular Disease Management Unit, St. Vincent's Healthcare Group/St. Michael's Hospital, Dublin, IrelandChronic Cardiovascular Disease Management Unit, St. Vincent's Healthcare Group/St. Michael's Hospital, Dublin, IrelandChronic Cardiovascular Disease Management Unit, St. Vincent's Healthcare Group/St. Michael's Hospital, Dublin, IrelandSchool of Medicine & Medical Science, UCD Conway Institute, University College Dublin, Dublin 4, IrelandSchool of Medicine & Medical Science, UCD Conway Institute, University College Dublin, Dublin 4, IrelandChronic Cardiovascular Disease Management Unit, St. Vincent's Healthcare Group/St. Michael's Hospital, Dublin, IrelandChronic Cardiovascular Disease Management Unit, St. Vincent's Healthcare Group/St. Michael's Hospital, Dublin, IrelandChronic Cardiovascular Disease Management Unit, St. Vincent's Healthcare Group/St. Michael's Hospital, Dublin, IrelandBackground. Persistently elevated natriuretic peptide (NP) levels in heart failure (HF) patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in clinically stable patients are persistent occult fluid overload, wall stress, inflammation, fibrosis, and ischemia. The purpose of this study was to identify associates of B-type natriuretic peptide (BNP) in a stable HF population. Methods. In a prospective observational study of 179 stable HF patients, the association between BNP and markers of collagen metabolism, inflammation, and Doppler-echocardiographic parameters including left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), and E/e prime (E/e′) was measured. Results. Univariable associates of elevated BNP were age, LVEF, LAVI, E/e′, creatinine, and markers of collagen turnover. In a multiple linear regression model, age, creatinine, and LVEF remained significant associates of BNP. E/e′ and markers of collagen turnover had a persistent impact on BNP independent of these covariates. Conclusion. Multiple variables are associated with persistently elevated BNP levels in stable HF patients. Clarification of the relative importance of NP stimuli may help refine NP-guided therapy, potentially improving outcome for this at-risk population.http://dx.doi.org/10.1155/2013/562763 |
| spellingShingle | Aftab Jan Ian Dawkins Niamh Murphy Patrick Collier John Baugh Mark Ledwidge Kenneth McDonald Chris J. Watson Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management The Scientific World Journal |
| title | Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management |
| title_full | Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management |
| title_fullStr | Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management |
| title_full_unstemmed | Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management |
| title_short | Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management |
| title_sort | associates of an elevated natriuretic peptide level in stable heart failure patients implications for targeted management |
| url | http://dx.doi.org/10.1155/2013/562763 |
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