Relationship between the serum level and its change of N-terminal pro-B-type natriuretic peptides and prognosis of acute decompensated heart failure with preserved ejection fraction in the elderly
10.3760/cma.j.issn.0254-9026.2018.01.002
- VernacularTitle:老年急性失代偿射血分数保留的心力衰竭患者N末端B型利钠肽水平及变化与预后关系
- Author:
Yingshuo HUANG
1
;
Qianqian WANG
;
Ying SUN
;
Wei HUANG
;
Mengran WANG
;
Li BAI
;
Jian ZHANG
Author Information
1. 100050,首都医科大学附属北京友谊医院医疗保健中心心血管病区
- Keywords:
Stroke volume;
Heart failure;
Natriuretic peptide,brain
- From:
Chinese Journal of Geriatrics
2018;37(1):4-8
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the prognostic value of the serum level and its change of N-terminal pro-B-type natriuretic peptides(NT-proBNP)in the elderly with acute decompensated heart failure with preserved ejection fraction(HFpEF). Methods A total of 138 consecutive patients(≥ 65 years old) admitted in Geriatrics and Gerontology Department at Beijing Friendship Hospital were enrolled from June 2013 to June 2015.Demographic characteristics,combination of diseases,medication administration, laboratorial and echocardiographic data were recorded.Meanwhile,NT-proBNP levels at admission,7thday after admission,changes over 7 days were also recorded and calculated.At the end of 1 year follow up,all patients were divided into events group(n=72)with,and control group(n=66)without,adverse outcomes of heart failure death,heart failure readmission and all-cause death.The differences in NT-proBNP level at admission,7thday after admission,and its changed value and rate over 7 days were compared between the two groups.Logistic regression was used for analysis of independent risk factors for prognosis.And the cut-off points of NT-proBNP values to predict adverse events were determined by receiver operating characteristic (ROC)curve. Results NT-proBNP values were significantly higher at admission and at 7thdays after admission in the events group than in control group(P=0.000).There were no significantly differences in NT-proBNP level and its changes over 7 days between two groups(P= 0.370 and P= 0.272).Logistic regression analysis showed that NT-proBNP values at admission and 7thdays after admission,and NYHA functional classification were independent risk factors for adverse outcomes in 1 year in the elderly with HFpEF(all P<0.05).Furthermore,by the ROC curve,NT-proBNP values at admission and 7thdays after admission could predict adverse outcomes including composite endpoints of heart failure,re-admission,heart failure associated death,and all-cause mortality in 1 year. Conclusions Both the plasma NT-proBNP levels at admission and at 7thdays after admission have a correlation with prognosis in elderly patients with acute decompensated HFpEF,while changes of NT-proBNP concentration over 7 days could not predict adverse outcomes in this cohort.
