No abstract available.
Brain ; Natriuretic Peptide, Brain

No abstract available.
Anesthesia ; Natriuretic Peptide, Brain

Objective: This pilot study investigated whether serum B-type Natriuretic Peptide (BNP), bioelectrical impedance analysis (BIA), and left ventricular end-diastolic diameter (LVEDD) can be used to predict fluid overload and clinical outcomes in pediatric sepsis. Methods: Pediatric sepsis patients were enrolled. BNP, BIA, and LVEDD were obtained on admission and on Day 3. Diagnostic performances of BNP, BIA, LVEDD and correlation with fluid status were obtained. Results: Twenty-two patients were enrolled. Day 3 BNP was higher in non-survivors (9241 vs. 682.2 pg/mL, p=0.04) and day 3 LVEDD Z-score was lower in non-survivors (-3.51 vs. -0.01, p=0.023). There was no difference in the fluid balance between survivors and non-survivors. Admission BNP >670.34pg/mL predicted vasopressor use with a sensitivity of 85.71% and specificity of 86.67% while ΔBNP>5388.13pg/mL predicted mortality with 100% sensitivity. Day 3 LVEDD <22mm predicted mortality with a sensitivity of 94.74%. Cumulative fluid balance was strongly correlated with BIA and LVEDD (r=0.65, p=0.001; r=0.74, p<0.001 respectively). The median length of stay in hospital days for non-survivors was not significantly different from survivors (4 [1-12] vs. 8 [6-12] days,p=0.21). Conclusion Rise in BNP levels appear to be independent of fluid status and is a good predictor of mortality, vasopressor, and mechanical ventilator use but not of length of hospital stay. LVEDD and BIA are good estimates of cumulative fluid balance but not as predictors of mortality, vasopressor, mechanical ventilator use, and length of hospital stay. Significance of the outcomes of the study was limited due to the small sample size.
Natriuretic Peptide, Brain ; Echocardiography

No abstract available.
Ductus Arteriosus, Patent ; Natriuretic Peptide, Brain

Heart Failure ; Humans ; Natriuretic Peptide, Brain ; Peptide Fragments

BACKGROUND: B-type natriuretic peptide (BNP) has been useful as a diagnostic tool to define heart failure. Recently, the BNP assay was used on an automated immunochemistry platform. Studies included precision, analytical correlation between the Biosite Triage BNP assay and Bayer ADVIA Centaur BNP assay. METHODS: Between February 22, 2005 and March 4, 2005, 66 cases were anal-yzed. For the BNP measurement, 3 mL blood samples were collected in plastic tubes containing EDTA. Precision was analyzed with 20 repeat tests in 3 different control levels. RESULTS: The ADVIA Centaur assay had between-run precision (CV) of 3.9%, 3.7%, and 3.7% at BNP concentrations of 41.39, 420.08, and 1671.73 ng/L, respectively. The correlation between the ADVIA Centaur and Triage was as follows: ADVIA Centaur=0.753(Triage)-21.888 ng/L (r=0.94). At a cutoff of 100 ng/L, however, the diagnostic agreement was 89.4%. CONCLUSIONS: The ADVIA Centaur BNP assay is the first commercially available BNP assay using an automated immunochemistry platform. This assay has good analytical and clinical performances and agreement with the Biosite Triage BNP Assay.
Edetic Acid ; Heart Failure ; Immunochemistry ; Natriuretic Peptide, Brain ; Plastics ; Triage*

BACKGROUN: B-type natriuretic peptide (BNP) is a cardiac neurohormone secreted from ventricles as a response to ventricular volume expansion and pressure overload. Myocardial performance index (MPI) reflects cardiac systolic and diastolic function and increase in the patients with congestive heart failure (CHF). The purpose of this study was to evaluate the correlation of clinical status of CHF, BNP level, and MPI. METHODS: We followed 30 patients (mean age: 64 +/- 13) admitted with symptomatic New York Heart Association (NYHA) class III to IV CHF. Medical treatment was done. Biochemical study including BNP level and evaluation of left ventricular (LV) function including MPI by echocardiography were performed at admission and 2 months later. RESULTS: Mean BNP level increased to 488.64 +/- 519.85 pg/mL at admission with symptomatic CHF and significantly decreased to 319.56 +/- 385.39 pg/mL (p-value: 0.014) after clinical improvement. Mean MPI tended to decrease from 0.62 +/- 0.37 to 0.45 +/- 0.26. Readmission rate in 4 months was high in the patients with small decrease in BNP level. At admission, the patients with symptomatic CHF showed increased MPI despite of normal LV systolic function and tendency to decrease in MPI after clinical improvement. CONCLUSION: Increased BNP level and MPI of patients admitted with symptomatic CHF decreased with clinical improvement. The results suggest that BNP level and MPI might be useful to guide treatment of patients with CHF and changes in BNP level during treatment are predictors of early readmission.
Echocardiography ; Heart Failure* ; Heart* ; Humans ; Natriuretic Peptide, Brain* ; Plasma*

Heart Defects, Congenital ; metabolism ; Humans ; Natriuretic Peptide, Brain ; metabolism

The measurements of B-type natriuretic peptide (BNP) or N-terminal proBNP (NT-proBNP), when taken together with conventional clinical assessment, may assist in making the prognosis and also for making serial adjustment of such treatment. But although such commercial assays are currently approved for the diagnosis of heart failure, the role of the natriuretic peptides for monitoring the success of congestive heart failure (CHF) therapy has not as yet been submitted for regulatory approval. Moreover, because of the intra-individual biologic variation of the BNP or because of multiple factors that affect the BNP levels, the magnitude of the change of BNP levels must be large to confidently interpret BNP changes within an individual, and just how large has not been determined. Yet the levels of plasma BNP and NT-pro BNP are well correlated with the concurrent haemodynamic measurements and indicators of left ventricular systolic function. Also, BNP and NT-pro BNP serve as significant prognostic information and it is possible that adjustment of anti-heart failure therapy according to serial measurements of BNP (in addition to the standard clinical assessment) may offer improved outcomes. Better understanding of the test characteristics is needed before we can effectively use this valuable test to guide therapeutic strategies.
Diagnosis ; Heart Failure* ; Heart* ; Humans ; Natriuretic Peptide, Brain* ; Natriuretic Peptides ; Plasma ; Prognosis

BACKGROUND AND OBJECTIVES: The role of preoperative transthoracic echocardiography (TTE) for the risk stratification has not been well investigated yet. We compared the predictive power of TTE with N-terminal pro-brain natriuretic peptide (NT-proBNP), a representative biomarker that predicts perioperative cardiovascular risk, and investigated whether these tests have incremental value to the clinically determined risk. SUBJECTS AND METHODS: We evaluated the Revised Cardiac Risk Index (RCRI), TTE, and NT-proBNP in 1,923 noncardiac surgery cases. The primary endpoint was a perioperative major cardiovascular event (PMCE), which was defined by any single or combined event of secondary endpoints including myocardial infarction, development of pulmonary edema, or primary cardiovascular death within 30 days after surgery. RESULTS: All echocardiographic parameters including left ventricular ejection fraction, regional wall motion score index, and transmitral early diastolic velocity/tissue Doppler mitral annular early diastolic velocity (E/E') were predictive of PMCE (c-statistics=0.579+/-0.019 to 0.589+/-0.015), but none of these parameters were better than the clinically determined RCRI (c-statistics=0.594+/-0.019) and were inferior to NT-proBNP (c-statistics=0.748+/-0.019, p<0.001). The predictive power of RCRI {adjusted relative risk (RR)=1.4} could be improved by addition of echocardiographic parameters (adjusted RR=1.8, p<0.001), but not to that extent as by addition of NT-proBNP to RCRI (adjusted RR=3.7, p<0.001). CONCLUSION: TTE was modestly predictive of perioperative cardiovascular events but was not superior to NT-proBNP. Moreover, it did not have incremental value to the clinically determined risk. The results of our study did not support the use of routine echocardiography before noncardiac surgery.
Cardiovascular Diseases ; Echocardiography ; Humans ; Myocardial Infarction ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Peptide Fragments ; Postoperative Complications ; Pulmonary Edema ; Stroke Volume