Article

Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure

Department of Cardiology, Thoraxcenter, University Medical Centre Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
European Journal of Heart Failure (Impact Factor: 6.58). 08/2007; 9(8):787-94. DOI: 10.1016/j.ejheart.2007.04.001
Source: PubMed

ABSTRACT Anaemia may affect B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (HF) patients without the exclusion of patients with renal dysfunction.
To study the influence of both anaemia and renal function on BNP and NT-proBNP levels in a large group of hospitalised HF patients.
We studied 541 patients hospitalised for HF (mean age 71+/-11 years, 62% male, and left ventricular ejection fraction 0.33+/-0.14). Of these patients, 30% (n=159) were anaemic (women: Hb<7.5 mmol/l, men: Hb<8.1 mmol/l). Of the 159 anaemic patients, 73% had renal dysfunction (eGFR<60 ml/min/1.73 m2) and of the non-anaemic patients, 57% had renal dysfunction. BNP and NT-proBNP levels were measured in all patients before discharge. In multivariable analyses both plasma haemoglobin and eGFR were independently related to the levels of BNP and NT-proBNP (standardised beta's of -0.16, -0.14 [BNP] and -0.19, -0.26 [NT-proBNP] respectively, P-values<0.01).
Anaemia and renal dysfunction are related to increased BNP and NT-proBNP levels, independent of the severity of HF. These results indicate that both anaemia and renal dysfunction should be taken into consideration during the interpretation of BNP and NT-proBNP levels in HF patients.

Download full-text

Full-text

Available from: Tiny Jaarsma, May 08, 2014
2 Followers
 · 
66 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Elevated plasma B-type natriuretic peptide (BNP) is a predictor of outcome and helpful for risk stratification in aortic stenosis (AS). However, left ventricular (LV) diastolic dysfunction progresses with aging and may also influence plasma BNP levels in elderly patients. We hypothesized that plasma BNP levels may be influenced by age in severe AS, and that factors that affect the elevation of plasma BNP levels may be different between elderly and younger patients with AS. We performed echocardiography in 341 patients with severe AS [aortic valve area (AVA)<1.0cm(2)] and classified them into two groups by age (elderly ≥75 years old, n=201; younger patients <75 years old, n=140). We used multivariate linear regression analysis to assess the factors that determine plasma BNP levels in both groups. Age was found to be one of the independent determinants of plasma BNP levels in all patients (β=0.135, p=0.005). Although AVA was similar in the two groups, plasma BNP levels and E/e' were significantly higher in elderly than younger patients [133.0 (IQR, 73.3-329.7)pg/dl vs 92.8 (IQR, 40.6-171.8)pg/dl, p<0.01; 20±8 vs 16±6, p<0.01, respectively). In multivariate stepwise linear regression analysis, AVA index, LV ejection fraction, mass index, E/e', estimated systolic pulmonary artery pressure (eSPAS), and the presence of atrial fibrillation were independent determinants of plasma BNP levels in younger patients. In contrast, the independent determinants of plasma BNP levels in elderly patients were LV ejection fraction, mass index, E/e', eSPAS, the presence of atrial fibrillation, age, and hemoglobin levels, but not AVA index. There may be differences in the factors that influence plasma BNP levels between elderly and younger patients with severe AS. In elderly patients, plasma BNP levels may be influenced more by these factors than AS severity compared with younger patients.
    Journal of Cardiology 05/2014; DOI:10.1016/j.jjcc.2014.03.005 · 2.57 Impact Factor
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Heart failure is a major health problem with an increasing incidence and prevalence of the disease. The role of both established natriuretic peptides: B-type natriuretic peptide (BNP) and N-terminal prohormone pro-brain natriuretic peptide (NT-proBNP) in acute and chronic heart failure (HF) has been intensively studied. Its testing is routine in clinical practice for diagnosis and prognosis in HF. However, increased clarification and understanding of the interplay in the pathophysiology of HF revealed several new potential cardiac biomarkers. These novel biomarkers soluble ST2, galectin, copeptin and, mid-regional fragment of pro-adrenomedullin (MR-proADM) may aid in the diagnostic and prognostic evaluation of acute and chronic heart failure.
    Cor et vasa 08/2013; 55(4):e345–e354. DOI:10.1016/j.crvasa.2013.04.003