Russian Heart Failure Journal 2009year Systolic and diastolic CHF: Interrelation between NT-proBNP and severity of clinical signs and cardiohemodynamic disorders


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2009/

Systolic and diastolic CHF: Interrelation between NT-proBNP and severity of clinical signs and cardiohemodynamic disorders

Solomakhina N. I.

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Urgency. It has been unclear up to the present whether levels of NT-proBNP differ in patients with systolic and diastolic CHF (S-CHF and D-CHF) including those with similar clinical presentation and in the same phase of disease. The relationship of NT-proBNP with pronouncement of systolic and diastolic dysfunction and severity of clinical signs in such patients is also understudied. Aim. To compare mean levels of NT-proBNP in patients with S-CHF and D-CHF and to investigate the relationship of NT-proBNP levels with severity of clinical manifestations of heart failure and pronouncement of systolic and diastolic LV dysfunction. Materials and methods. 47 patients with CHF and dilated LV and reduced ejection fraction (EDR >6.0 cm and EF <40%) – S-CHF (n=21) and without LV dilation and with preserved EF (EDR <5.0  cm and EF >40%) – D-CHF (n=26) were evaluated. 14 patients without signs of CHF were included into the control group (CG). Serum level of NT-proBNP was measured using the enzyme-linked immunosorbent assay (ELISA). Results. Significant increases in mean levels of NT-proBNP compared to CG were observed in patients with S-CHF and D-CHF; there were no significant differences between levels of NT-proBNP in S-CHF and D-CHF. Levels of NT-proBNP did not significantly differ in patients with cardiac asthma, anasarca and atrial fibrillation in the setting of S-CHF and D-CHF. There were no significant correlations between mean levels of NT-proBNP and EF in patients with S-CHF or D-CHF, nor for a pooled group. A strong positive correlation was found between the mean level of NT‑proBNP and the minute volume along with a moderate positive correlation between the mean level of NT-proBNP and the cardiac index in patients with S-CHF; these correlations were weak and non-significant in patients with D-CHF. A moderate (non-significant) correlation was observed between mean levels of NT-proBNP and phases of diastolic dysfunction in patients with D-CHF; this correlation was absent in patients with S-CHF.
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