The importance of determination of Nt-proBNP and big endothelin in diagnosing chronic heart failure in patients on regular haemodialysis treatment
Authors:
O. Ludka 1; J. Špinar 1; L. Vítovcová 2; D. Sobotová 2; L. Špinarová 3; J. Vítovec 3; J. Tomandl 4
Authors‘ workplace:
Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC
1; II. interní klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Miroslav Souček, CSc.
2; I. interní kardiangiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc., FESC
3; Biochemický ústav Lékařské fakulty MU Brno, přednostka prof. RNDr. Eva Táborská, CSc.
4
Published in:
Vnitř Lék 2007; 53(1): 38-45
Category:
Original Contributions
Overview
We have followed 99 patients with end stage renal failure, treated by regular haemodialysis. Chronic renal failure is frequently accompanied by chronic heart failure (60 %), especially by heart failure with preserved ejection fraction. Patients treated by regular haemodialysis had a tendency to cardiomegaly (51 %), mild systolic dysfunction of the left ventricle (mean LVEF 53 %) and diastolic dysfunction (88 %) of the hypertrophic left ventricle. They had also activated endothelin and neurohumoral system. Only 3 % of the patients had normal values of Nt-proBNP and big endothelin. The plasma level of Nt-proBNP in haemodialysed patients correlated with cardiothoracic ratio and with ejection fraction. The plasma level of big endothelin correlated only with cardiothoracic ratio.
Key words:
congestive heart failure - hemodialysis - neurohumoral activation
Sources
1. Cataliotti A, Malatino LS, Jougasaki M. Circulating natriuretic peptide concentration in patiens with end-stage renal disease: role of brain natriuretic peptide as a biomarker for ventricular remodeling. Mayo Clin Proc 2001; 76: 1111-1119.
2. Clerico A, Caprioli R, Del Ry S. Clinical relevance of cardiac natriuretic peptides measured by means of competitive and non-competitive immunoassay methods in patiens with renal failure on chronic hemodialysis. J Endocrinol Invest 2001; 24: 24-30.
3. Fagugli RM, Palubo B, Ricciardi D et al. Association between Brain Natriuretic Peptide and Extracellular Water in Hemodialysis Patiens. Nephron Clin Pract 2003; 95: 60-66.
4. Iwashima Y, Horio T, Takami Y et al. Effects of the Creation of Arteriovenous Fistula for Hemodialysis on Cardiac Function and Natriuretic Peptide Levels in CRF. Am J Kidney Dis 2002; 40: 974-982.
5. Lee SW, Song JH, Kim GA et al. Plasma Brain Natriuretic Peptide Concentration on Assessment of Hydratation status in Hemodialysis Patient. Am J Kidney Dis 2003; 41: 1257-1266.
6. Naganuma T, Sugimura K, Wada S. The prognostic role of brain natriuretic peptides in hemodialysis patiens. Am J Nephrol 2002; 22: 437-444.
7. Nishimura M, Hashimoto T, Kobayashi H et al. Different Remodeling against Left Ventricular Overload between Diabetic and Non Diabetic Haemodialysis Patiens. Clinical and Experimental Pharmacology and Physiology 2003; 30: 786-792.
8. Swedberg K, Cleland J, Dargie H et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005). Eur Heart J 2005; 26: 1115-1140.
9. Špinar J, Hradec J, Málek I et al. Doporučení pro diagnostiku a léčbu chronického srdečního selhání. Cor et Vasa 2001; 43: 123-137.
10. Špinar J, Vítovec J, Špác J et al. Non-invasive prognostic factors in chronic heart failure. One year survival of 300 patients with diagnosis of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy. Int J of Cardiology 1996; 56: 283-288.
11. Špinar J, Špinarová L, Vítovec J et al. Big endothelin and chronic heart failure. Vnitř Lék 2002; 48: 3-7.
12. Štejfa M et al. Kardiologie. 2. ed (přepracované a doplněné vydání). Praha: Grada Publishing 1998.
13. Sulková S et al. Hemodialýza. Praha: Maxdorf 2000.
14. Vesely DL. Natriuretic Peptides and Acute Renal Failure. Am J Physiol Renal Physiol 2003; 285: 167-177.
15. Wahl HG, Graf S, Renz H et al. Elimination of the Cardiac Natriuretic Peptides B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP by Hemodialysis. Clinical Chemistry 2004; 50: 1071-1074.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2007 Issue 1
Most read in this issue
- The FEVER (Felodipine EVEnt Reduction) trial; a randomised, double-blind, placebo-controlled trial in Chinese hypertensive patients
- Guidelines for pharmacotherapy of acute and chronic non-oncological pain
- The importance of determination of Nt-proBNP and big endothelin in diagnosing chronic heart failure in patients on regular haemodialysis treatment
- Epilepsy and disorders of reproduction