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Published on: October 1, 2019
Prognostic value of brain natriuretic peptide in patients with heart failure and reserved left ventricular systolic
Hui Gong1, Xin Wang2, Yi Ling2
1Division of Cardiology, Department of Medicine, Huashan Hospital of Fudan University, Shanghai 200040, P.R. China.
Insights
Brain natriuretic peptide (BNP) can predict heart failure prognosis. Higher BNP levels indicate worse outcomes, even in patients with preserved left ventricular systolic function, aiding clinical decision-making.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Brain natriuretic peptide (BNP) is a recognized prognostic biomarker for heart failure (HF).
- The prognostic value of BNP in HF patients with reserved left ventricular systolic function (RLVSF) remains unclear.
- Understanding BNP's role in RLVSF is crucial for refining HF patient management.
Purpose of the Study:
- To assess the added prognostic value of BNP in heart failure patients with reserved left ventricular systolic function (RLVSF).
- To investigate the correlation between BNP levels and cardiovascular outcomes in this specific patient group.
Main Methods:
- Retrospective analysis of 1,415 inpatients with cardiovascular disease, including 395 with HF and LVEF ≥45% (NYHA classes II-IV).
- Plasma BNP levels were measured, and left ventricular ejection fraction (LVEF) was assessed via echocardiography.
- Follow-up for 21-63 months recorded cardiovascular mortality, readmissions, and all-cause mortality.
Main Results:
- Survival time decreased significantly with increasing BNP levels across all patients (P<0.0001).
- In HF patients with RLVSF, those with BNP >100 pg/ml had a higher incidence of endpoint events (37.07% vs. 23.93%, P=0.0039).
- A significant negative correlation was found between BNP levels and survival time in HF patients with RLVSF (P=0.0005).
Conclusions:
- BNP levels are a significant predictor of prognosis in patients with heart failure, including those with reserved left ventricular systolic function.
- Higher BNP levels are associated with poorer outcomes and reduced survival time in HF patients with RLVSF.
- BNP measurement provides valuable prognostic information for HF patients with preserved ejection fraction.
Abstract:
Brain natriuretic peptide (BNP) is used as a prognostic biomarker for patients with heart failure (HF) in clinical practice, however, the correlation between BNP levels and the prognosis of HF in patients with reserved left ventricular systolic function (RLVSF) is not clear. Thus, the aim of the present study was to evaluate the added value of BNP in the prognosis of HF patients with RLVSF. Inpatients with cardiovascular disease (mean age, 65.7 years; male, 790; female, 625) admitted to the Division of Cardiology at Jinshan Hospital of Fudan University (Shanghai, China) between June 2006 and December 2009 underwent follow-up examinations. Plasma BNP levels were analyzed and measurements of the left ventricular ejection fraction (LVEF) were performed by echocardiography. Evaluations of the patients with HF were performed according to the New York Heart Association (NYHA) classification system. The duration of the follow-up period ranged between 21 and 63 months (average duration, 35.8 months) and key events included cardiovascular mortality, readmission due to cardiovascular disease or mortality due to other reasons. Survival times decreased with increasing BNP levels in all the follow-up patients (Spearman's ρ, -0.1877; P<0.0001). Among the 1,415 patients, 1,312 underwent echocardiographic detection. A total of 395 patients with NYHA classes II-IV and a LVEF ≥45% were selected. The incidence of compound endpoint events was significantly higher in the patients that had BNP levels of >100 pg/ml when compared with the patients that had BNP levels of ≤100 pg/ml (37.07 vs. 23.93%; relative risk, 1.55); consequently the survival times were significantly reduced (P=0.0039). A negative correlation was identified between the BNP levels and the survival times in these patients (Spearman's ρ, -0.1738; P=0.0005). These results indicated that the levels of BNP may be used to predict the prognosis of patients with cardiovascular disease. The prognoses of patients with higher BNP levels were worse compared with the patients with lower BNP levels. Furthermore, significant correlations were confirmed in the HF patients with RLVSF.
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