Renal function, N-terminal Pro-B-type natriuretic peptide, propeptide big-endothelin and patients with heart failure and preserved ejection fraction
Renal dysfunction may limit the clinical application of NT-proBNP in the diagnosis of heart failure. In general practice, where echocardiography is not readily available, a biomarker for the diagnosis of a heart failure with preserved ejection fraction (HFpEF) would be useful. Since cardiac diseases...
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| Main Authors: | , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
Peptides
Year: 2018, Volume: 111, Pages: 112-117 |
| ISSN: | 1873-5169 |
| DOI: | 10.1016/j.peptides.2018.04.003 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1016/j.peptides.2018.04.003 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0196978118300718 
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| Author Notes: | Ingrid Gergei, Bernhard K. Krämer, Hubert Scharnagl, Tatjana Stojakovic, Winfried März |
| Summary: | Renal dysfunction may limit the clinical application of NT-proBNP in the diagnosis of heart failure. In general practice, where echocardiography is not readily available, a biomarker for the diagnosis of a heart failure with preserved ejection fraction (HFpEF) would be useful. Since cardiac diseases frequently coincide with renal disease, there is a high need of valid risk stratification methods in patients affected with both. We therefore examined NT-proBNP and another biomarker, Big-Endothelin-1, as a marker of HFpEF in patients with CKD. NT-proBNP and Big-ET-1 were determined in 439 patients with HFpEF in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. NT-proBNP plasma level has shown an exponential increase with declining GFR, while Big-ET-1 plasma level increased only in a moderate and linear fashion. In patients without CKD, a NT-proBNP cut-off point at 250pg/mL was suitable for the discrimination between HFpEF and patients without HF. When the GFR was less than 60mL/min/1.73m2, the NT-proBNP cut-off point should be raised to 750pg/mL. At a cutoff point at 0.85 fmol/L, Big-ET-1 allowed to distinguish patients with HFpEF from persons without HF, independently of GFR. In general, NT-proBNP is a good indicator of suspected heart failure. While for NT-proBNP different cut-off points have to be considered in the diagnosis of HFpEF, a single cut-off point of Big-ET-1 was appropriate in the diagnosis of HFpEF, regardless of the presence or absence of CKD. An additional measurement of Big-ET-1 improves the diagnosis of HFpEF in patients with chronic kidney disease. |
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| Item Description: | Available online 21 April 2018 Gesehen am 29.03.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1873-5169 |
| DOI: | 10.1016/j.peptides.2018.04.003 |