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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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Hauptverfasser: Gergei, Ingrid (VerfasserIn) , Krämer, Bernhard (VerfasserIn) , März, Winfried (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2019
In: Peptides
Year: 2018, Jahrgang: 111, Pages: 112-117
ISSN:1873-5169
DOI:10.1016/j.peptides.2018.04.003
Online-Zugang:Verlag, Volltext: https://doi.org/10.1016/j.peptides.2018.04.003
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0196978118300718
Volltext
Verfasserangaben:Ingrid Gergei, Bernhard K. Krämer, Hubert Scharnagl, Tatjana Stojakovic, Winfried März

MARC

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520 |a 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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