Objective. The prognostic value of N-terminal procerebral natriuretic peptide (NT-proBNP) in patients with heart failure (HF) is well established. In contrast, its role as an early predictor of mortality in patients hospitalized for heart failure with preserved ejection fraction (HF-EF) and heart failure with reduced ejection fraction (HF-EF) is less well documented. Therefore, the objective of this study is to evaluate the usefulness and prognostic value of plasma NT-proBNP in these patients. Method. This retrospective observational study included 620 patients admitted for acute heart failure, classified into 3 groups according to their left ventricular ejection fraction (LVEF): HF-EF (LVEF ≥ 50%), HF-mEF (heart failure with ejection fraction mean) (LVEF 35-49%) and HF-rEF (LVEF <40%), whose plasma levels of NT-proBNP and clinical data were determined at hospital admission. Univariate and multivariate logistic regression was used to perform prognostic values of NT-proBNP levels for 3.4 years of all-cause mortality in each group. Results: The mean plasma levels of NT-proBNP in patients with HF-cEF (35%) and borderline HF-cEF (43%) was 1001-5000 pg / ml; patients with HF-rEF were similarly distributed between the groups 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) and> 15001pg / ml (30.6%). The mortality rate increased significantly in patients with NT-proBNP concentrations > 15001 pg / ml (40%) and decreased with NT-proBNP levels <250 pg / ml (4%), compared to the other NT-proBNP groups. The mortality rate increased proportionally to elevated baseline NT-proBNP, regardless of LVEF. Conclusion. In patients hospitalized for an acute decompensated event with HF-cEF (LVEF ≥50%) and HF-mEF (LVEF 35-49%), plasma levels of NT-proBNP are a useful tool to predict early mortality, as for HF -FEr (LVEF <40%).
La enfermedad por Coronavirus 2019 (COVID-19) ha resultado en una pandemia nueva y de rápido crecimiento causada por el coronavirus del síndrome respiratorio agudo severo 2 (SARS-CoV-2). La comprensión de la base fisiopatológica e inmunológica detrás de las manifestaciones clínicas es esencial para el desarrollo de terapias efectivas en pacientes infectados. Informes recientes han descrito una correlación clínica y molecular entre el SARS-CoV-2 y la hemoglobina, por lo que en este estudio se proporciona una descripción estructural de la hemoglobina y una descripción molecular del SARS-CoV-2, al igual que inferencias sobre las características fisiopatológicas del virus y los hallazgos clínicos relacionados con los componentes estructurales de la hemoglobina.
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