Biomarker Changes During Acute Heart Failure Treatment

Abstract

Introduction Biomarker changes may provide physicians with objective evidence of treatment efficacy in patients with acute decompensated heart failure (ADHF), and facilitate early hospital discharge. We hypothesize that MR-proADM, CT-pro-ET-1 and MR-proANP change during the first 24 hours of ADHF therapy. Methods Eligible subjects had an ED diagnosis of ADHF and fulfilled modified Framingham Criteria. Clinical data, serum, and plasma were collected at enrollment, 2–4 hours, and 12–24 hours after treatment. We calculated changes in biomarker concentrations from baseline to 2–4 hours, baseline to 12–24 hours, and 2–4 to 12–24 hours. Fisher’s exact and Kruskal-Wallis tests were used for comparisons. Results Forty-eight subjects were included. Median age was 62 years (range 40–88), 54% were male and 50% were white. More subjects had changes in MR-pro-ANP levels in the first 2–4 hours after ADHF therapy compared to MR-proADM or CT-pro-ET-1 (36% vs. 16% and 24%). However, 12–24 hours after therapy similar proportions of patients had changes in MR-proANP, MR-proADM, and CT-proET-1 levels (47%, 41% and 49%). Conclusion In this preliminary study patients with ADHF had measurable changes in MR-proANP, MR-proADM and CT-pro-ET-1 24 hours after initial therapy. A study of association with clinical course and outcomes to determine the role of these markers in risk-stratification is warranted.

Differential response of the natriuretic peptide system to weight loss and exercise in overweight or obese patients

“…Indeed, mR-proANP increases with exercise, a known stimulus for ANP secretion. Conversely, cardiac unloading through heart failure treatment reduces mR-proANP levels [23].…”

Association of Biochemical, Cytokine and Echocardiographic Markers of Cardiovascular Injuries with T894G Polymorphism of Endothelial Nitric Oxide Synthase Gene in Patients with Nonviral Liver Cirrhosis

“…13,15 However, there is a little information about the changes of central blood flow and condition of cardiovascular system in such patients. Together with echocardiac findings, plasma levels of proANP, a molecule which is one of the most undisputable markers of cardiovascular insufficiency, 49,50 were increased in patients with liver cirrhosis. Moreover, it was found that T-allele carriers had significantly higher proANP plasma level compared with GG-genotype carriers, which correlated with structural changes of the heart: increased LA diameter and LVMM and LVMMI in males.…”

Insuficiencia cardíaca aguda

“…En la presentación en la emergencia o UCI, por tanto, el nivel de PN (BNP, NT pro-BNP) debería medirse en todos los pacientes con disnea de inicio agudo y sospecha de ICA para ayudar a la diferenciación de causas no cardíacas de disnea (24) .…”