Obesity and natriuretic peptides, BNP and NT-proBNP: Mechanisms and diagnostic implications for heart failure

Madamanchi, Chaitanya; Alhosaini, Hassan; Sumida, Arihiro; Runge, Marschall S.

doi:10.1016/j.ijcard.2014.08.007

Cited by 270 publications

(193 citation statements)

References 118 publications

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“…But, on the other hand, NT-pro-BNP and NT-pro-ANP are different molecules than natriuretic peptides, so the above mentioned mechanism cannot explain their lower levels in obese heart failure patients. Reduced cardiac synthesis or secretion of natriuretic peptides may at least, partially explain this phenomenon [21,22]. In the current study, NT-pro-BNP values were inverse correlated with total-cholesterol, LDL-cholesterol, triglycerides values and ejection fraction, which was interpreted as a marker of poor prognosis.…”

Section: Discussionsupporting

confidence: 50%

The profile of cardiovascular risk factors in heart failure obese patients hospitalised in a rehabilitation romanian hospital

Dădârlat¹,

Sitar-Tăut²,

Zdrenghea³

et al. 2018

Balneo

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Introduction.Despite all advanced evidence-based therapeutic opportunities, heart failure remains a major public health burden, with a dramatically increasing in prevalence. Moreover, the diagnosis of chronic heart failure in obese patients brings unique challenges. So, the aim of this study was to identify the cardiovascular risk factors profile in heart failure obese patients, admitted in rehabilitation programs. Material and methods.This study enrolled 80 obese (body mass index ≥30 kg/m2) patients, 56.2% men with average age ranged of 69.75 ± 9.12 years who were hospitalized for decompensated heart failure in the Rehabilitation Hospital, Cardiology-Department, Cluj-Napoca, Romania. Baseline characteristics, clinical presentation, NT-proBNP values, echocardiographic parameters and in-hospital therapies were evaluated. The lot was divided into three groups: obese heart failure patients with reduced (<40%), preserved (≥50%), and midrange (40-49%) ejection fraction. Heart failure was defined according to 2016 ESC criteria. NT-pro-BNP values higher than 125 pg/ml were considered to be associated with heart failure development. Statistics were performed using SPSS 16.0 for Windows. Results.The mean age of the analyzed study population was 69.75 ± 9.12 years and 56.2% were men. The most frequent associated risk factor was smoking (45%), followed by diabetes mellitus (40%) and hypertension (25%). The mean ejection fraction value was 43.58±10.85% and the median value was 45%. The mean NT-pro-BNP registered levels were 2887.03±3157 pg/ml. An inverse relationship was found between NT-pro-BNP levels and plasma lipid fractions, total-cholesterol-r=-0.194, LDL-cholesterol-r=-0.0971, triglycerides-r=-0.155, HDL-cholesterol-r=-0.07. Also, NT-proBNP negatively correlated with left ventricular ejection fraction-r=-0.307, p=0.0086. In conclusion, obese heart failure patients presented particular characteristics, the most frequent observed cardiovascular risk factors were smoking, diabetes mellitus and arterial hypertension. Identifying the major comorbidities in this subgroup of patients is of major importance, especially for improving heart failure's prognosis and survival.

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Section: Discussionsupporting

confidence: 50%

The profile of cardiovascular risk factors in heart failure obese patients hospitalised in a rehabilitation romanian hospital

Dădârlat¹,

Sitar-Tăut²,

Zdrenghea³

et al. 2018

Balneo

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show abstract

“…For example, some obese patients with HFpEF have a BNP of 60 to 100 pg/mL when in symptomatic HF; BNP levels rise in these patients after weight loss from bariatric surgery to levels >100 pg/mL. [94][95][96] Markers of Diastolic Dysfunction A significant proportion of patients with HFpEF have diastolic dysfunction. 97 Cardiac stress releases marker candidates such as insulin growth factor-binding protein-7, which is released by the myocardium in the setting of abnormal filling pressure.…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Chow¹,

Maisel²,

et al. 2017

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Background and Purpose: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. Methods: The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations. Results: A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners. Conclusions: HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their concentrations in blood not only can provide the clinician information about the diagnosis and severity of HF but also can improve prognostication and treatment strategies.

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“…Najważniejsze z nich to obecność AF, starszy wiek, niewydolność nerek [55]. Z kolei w przypadku otyłych pacjentów stężenia NP mogą być nieproporcjonalnie niskie [62] (patrz także rozdz. 12.2 i tab.…”

Section: Podstawowe Wstępne Badaniaunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

459

446

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Obesity and natriuretic peptides, BNP and NT-proBNP: Mechanisms and diagnostic implications for heart failure

Cited by 270 publications

References 118 publications

The profile of cardiovascular risk factors in heart failure obese patients hospitalised in a rehabilitation romanian hospital

The profile of cardiovascular risk factors in heart failure obese patients hospitalised in a rehabilitation romanian hospital

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

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