Predictors of prognosis in severe chronic heart failure

Parameshwar, Jayan; Keegan, Jennifer; Sparrow, Jane; Sutton, George C.; Poole‐Wilson, Philip A.

doi:10.1016/0002-8703(92)90656-g

Cited by 158 publications

(64 citation statements)

References 30 publications

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“…The size of the left ventricular cavity, as well as the heart index and the ejection fraction, have been demonstrated to have a correlation with the survival of patients with heart failure [3,4]. The greater the size of the left ventricular cavity, the lower the expected survival is [7,8].…”

Section: Commentsmentioning

confidence: 99%

Reconstrução fisiológica do ventrículo esquerdo: o conceito de máxima redução ventricular e mínima resposta inflamatória

Gomes¹,

Jaramillo²,

Asanuma³

et al. 2004

Rev Bras Cir Cardiovasc

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Section: Commentsmentioning

confidence: 99%

Reconstrução fisiológica do ventrículo esquerdo: o conceito de máxima redução ventricular e mínima resposta inflamatória

Gomes¹,

Jaramillo²,

Asanuma³

et al. 2004

Rev Bras Cir Cardiovasc

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“…In the literature, there is evidence that EF by RNVE is an independent predictive marker of mortality. 8,[13][14][15][16][17][18] The low EF in the 68 patients is consistent with a poor prognosis.…”

Section: Discussionmentioning

confidence: 83%

BNP and ANP as diagnostic and predictive markers in heart failure with left ventricular systolic dysfunction

Falcão

Pinto

Ravara

et al. 2004

J Renin Angiotensin Aldosterone Syst

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BackgroundThe prevalence of chronic heart failure (CHF) with systolic dysfunction is increasing. Plasma natriuretic peptides have been envisaged as diagnostic and predictive markers. AimsTo investigate the relationship between the levels of B-type natriuretic peptide (BNP) and A-type natriuretic peptide (ANP) and the clinical and functional parameters of CHF in outpatients with CHF at baseline, compared with normal healthy controls; to find out the differences in a randomised controlled trial between patients treated with an angiotensin-converting enzyme (ACE) inhibitor, captopril, or an angiotensin receptor blocker (ARB), irbesartan. These differences were assessed throughout the six-month treatment period and at the sixth month. MethodsPlasma BNP (pmol/L) and ANP (pmol/L) were determined in 68 hypertensive patients with dilated cardiomyopathy, NYHA class III-IV and ejection fraction (EF) <40%, and in 26 normal controls. Statistical analysis for BNP and ANP was done by Student's t-test. The patient group was randomly subdivided into two subgroups of 34 patients, each treated with either an ARB, irbesartan, or an ACE inhibitor (ACE-I), captopril. BNP and ANP were measured in both subsamples and correlated with clinical, functional and neurohormonal parameters throughout a follow-up period of six months and at the sixth month. ResultsThe mean EF in the patient sample was 33.43±6.52% and in the controls was 61.96 ±3.53% (p=0.000). The mean BNP (pmol/L) in patients was 44.78±54.36 and in the controls was 7.12±8.28 (p=0.000) and the mean ANP (pmol/L) was 30.32±25.97 in patients and 11.18±7.92 in controls (p=0.000). A statistically significant difference was found between patients and healthy controls. Significant correlations were found between natriuretic peptides and EF. Between the baseline phase and the sixth month, BNP and ANP decreased significantly in the ARB group. At the sixth month, both BNP and ANP were lower in the ARB group. Evidence of clinical benefit was found with both ARB or ACE-I treatment throughout the six months, with patients moving from classes III and IV to class II NYHA. Improvement of EF was also found, with transition of patients with lower EF (even <30%) to higher values. EF was higher in the ARB group at the sixth month. ConclusionsBNP and ANP can be useful diagnostic tools in hypertensive CHF patients with moderate-to-severe LV dysfunction. The decrease in BNP and ANP in the ARB group throughout six months, as well as the lower value at the sixth month, suggest a prognostic value of these parameters.

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“…In the Veterans' study 26 and in the studies of Cohn et al 27 and Parameshwar et al 28 , the presence of CAD was not related to worse prognosis.…”

Section: Etiology Of Congestive Heart Failurementioning

confidence: 79%

“…This way, the degree of the patient's tolerance to effort provides significant information and can be measured in an objective way. A frequently used index to assess the exercise capacity is VO 2 , which provides indirect information about the cardiovascular and pulmonary reserves and has been useful in the prognostic evaluation of the patients with CHF 28,45,46 . Maximum oxygen consumption would be the ideal index, but it is often impossible to be obtained because the patient usually interrupts the effort before that point, due to muscular fatigue and exhaustion.…”

Section: Exercise Capacitymentioning

confidence: 99%