Prognostic Utility of B-Type Natriuretic Peptide Assessment in Stable Low-Risk Outpatients With Nonischemic Cardiomyopathy After Decompensated Heart Failure

Nishii, Mototsugu; Inomata, Takayuki; Takehana, Hitoshi; Naruke, Tsuguo; Yanagisawa, Tomoyoshi; Moriguchi, Masahiko; Takeda, Sadao; Izumi, Tohru

doi:10.1016/j.jacc.2007.11.085

Cited by 57 publications

(45 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is no generally accepted level of BNP by stable heart failure patients with optimal medical therapy which would clearly present a dividing line for prognosis setting. Criterium of BNP being higher than median, which was 210 pg/mL, corresponds relatively well with the values characterising poor prognosis in relatively comparable data files 23,24 . These data confirm the significance of present BNP and pVO2 use in prognostic stratification 24 .…”

Section: Discussionsupporting

confidence: 78%

Usefulness of exercise tissue doppler echocardiography for prognostic stratification of congestive heart failure patients with left ventricular systolic dysfunction

Ludka¹,

Trna²,

Galková³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Aim. Determination of the importance of exercise tissue Doppler echocardiography in prognostic stratification of congestive heart failure patients with systolic dysfunction. Methods. 106 patients with congestive heart failure and LVEF ≤ 45% on optimal pharmacotherapy were included in the study. Results of resting and post-exercise echocardiography, cardiopulmonary exercise test and serum BNP levels were available for all patients. Two patient groups were constituted, based on the prognostic classification. Group I contained 21 patients with poor prognosis (defined by predicted value of pVO2 < 76% together with both VE/VCO2 slope > 32.7 and BNP > 210 pg/mL) and group II with 85 patients who did not meet the criteria. Results. The patient groups significantly differed in indexed volume of left atrium, mitral regurgitation severity, rest and post-exercise systolic velocity of mitral annulus and in rest and post-exercise E/Em. Multivariate analysis identified E/ Em as the only independent predictor of prognosis. E/Em at rest (post-exercise) ≥ 16.6 (≥ 18.7) defined poor prognosis with sensitivity of 71% (86%) and specificity of 71% (71%). Conclusion. Our study suggests usefulness of exercise tissue Doppler echocardiography for prognostic stratification of patients with congestive heart failure with possible superiority to resting parameters.

show abstract

Section: Discussionsupporting

confidence: 78%

Usefulness of exercise tissue doppler echocardiography for prognostic stratification of congestive heart failure patients with left ventricular systolic dysfunction

Ludka¹,

Trna²,

Galková³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown a correlation between higher BNP levels and worsening HF classes and measures of functional status. 6,13,19 These studies included subjects with HF classes I to IV, whereas in the current study, 72% of the subjects had HF class II and 27% had HF class III or IV, with Survival analysis of time to hospitalization for worsening HF, death, or transplant showed significantly worse event-free survival in subjects with BNP Ն140 pg/mL. Event-free survival at 6 and 9 months was 90% and 78%, respectively, for a BNP level Ͻ140 pg/mL and 68% and 50%, respectively, for a BNP level of Ն140 pg/mL.…”

Section: Discussionmentioning

confidence: 99%

“…Although these data are consistent with previous studies showing that BNP levels can predict adverse outcomes in both children and adults with HF, further validation is needed to determine the BNP level necessary to stratify risk in other specific and/or broader cohorts. 15,19 In a cohort of mostly asymptomatic older children, all of whom had a diagnosis of dilated cardiomyopathy with anatomically normal hearts, Price et al 15 reported a positive association of a BNP level of 300 pg/mL with a 90-day composite outcome of HF-related hospitalization, HF-related death, or listing for transplantation. Our study population was very different in that all subjects were symptomatic and 40% of the subjects had a diagnosis of CHD, 27% with a non-LV systemic ventricle.…”

Section: Auerbach Et Al Bnp Predicts Pediatric Heart Failure Outcomesmentioning

confidence: 99%

BNP Levels Predict Outcome in Pediatric Heart Failure Patients

Auerbach

Richmond

Lamour

et al. 2010

Circ: Heart Failure

View full text Add to dashboard Cite

Background-The ability of serum B-type natriuretic peptide levels (BNP) to predict outcomes in children with heart failure (HF) has not been well demonstrated. This study was designed to determine whether BNP levels predict outcomes in patients with moderate symptomatic HF. Methods and Results-We investigated whether enrollment BNP levels for the Pediatric Carvedilol Trial were associated with baseline characteristics. Freedom from a composite end point of HF hospitalization, death, or transplantation at 9 months was compared using a threshold BNP level identified using receiver operating curve analysis. Median BNP level was 110 pg/mL (interquartile range, 22.4 to 342.0 pg/mL) in 138 subjects. Median age was 3.4 years (interquartile range, 1.1 to 11.0 years). Diagnoses were cardiomyopathy (60%) and congenital heart disease (40%); 73% had a systemic left ventricle. BNP levels correlated moderately with left ventricular ejection fraction (Rϭ0.39, PϽ0.001) but did not differ by HF class, age, diagnosis, sex, ventricular morphology, or left ventricular end-diastolic dimension Z-score (Rϭ0.19).Outcome events included 25 HF hospitalizations, 4 deaths, and 2 transplants. Sensitivity was 71% and specificity 63%, for a BNP cutoff value of 140 pg/mL. BNP Ն140 pg/mL (hazard ratio, 3.7; 95% confidence interval, 1.62 to 8.4; Pϭ0.002) and age Ͼ2 years (hazard ratio, 4.45; 95% confidence interval, 1.68 to 12.04; Pϭ0.003) were independently associated with worse outcomes. Conclusions-In children with moderately symptomatic HF, BNP Ն140 pg/mL and age Ͼ2 years identified subjects at higher risk for worse outcome. Further validation is needed to determine the BNP levels necessary to stratify risk in other pediatric cohorts. (Circ Heart Fail. 2010;3:606-611.)

show abstract

“…After the treatment, the predischarge cutoff point for the risk of readmission and mortality falls to about 500 pg/ml (12). The cutoff point further declined to abut 200 pg/ml in clinically stable outpatients after decompensated HF (13). These obsevations suggested that the therapeutic strategies for HF including a safe hospital discharge and the prevention of readmission or cardiac event may be guided by BNP measurement.…”

Section: Heart Failurementioning

confidence: 99%

“…Recently, we reported prognostic utility of BNP in clinically stable 83 outpatients with nonischemic DCM after decompensated HF (13). They were in a clinically stable status during at least 6 months after hospital discharge at relatively low BNP level, namely mean BNP level of about 200 pg/ml.…”

Section: Dilated Cardiomyopathymentioning

confidence: 99%

Biomarker for Cardiomyopathy-B-Type Natriuretic Peptide

Nishii¹,

Izumi²

2012

Cardiomyopathies - From Basic Research to Clinical Management

Self Cite

View full text Add to dashboard Cite

Cardiomyopathy means "heart (cardio) muscle (myo) disease (pathy)". Currently, cardiomyopathies are defined as myocardial disorders in which the heart muscle is structurally and/or functionally abnormal in the absence of a coronary artery disease, hypertension, valvular heart disease or congenital heart disease sufficient to cause the observed myocardial abnormalities. This book provides a comprehensive, state-of-theart review of the current knowledge of cardiomyopathies. Instead of following the classic interdisciplinary division, the entire cardiovascular system is presented as a functional unity, and the contributors explore pathophysiological mechanisms from different perspectives, including genetics, molecular biology, electrophysiology, invasive and non-invasive cardiology, imaging methods and surgery. In order to provide a balanced medical view, this book was edited by a clinical cardiologist.

show abstract

Prognostic Utility of B-Type Natriuretic Peptide Assessment in Stable Low-Risk Outpatients With Nonischemic Cardiomyopathy After Decompensated Heart Failure

Abstract: Even in stable low-risk outpatients with NICM at 6 months after hospital discharge for decompensated HF, BNP assessment predicts a long-term risk of redecompensation.

Cited by 57 publications

References 35 publications

Usefulness of exercise tissue doppler echocardiography for prognostic stratification of congestive heart failure patients with left ventricular systolic dysfunction

Usefulness of exercise tissue doppler echocardiography for prognostic stratification of congestive heart failure patients with left ventricular systolic dysfunction

BNP Levels Predict Outcome in Pediatric Heart Failure Patients

Biomarker for Cardiomyopathy-B-Type Natriuretic Peptide

Contact Info

Product

Resources

About