Relation of body fluid status to B‐type natriuretic peptide levels in patients with chronic heart failure during long‐term follow‐up

Kataoka, Hiroyuki

doi:10.1002/clc.4960291008

Cited by 13 publications

(20 citation statements)

References 24 publications

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“…4,14 Elderly patients with chronic heart failure and previous decompensation often have persistent pulmonary crackles, even during stable periods, 22 associated in some cases with the agerelated phenomena, not heart failure status. Whether crackles are related to cardiac dysfunction should be interpreted in light of other clinical tests including, for example, Doppler echocardiography, 7,8 serum BNP measurement, 17,22,25 or thoracic CT scans. 12,13 This study had several limitations.…”

Section: Discussionmentioning

confidence: 99%

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Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients

Kataoka¹,

Matsuno²

2008

The Annals of Family Medicine

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PURPOSEThe presence of age-related pulmonary crackles (rales) might interfere with a physician's clinical management of patients with suspected heart failure. We examined the characteristics of pulmonary crackles among patients with stage A cardiovascular disease (American College of Cardiology/American Heart Association heart failure staging criteria), stratifi ed by decade, because little is known about these issues in such patients at high risk for congestive heart failure who have no structural heart disease or acute heart failure symptoms.METHODS After exclusion of comorbid pulmonary and other critical diseases, 274 participants, in whom the heart was structurally (based on Doppler echocardiography) and functionally (B-type natriuretic peptide <80 pg/mL) normal and the lung (X-ray evaluation) was normal, were eligible for the analysis. RESULTSThere was a signifi cant difference in the prevalence of crackles among patients in the low (45-64 years; n = 97; 11%; 95% CI, 5%-18%), medium (65-79 years; n = 121; 34%; 95% CI, 27%-40%), and high (80-95 years; n = 56; 70%; 95% CI, 58%-82%) age-groups (P <.001). The risk for audible crackles increased approximately threefold every 10 years after 45 years of age. During a mean follow-up of 11 ± 2.3 months (n = 255), the short-term (≤3 months) reproducibility of crackles was 87%. The occurrence of cardiopulmonary disease during follow-up included cardiovascular disease in 5 patients and pulmonary disease in 6.CONCLUSIONS Recognition of age-related pulmonary crackles (rales) is important because such clinically unimportant crackles are so common among elderly patients that, without knowledge of this phenomenon, their existence might interfere with the physician's management of cardiopulmonary patients.

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Section: Discussionmentioning

confidence: 99%

“…Serum BNP was measured using the Shionoria assay method. 17 The Doppler echocardiogram was performed using a commercially available real-time, wide-angle phased-array system (Aloka SSD-2000, Aloka Co, Ltd, Tokyo, Japan).…”

Section: Other Main Measurementsmentioning

confidence: 99%

Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients

Kataoka¹,

Matsuno²

2008

The Annals of Family Medicine

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“…Deterioration in chronic HF was clinically defined as the new appearance or worsening of HF-related symptom(s) and/or sign(s) when compared to the stable clinical status evaluated at the time of study entry. 7 The main HF-related signs evaluated in this study were pulmonary rales, peripheral edema, third heart sound on physical examination, and pleural effusion detected using a sonogram. Patients with HF deterioration were treated on an outpatient basis with the option to hospitalize if clinically necessary.…”

Section: Assessment Of Deterioration In Chronic Heart Failurementioning

confidence: 92%

“…At every clinic visit, each patient was thoroughly examined for BNP levels measured by the Shionoria assay method, 7 symptoms, and HF-related signs of body fluid retention based on physical evaluation and sonography scanning for pleural effusion 5 by the same cardiologist. When new or worsening symptoms and/or signs were identified, patients were further evaluated by optimal use of chest x-ray and/or echocardiography.…”

Section: Study Protocolmentioning

confidence: 99%

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Utility of Thoracic Sonography for Follow‐up Examination of Chronic Heart Failure Patients with Previous Decompensation

Kataoka

2007

Clinical Cardiology

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SummaryBackground: Thoracic sonography searching for pleural effusion is helpful in diagnosing heart failure (HF) in emergency situations, but utility of this test for follow-up examination of chronic HF patient is unknown.Hypothesis: Thoracic sonography searching for pleural effusion may be suitable for monitoring deterioration in chronic HF outpatients during long-term follow-up.Methods: Patients with stable HF at the time of study entry, but with previous deterioration (n = 46) were recruited and followed between June 2003 and September 2005. Evaluated HF-related variables included symptoms and signs of HF, pleural effusion on an ultrasonogram, and B-type natriuretic peptide (BNP) levels.Results: During the study period, 26 patients developed deterioration in chronic HF and 20 maintained a stable clinical course. Of the 26 patients with deteriorating HF, 25 (96%) demonstrated objective HF-related sign(s) under examination. Among the signs tested in the present study, pleural effusion on a sonogram was the leading HF-related sign (77%), followed by rales (46%) and edema (46%). Eleven patients (42%) presented with only one feature, in which pleural effusion on a sonogram was the most frequent (7 of 11 patients). Using

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Clinical Characteristics of Lower‐Extremity Edema in Stage A Cardiovascular Disease Status Defined by the ACC/AHA 2001 Chronic Heart Failure Guidelines

Kataoka

2013

Clinical Cardiology

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Background: Checking for lower-extremity edema is important for diagnosing, monitoring, and managing heart failure (HF). However, the characteristics of this sign in the early stages of cardiovascular disease (stage A, as defined by the American College of Cardiology/American Heart Association 2001 chronic HF guidelines) have not been adequately explored. Hypothesis: We hypothesized that stage A HF patients (at risk for HF) are free from leg edema. Methods: After the exclusion of patients with high serum creatinine levels (≥1.2 mg/dL), abnormal electrocardiogram rhythm, and/or comorbid critical disease(s), we studied the prevalence and predictors for leg edema in 274 subjects at risk for heart failure but without structural heart disease or symptoms of HF. Results: The overall prevalence of lower-extremity edema was 33 of 274 patients (12.0%; 95% confidence interval: 8.2%-15.9%). In most patients (29/33, 88%), the leg edema involved only the ankle and foot. Compared with patients without leg edema (n = 241), those with leg edema (n = 33) were older (age, 74 ± 11 7 vs 69 ± 12 years, P = 0.006), more likely to present with pulmonary crackles (52% vs 31%, P < 0.03), and more likely to have varicose veins (55% vs 15%, P < 0.001). Leg edema and varicose veins coexisted in 19 (58%) patients, of whom 16 patients were women. On multivariate analysis, the presence of varicose veins was the only independent predictor of the appearance of bilateral leg edema (odds ratio: 8.18, 95% confidence interval: 3.92-17.1, P < 0.001). Conclusions: A mild degree of leg edema is not uncommon in patients at risk for HF. Recognition of this phenomenon might be important for evaluation, monitoring, and self-care of HF patients.

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Relation of body fluid status to B‐type natriuretic peptide levels in patients with chronic heart failure during long‐term follow‐up

Cited by 13 publications

References 24 publications

Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients

Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients

Utility of Thoracic Sonography for Follow‐up Examination of Chronic Heart Failure Patients with Previous Decompensation

Clinical Characteristics of Lower‐Extremity Edema in Stage A Cardiovascular Disease Status Defined by the ACC/AHA 2001 Chronic Heart Failure Guidelines

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