Transthoracic Bioimpedance and Brain Natriuretic Peptide Assessment for Prognostic Stratification of Outpatients With Chronic Systolic Heart Failure

Background:The risk of cardiovascular disease in dialysis patients is higher than the general population. Vitamin D receptors exist in myocardium inhibit cardiac hypertrophy. N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is a neurohormone secreted by the heart in response to ventricular mass increase. This study aimed to evaluate the effect of oral vitamin D on serum level of pro-B-type natriuretic peptide (pro-BNP) in peritoneal dialysis patients.Materials and Methods:In a randomized clinical trial, 84 peritoneal dialysis patients (49 males and 35 females) were randomly divided into two groups. The intervention group received 50000 units oral vitamin D per week, for 12 weeks if 25-hydroxy-vitamin D level was <10 ng/ml and for 8 weeks if it was between 10 ng/ml and 30 ng/ml. The control group received placebo. Parathyroid hormone, calcium, phosphor, 25-hydroxy-vitamin D, albumin and NT-pro-BNP were evaluated before and after the study.Results:The mean serum level of pro-BNP in patients receiving vitamin D and placebo group before the study was 875 pg/ml and 793 pg/ml, respectively. There was 895.9 pg/ml in the intervention group and 736.7 pg/ml in the control group (P = 0.7). Mean serum level of 25(OH) D in patients receiving oral vitamin D and placebo group before the study was 16.9 ng/ml and 31.9 ng/ml, respectively. There was 28.9 ng/ml in the intervention group and 12.9 ng/ml in the control group (P = 0.001). There were no significant differences regarding other indices (Alb, P, Ca, intact parathyroid hormone) between two groups.Conclusion:Vitamin D did not significantly change the serum level of pro-BNP in peritoneal dialysis patients.

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“…BNP and NT-pro-BNP are markers of severity and prognosis of acute coronary syndrome and heart failure. [ 19 ]…”

Section: Introductionmentioning

confidence: 99%

The effect of oral vitamin D on serum level of N-terminal pro-B-type natriuretic peptide

et al. 2014

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“…Evidently lower mortality (2.1%) was observed in the group with BNP values < 450 pg/ml and the TFC < 40/kΩ, while in patients with BNP values ≥ 450 pg/ml and TFC ≥ 40/kΩ, the mortality was 46.5%. The use of this type of diagnosis during the 1st visit may help ensure better treatment of the patient by enabling implementation of an appropriate therapeutic strategy [14].…”

Section: Methodological Principlesmentioning

confidence: 99%

Impedance cardiography – Old method, new opportunities. Part I. Clinical applications

Siedlecka¹,

Siedlecki²,

Bortkiewicz³

2015

Int J Occup Med Environ Health

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Monitoring of cardiovascular hemodynamic changes requires a very expensive and highly specialized equipment and skilled medical personnel. Up to the present time, an inexpensive, non-invasive and easy-to-use method which, like Doppler echocardiography, magnetic resonance angiography or radionuclide imaging, would assess hemodynamics of the cardiovascular system was not available. A method known as impedance cardiography (ICG) or thoracic electrical bioimpedance cardiography (TEBC) meets those criteria. It is non-invasive, which is of a particular advantage over the conventional methods that require catheterization. As a result, the patient is not at risk of possible complications and the procedure is less expensive and easier. Impedance cardiography, despite its non-invasive character, has not been so far extensively used for monitoring of hemodynamic parameters in hospitalized patients. Various authors report that attempts have been continued to compare the results from ICG and those obtained by other diagnostic methods. This paper presents the use of impedance cardiography in diagnosis of hypertension, cardiac insufficiency, differentiating the causes of acute dyspnea, as well as in assessing the effects of cardiac rehabilitation in patients with heart failure.

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“…A feasibility study using the BIM sensor for home TM has been conducted, where it was shown to predict episodes of hospitalization for worsening HF [SCHAUERTE P, UNPUBLISHED DATA]. Multimodal assessments of CHF patients with natriuretic peptides, BIM and clinical evaluation have been shown to identify those with thoracic congestion and more adverse prognosis [26]. This modality of lung congestion monitoring holds great promise in providing 'snap-shot' measurements, which may be easily performed at home on a daily basis, to provide crucial information about patients at risk of 'danger zone congestion status.'…”

Section: Spectroscopic Bioimpedancementioning

confidence: 99%

The utility of novel non-invasive technologies for remote hemodynamic monitoring in chronic heart failure

Mabote

Wong

Cleland

2014

Expert Review of Cardiovascular Therapy

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Monitoring a patient's hemodynamic status may be a revolutionary way to aid a 'health maintenance' strategy in which the physician strives to therapeutically keep the patient in an ideal hemodynamic range. Currently, home telemonitoring employs a 'crisis-prevention' approach. This strategy is still based on easily acquired measures such as heart rate, weight and blood pressure--measurements that are useful to help implement guideline-directed therapy but provide little information about impending decompensation or the risk of hospitalisation. Current systems provide limited information to personalize and adapt medication therapy for heart failure. Several innovative technologies that can remotely monitor estimates of cardiovascular hemodynamics, such as cardiac index, systemic vascular resistance, augmentation index and added heart sounds may enable earlier detection of heart failure decompensation. This editorial presents an overview of the innovative technologies that are available for non-invasive hemodynamic monitoring and maybe adapted for home telemonitoring for chronic heart failure.

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Transthoracic Bioimpedance and Brain Natriuretic Peptide Assessment for Prognostic Stratification of Outpatients With Chronic Systolic Heart Failure

Cited by 19 publications

References 38 publications

The effect of oral vitamin D on serum level of N-terminal pro-B-type natriuretic peptide

The effect of oral vitamin D on serum level of N-terminal pro-B-type natriuretic peptide

Impedance cardiography – Old method, new opportunities. Part I. Clinical applications

The utility of novel non-invasive technologies for remote hemodynamic monitoring in chronic heart failure

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