Leto Laura, Testa Marzia, Feola Mauro
School of Geriatrics, University of Medicine, 10100 Turin, Italy.
Cardiovascular Rehabilitation-Heart Failure Unit, Ospedale SS Trinita, 12045 Fossano, Italy.
Int J Endocrinol. 2015;2015:239136. doi: 10.1155/2015/239136. Epub 2015 Apr 22.
The determination of B-type natriuretic peptides (BNP) may have a role in the diagnosis of heart failure (HF) or guiding HF therapy. This study investigated the role of BNP determination in a cohort of elderly patients admitted to hospital with acute decompensated HF and its correlation with main demographic, clinical, and instrumental data and evaluated possible association with major outcome such as mortality or readmission after a 6-month period of follow-up. Methods. From October 2011 to May 2014 consecutive patients admitted to our unit with symptoms of acute HF or worsening of chronic HF entered the study collecting functional, echocardiographic, and hydration parameters. Correlation between BNP and main parameters was analysed, as well as the mortality/6-month readmission rate. Results. In 951 patients (mean age 71 ys; 37% females) a positive correlation was obtained between BNP and age, creatinine levels, NYHA class at admission and discharge, and levels of hydration; an inverse, negative correlation between BNP and sodium levels, LVEF, distance performed at 6MWT at admission and at discharge, and scores at MMSE at admission and discharge emerged. BNP levels at admission and at discharge were furthermore clearly associated with mortality at 6 months (Chi-square 704.38, p = 0.03) and hospital readmission (Chi-square 741.57, p < 0.01). Conclusion. In an elderly HF population, BNP is related not only with clinical, laboratory, and instrumental data but also with multidimensional scales evaluating global status; higher BNP levels are linked with a worse prognosis in terms of mortality and 6-month readmission.
B型利钠肽(BNP)的测定可能在心力衰竭(HF)的诊断或指导HF治疗中发挥作用。本研究调查了BNP测定在一组因急性失代偿性HF入院的老年患者中的作用,及其与主要人口统计学、临床和仪器检查数据的相关性,并评估了与主要结局(如6个月随访期后的死亡率或再入院率)的可能关联。方法。从2011年10月至2014年5月,连续有急性HF症状或慢性HF恶化症状入院的患者进入本研究,收集功能、超声心动图和水化参数。分析了BNP与主要参数之间的相关性,以及死亡率/6个月再入院率。结果。在951例患者(平均年龄71岁;37%为女性)中,BNP与年龄、肌酐水平、入院和出院时的纽约心脏协会(NYHA)分级以及水化水平呈正相关;BNP与钠水平、左心室射血分数(LVEF)、入院和出院时6分钟步行试验(6MWT)的距离以及入院和出院时简易精神状态检查表(MMSE)评分呈负相关。此外,入院和出院时的BNP水平与6个月时的死亡率(卡方值704.38,p = 0.03)和再次入院(卡方值741.57,p < 0.01)明显相关。结论。在老年HF人群中,BNP不仅与临床、实验室和仪器检查数据相关,还与评估整体状况的多维量表相关;就死亡率和6个月再入院率而言,较高的BNP水平与较差的预后相关。