Longitudinal NT‐proBNP: Associations With Echocardiographic Changes and Outcomes in Heart Failure
Rattachement africain : jp, sg, au, nz, nl. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background The relationship of serial NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) measurements with changes in cardiac features and outcomes in heart failure (HF) remains incompletely understood. We determined whether common clinical covariates impact these relationships. Methods and Results In 2 nationwide observational populations with HF, the relationship of serial NT‐proBNP measurements with serial echocardiographic parameters and outcomes was analyzed, further stratified by HF with reduced versus preserved left ventricular ejection fraction, inpatient versus outpatient enrollment, age, obesity, chronic kidney disease, atrial fibrillation, and attainment of ≥50% guideline‐recommended doses of renin‐angiotensin system inhibitors and β‐blockers. Among 1911 patients (mean±SD age, 65.1±13.4 years; 26.6% women; 62% inpatient and 38% outpatient), NT‐proBNP declined overall, with more rapid declines among inpatients, those with obesity, those with atrial fibrillation, and those attaining ≥50% guideline‐recommended doses. Each doubling of NT‐proBNP was associated with increases in left ventricular volume (by 6.1 mL), E/e′ (transmitral to mitral annular early diastolic velocity ratio) (by 1.4 points), left atrial volume (by 3.6 mL), and reduced left ventricular ejection fraction (by −2.1%). The effect sizes of these associations were lower among patients with HF with preserved ejection fraction, atrial fibrillation, or advanced age ( P interaction <0.001). A landmark analysis identified that an SD increase in NT‐proBNP over 6 months was associated with a 27% increase in the risk of the composite event of HF hospitalization or all‐cause death between 6 months and 2 years (adjusted hazard ratio, 1.27 [95% CI, 1.15–1.40]; P <0.001). Conclusions The relationships between NT‐proBNP and structural/functional remodeling differed by age, presence of atrial fibrillation, and HF phenotypes. The association of increased NT‐proBNP with increased risk of adverse outcomes was consistent in all subgroups.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Longitudinal NT‐proBNP: Associations With Echocardiographic Changes and Outcomes in Heart Failure
- Date Crossref
- 07/05/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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National Cerebral and Cardiovascular Center pays non établi dans la noticeÉtablissement de santé
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National Heart Centre Singapore pays non établi dans la noticeÉtablissement de santé
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National University of Singapore Department of Medicine Cardiovascular Research Institute pays non établi dans la noticeUniversité ou école supérieure
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Duke-NUS Medical School pays non établi dans la noticeUniversité ou école supérieure
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National University Health System pays non établi dans la noticeUniversité ou école supérieure
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The University of Western Australia pays non établi dans la noticeUniversité ou école supérieure
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National University Heart Centre Singapore pays non établi dans la noticeÉtablissement de santé
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University of Auckland Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Auckland University of Technology pays non établi dans la noticeUniversité ou école supérieure
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National Heart Foundation of New Zealand Gerry Devlin https://orcid.org/0009-0005-6545-6724 pays non établi dans la noticeOrganisation à but non lucratif
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Middlemore Hospital Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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University of Otago Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
National Cerebral and Cardiovascular Center, National Heart Centre Singapore et Department of Medicine Cardiovascular Research Institute — National University of Singapore, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.