Faida KuÄukalic
University of Sarajevo, Bosnia and Hercegovina
Title: The significance of natriuretic peptide in heart failure
Biography
Biography: Faida KuÄukalic
Abstract
Introduction: Congestive heart failure caused dominantly by coronary artery disease activates number of compensatory mechanism where secretion of natriuretic peptide takes a very important place. N-terminal pro brain natriuretic peptides is a established biomarker of ventricular dysfunction for diagnosis, screening, prognosis, monitoring and optimatisation of pharmacological management.
Aims: High plasma levels of NTproBNP before cardiac procedure are associated with higher prognostic importance.
Subjects and methods: We included 60 patients (43 man and 17 woman), undergoing coronary revascularisation (CABG), or replacement of aortic (mitral) valvule. All patients had left ventricular dysfunction with reduced ejection fraction (EF<40%). Plasma level of NTproBNP has been taken preoperatively, and postoperative 5 days after surgery.
Results: Our results have shown that concentration of NTproBNP were 1322,2 pg/ml preoperatively, and in postoperative period 6067,9 pg/ml for all participants. The subgroup with severe dysfunction of the left ventricule (EF<30%) had value of NTproBNP 1560,47 pg/ml preoperatively while the subgroup with intermediate left ventricular dysfunction (EF 31-40%) had a value of 1194,00 pg/ml. In postoperative period in subgroup of participants with EF<30% NTproBNP level was 7219,23 pg/ml, compared with subgroup with EF 31-40% where this parameter valued 5461,00 pg/ml.
Conclusions: Concentration of NTproBNP was correlated with left ventricular dysfunction. All participants had postoperative NTproBNP increase (p<1%). NTproBNP has a strong prognostic value and it will help us to identify patients who will need more intensive management after hospital discharge. Repeated biomarker measurement will become the strongest independent prognostic marker for rehospitalisation, adverse cardiovascular events and mortality in short and long-term period. Using NTproBNP as a biomarker-guide therapy we will try to act on the main goal of heart failure treatment, which include: prognosis, morbidity and motrtality.