Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: A pilot study
Autore:
Kazanegra, R; Cheng, V; Garcia, A; Krishnaswamy, P; Gardetto, N; Clopton, P; Maisel, A;
Indirizzi:
VAMC Cardiol 111A, Div Cardiol, San Diego, CA 92161 USA VAMC Cardiol 111ASan Diego CA USA 92161 Cardiol, San Diego, CA 92161 USA Vet Affairs Med Ctr, Dept Med, San Diego, CA 92161 USA Vet Affairs Med Ctr San Diego CA USA 92161 t Med, San Diego, CA 92161 USA Univ Calif San Diego, San Diego, CA 92103 USA Univ Calif San Diego San Diego CA USA 92103 iego, San Diego, CA 92103 USA
Titolo Testata:
JOURNAL OF CARDIAC FAILURE
fascicolo: 1, volume: 7, anno: 2001,
pagine: 21 - 29
SICI:
1071-9164(200103)7:1<21:ARTFBN>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; PULMONARY-HYPERTENSION; BIOCHEMICAL MARKER; SECRETION PATTERNS; SEQUENCE-ANALYSIS; BRAIN; ATRIAL; PREDICTION; MORTALITY;
Keywords:
neurohormonal; Swan-Ganz; left ventricular pressure; NYHA; inotrope; vasodilator;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
67
Recensione:
Indirizzi per estratti:
Indirizzo: Maisel, A VAMC Cardiol 111A, Div Cardiol, 3350 La Jolla Village Dr, San Diego, CA 92161 USA VAMC Cardiol 111A 3350 La Jolla Village Dr San Diego CA USA 92161
Citazione:
R. Kazanegra et al., "A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: A pilot study", J CARD FAIL, 7(1), 2001, pp. 21-29

Abstract

Objectives: To determine if changes in B-type natriuretic peptide (BNP) levels can accurately reflect acute changes in pulmonary capillary wedge pressure during treatment of decompensated heart failure. Background: Tailored therapy of decompensated congestive heart failure with hemodynamic monitoring is controversial. Other than the expense and complications of Swan-Ganz catheters, its use in titration of drug therapy has no conclusive end point. Because BNP reflects both elevated left ventricularpressure and neurohormonal modulation and has a short half-life, we hypothesized that levels of BNP would decline in association with falling wedge pressures. Final BNP levels would perhaps signify a new set point of neuromodulation. Methods and Results: Twenty patients with decompensated New York Heart Association (NYHA) class: III-IV congestive heart failure (CHF) undergoing tailored therapy were studied. BNP levels were drawn every 2 to 4 hours for the first 24 hours (active treatment phase) and then every 4 hours for the next 24 to 48 hours (stabilization period). Hemodynamic data was recorded simultaneously. In 15 patients whose wedge pressure responded to treatment in the first 21 hours. there was a significant drop in BNP levels (55%) versusnonresponders (8%). There was a significant correlation between percent change in wedge pressure from baseline per hour and the percent change of BNPfrom baseline per hour (r = 0.79, P < .05). When the wedge pressure was kept at a stable, low level during the stabilization phase. BNP levels continued to frill another 37% (937 <plus/minus> 140 pg/mL at 24 hours to 605 +/-128 pg/mL). Patients who died (n = 1) had higher final BNP levels (1,078 +/- 123 pg/mL v 701 +/- 107 pg/mL). Conclusions: The data suggest that rapid testing of BNP may be an effective way to improve the in-hospital management of patients admitted with decompensated CHF. Although BNP levels will not obviate the need for invasive hemodynamic monitoring, it may be a useful adjunct in tailoring therapy to these patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 16:42:51