Prognostički značaj dijametra desne komore, plućnog arterijskog pritiska i biomarkera kod pacijenata sa akutnom srčanom insuficijencijom
Ključne reči:
akutna srčana insuficijencija; biomarkeri; plućni arterijski pritisak; dijametar desne komore.
Sažetak
Cilј rada: Proceniti prognostički značaj dijametra desne komore, plućnog arterijskog pritiska (PAP) i biomarkera: natriuretski peptid tipa B (BNP), troponin I (TnI) i C-reaktivni protein visoke osetlјivosti (hsCRP), na jednogodišnji mortalitet kod pacijenata sa akutnom srčanom insuficijencijom (ASI).
Materijal i metode: Studija je obuhvatila ukupno 225 pacijenata (pts) (70,29±9,74 godina) koji su primlјeni na odelenje intenzivne nege zbog znakova i simptoma ASI. Vrednosti svih standardnih biohemijskih parametara i BNP, Tnl i hsCRP određene su tokom prva 24 sata nakon prijema. Svim pacijentima urađen je ehokardiografski pregled.
Rezultati: Tokom jednogodišnjeg praćenja umrlo je 78 (34,70%) pacijenata. U poređenju sa grupom preživelih (n=147), grupa umrlih imala je veće vrednosti BNP (853,10±384,92 naspram 1399,68±464,44 pg/ml, p<0,001), TnI (0,59±2,04 naspram 2,00±8,29 ng/ml, p<0,05), dijametra desne komore i PAP (p<0,001). BNP je pozitivno korelirao sa TnI (ρ=0,311), PAP (ρ=0,255) i dijametrom desne komore (ρ=0,304, p<0,001). Vrednosti BNP≥1062,04 pg/ml, PAP≥44,5 mmHg i TnI≥0,04 ng/ml bile su povezane sa većim rizikom od smrti.
Zaklјučak: Naši rezultati su pokazali da su BNP, PAP i TnI snažni i nezavisni prediktori jednogodišnjeg mortaliteta kod hospitalizovanih pacijenata sa akutnom srčanom
Reference
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21.Bistola V, Parissis JT, Paraskevaidis I, et al.Prognostic value of tissue Doppler right ventricular systolic and diastolic dysfunction indexes combined with plasma B type natriuretic peptide in patients with advanced heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 2010; 105: 249-254.
DOI:10.1016/j.amjcard.2009.08.682
22.Meyer P, Desai R, Mujib M, et al.Right ventricular ejection is an independent predictor of mortality but not of hospitalization in older systolic heart failure patients. Int J Cardiol. 2012;155(1):120–125. DOI: 10.1016/j.ijcard.2011.05.046
2. Petrovic D, Deljanin Ilić M, Stojanović S. Prognostic value of biomarkers and co-morbidities in patients with acute heart failure: one-year follow-up study. Srp Arh Celok Lek 2017; 145(3-4):118-123.
3. Maggioni A, DahlströmU, FilippatosG, et al. EURObservational Research Programme: regional differences and 1-year follow-up results of theHeart Failure Pilot Survey (ESC-HF Pilot). European Heart Journal2013; 15: 808–817.DOI: 10.1093/eurjhf/hft050
4. Hobbs FDR, Jones MI, Allan TF, et al. European survey of primary care physician perceptions on heart failure diagnosis and management (Euro-F). Eur Heart J 2000;21:1877–1887. DOI: 10.1053/euhj.2000.2170
5.Mueller C, Scholer A, Laule-Kilian K, et al.Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med 2004;350:647–54.DOI: 10.1056/NEJMoa031681
6.Harjola VP, Follath F, Nieminen MS, et al.Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure. Eur J Heart Fail 2010;12:239–48. DOI: 10.1093/eurjhf/hfq002
7.Kenneth D, Gerasimos F, Piotr P, et al. ESC guidelines for the diagnosis and treatment of acute and chronic Heart Failure 2008. European J of Heart Failure 2008;10:933-989.
DOI:10.1016/j.ejheart.2008.08.005
8.Mendes LA, Dec GW, Picard MH, et al.Right ventricular dysfunction: an independent predictor of adverse outcome in patients with myocarditis. Am Heart J. 1994; 128: 301–307. DOI: 10.1016/0002-8703(94)90483-9
9.ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal 2012; 33:1787–1847. DOI: 10.1093/eurheartj/ehs104
10.Lang RM, Badano LP, Mor-Avi V, et al.Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015;16:233–270. DOI: 10.1093/ehjci/jev014
11. Petrovic D, Deljanin Ilic M, Ilic S, at al. Prognostic significance of B-type natriuretic peptide and pulmonary arterial pressure in patients with acute heart failure. European Journal of Heart Failure 2017; 19 (Suppl. S1): 392-392.
12.Siirila-Waris K, Lassus J, Melin J, et al.Characteristics, outcomes, and predictors of 1-yearmortality in patients hospitalized for acute heart failure. Eur Heart J 2006;27:3011–3017. DOI: 10.1093/eurheartj/ehl407
13.Bosseau C, Galli E, Donal E. Prognostic value of BNP in heart failure with preserved or reduced EF. Heart 2015; 101(23): 1855-6. DOI:10.1136/heartjnl-2015-308515.
14.Peacock WF, De Marco T, Fonarow GC, et al.Cardiac troponin and outcome in acute heart failure. N Engl J Med 2008; 358(20): 2117-2126. DOI: 10.1056/NEJMoa0706824
15.Araújo JP, Lourenço P, Azevedo A. Prognostic value of high-sensitivity C-reactive protein in heart failure: a systematic review. J Card Fail 2009; 15:256–266.
DOI: 10.1016/j.cardfail.2008.10.030
16.O'Connor CM, Stough WG, Gallup DS, et al.Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: observations from the IMPACT-HF registry. J Card Fail 2005;11(3):200-205. DOI: 10.1016/j.cardfail.2004.08.160
17. Burke MA, Katz DH, Beussink L, et al.Prognostic importance of pathophysiologic markers in patients with heart failure and preserved ejection fraction.Circ Heart Fail. 2014;7(2):288-99.DOI: 10.1161/CIRCHEARTFAILURE.113.000854
18. Vincent FMS, Dirk LB, Gilles WDeK. Pulmonary hypertension and right heart failure in heart failure with preserved left ventricular ejection fraction: pathophysiology and natural history.Curr Opin Cardiol 2012,27:273–280.DOI: 10.1097/HCO.0b013e3283512035
19.Vogelsang TW, Jensen RJ, Monrad AL, et al.Independent effects of both right and left ventricular function on plasma brain natriuretic peptide. Eur J Heart Fail 2007; 9: 892–896. DOI: 10.1016/j.ejheart.2007.05.015
20.Mariano-Goulart D, Eberlé MC, Boudousq V, et al.Major increase in brain natriuretic peptide indicates right ventricular systolic dysfunction in patients with heart failure. Eur J Heart Fail 2003; 5: 481–488. DOI: 10.1016/s1388-9842(03)00041-2
21.Bistola V, Parissis JT, Paraskevaidis I, et al.Prognostic value of tissue Doppler right ventricular systolic and diastolic dysfunction indexes combined with plasma B type natriuretic peptide in patients with advanced heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 2010; 105: 249-254.
DOI:10.1016/j.amjcard.2009.08.682
22.Meyer P, Desai R, Mujib M, et al.Right ventricular ejection is an independent predictor of mortality but not of hospitalization in older systolic heart failure patients. Int J Cardiol. 2012;155(1):120–125. DOI: 10.1016/j.ijcard.2011.05.046
Objavljeno
2025/12/21
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Rubrika
Originalni rad / Original article