عنوان انگلیسی مقاله:
Renal function, N-terminal Pro-B-Type natriuretic peptide, propeptide big endothelin and patients with heart failure and preserved ejection fraction
ترجمه فارسی عنوان مقاله:
عملکرد کلیوی، N ترمینال نرم افزار-B پپتید ناتریورتیک، propeptide اندوتلین بزرگ و بیماران مبتلا به نارسایی قلب و کسر خروجی حفظ
Sciencedirect - Elsevier - Peptides,Corrected proof,doi:10:1016/j:peptides:2018:04:003
Ingrid Gergeia,⁎, Bernhard K. Krämera, Hubert Scharnaglb, Tatjana Stojakovicb, Winfried Märza,b,c
Renal dysfunction may limit the clinical application of NT-proBNP in the diagnosis of heart failure. In general
practice, where echocardiography is not readily available, a biomarker for the diagnosis of a heart failure with
preserved ejection fraction (HFpEF) would be useful. Since cardiac diseases frequently coincide with renal
disease, there is a high need of valid risk stratification methods in patients affected with both. We therefore
examined NT-proBNP and another biomarker, Big-Endothelin-1, as a marker of HFpEF in patients with CKD.
NT-proBNP and Big-ET-1 were determined in 439 patients with HFpEF in the Ludwigshafen Risk and
Cardiovascular Health (LURIC) study.
NT-proBNP plasma level has shown an exponential increase with declining GFR, while Big-ET-1 plasma level
increased only in a moderate and linear fashion. In patients without CKD, a NT-proBNP cut-off point at 250 pg/
mL was suitable for the discrimination between HFpEF and patients without HF. When the GFR was less than
60 mL/min/1.73m2, the NT-proBNP cut-off point should be raised to 750 pg/mL. At a cutoff point at 0.85 fmol/
L, Big-ET-1 allowed to distinguish patients with HFpEF from persons without HF, independently of GFR.
In general, NT-proBNP is a good indicator of suspected heart failure. While for NT-proBNP different cut-off
points have to be considered in the diagnosis of HFpEF, a single cut-off point of Big-ET-1 was appropriate in the
diagnosis of HFpEF, regardless of the presence or absence of CKD.
An additional measurement of Big-ET-1 improves the diagnosis of HFpEF in patients with chronic kidney
Keywords: N-Terminal Pro-B-Type natriuretic peptide ، (NT-proBNP)، Big-Endothelin-1 (Big-ET-1) ، Heart failure with preserved ejection fraction ، (HFpEF) ، Chronic kidney disease (CKD) ، Peptides ، Biomarkers