This study aimed to evaluate left ventricular assist device (LVAD) effects on natriuretic peptide (NP) prohormone plasma levels in end-stage heart failure (HF) patients, especially NT-proCNP, in order to better characterize the NP system during hemodynamic recovery by LVAD. HF patients (n = 17, NYHA III-IV) undergoing LVAD were studied: 6 died of multi-organ failure syndrome (NS) and 11 survived (S). Total sequential organ failure assessment (t-SOFA) score and blood samples were obtained at admission (T1) and at 24, 72 h and 1, 2, 4 weeks (T2-T6) after LVAD. In S, NT-proANP and NT-proCNP significantly increased at 24 h after implantation, reaching a reduction to basal levels at 4 weeks following LVAD [NT-proANP: T1 vs. T2 p = 0.017, NT-proCNP: T1 vs. T2 p = 0.028, T1 vs. T3 p = 0.043]. Elevated NT-proBNP plasma levels were observed at all times. In NS, NP plasma levels sustained higher with respect to S. No statistical variation was observed for NT-proCNP and NT-proANP in S and NS while NT-proBNP reached significant differences at T4 in NS. Considering S + NS, only NT-proCNP strongly correlated with t-SOFA score at T1 (rho = 0.554, p = 0.04) while subdividing patients NT-proCNP positively correlated in NS with t-SOFA score (rho = 0.988, p = 0.002) only at T4. In NS a correlation between NT-proCNP and NT-proBNP at T1 was observed (rho = -0.900, p = 0.037). Both IL-6 and TNF-alpha sustained higher in NS patients than in S; in particular, statistical significance was observed for IL-6. The study of new peptides, such as NT-proCNP, would provide additional information for identifying patients who are more likely to recover. (C) 2012 Elsevier Inc. All rights reserved.
The natriuretic peptide time-course in end-stage heart failure patients supported by left ventricular assist device implant: Focus on NT-proCNP
2012
Abstract
This study aimed to evaluate left ventricular assist device (LVAD) effects on natriuretic peptide (NP) prohormone plasma levels in end-stage heart failure (HF) patients, especially NT-proCNP, in order to better characterize the NP system during hemodynamic recovery by LVAD. HF patients (n = 17, NYHA III-IV) undergoing LVAD were studied: 6 died of multi-organ failure syndrome (NS) and 11 survived (S). Total sequential organ failure assessment (t-SOFA) score and blood samples were obtained at admission (T1) and at 24, 72 h and 1, 2, 4 weeks (T2-T6) after LVAD. In S, NT-proANP and NT-proCNP significantly increased at 24 h after implantation, reaching a reduction to basal levels at 4 weeks following LVAD [NT-proANP: T1 vs. T2 p = 0.017, NT-proCNP: T1 vs. T2 p = 0.028, T1 vs. T3 p = 0.043]. Elevated NT-proBNP plasma levels were observed at all times. In NS, NP plasma levels sustained higher with respect to S. No statistical variation was observed for NT-proCNP and NT-proANP in S and NS while NT-proBNP reached significant differences at T4 in NS. Considering S + NS, only NT-proCNP strongly correlated with t-SOFA score at T1 (rho = 0.554, p = 0.04) while subdividing patients NT-proCNP positively correlated in NS with t-SOFA score (rho = 0.988, p = 0.002) only at T4. In NS a correlation between NT-proCNP and NT-proBNP at T1 was observed (rho = -0.900, p = 0.037). Both IL-6 and TNF-alpha sustained higher in NS patients than in S; in particular, statistical significance was observed for IL-6. The study of new peptides, such as NT-proCNP, would provide additional information for identifying patients who are more likely to recover. (C) 2012 Elsevier Inc. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
