What comorbidities and other factors affect the level of natriuretic peptides in chronic heart failure? Data from FAR NHL registry

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F21%3A00075313" target="_blank" >RIV/00159816:_____/21:00075313 - isvavai.cz</a>

Result on the web

<a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.2297" target="_blank" >https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.2297</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1002/ejhf.2297" target="_blank" >10.1002/ejhf.2297</a>

Result language

angličtina

Original language name

What comorbidities and other factors affect the level of natriuretic peptides in chronic heart failure? Data from FAR NHL registry

Original language description

Background: /Aim: Heart failure is diagnosed with natriuretic peptides and their serum levels indicate the severity of heart failure. There are many other factors besides heart failure that can increase natriuretic peptides. The aim is to identify these factors. Methods: The FAR NHL (FARmacology and NeuroHumoraL activation) multicentre prospective registry included 1.052 patients with chronic heart failure at three cardiology centres specializing in heart failure in the Czech Republic from October 2014 to November 2015. Patients had left ventricular ejection fraction below 50% and had to be on stable treatment for at least one month. Blood samples were taken, basic blood analysis was performed, including the determination of the NT-proBNP level. Results: The registry included 81% of male patients with a median age of 65 years. Most patients were in NYHA class II. The aetiology of heart failure was most often ischemic heart disease in 49.4%, followed by dilated cardiomyopathy in 42.3% and 0.5% had hypertrophic cardiomyopathy. A univariate linear regression was performed to predict NT-proBNP. Higher NT-proBNP was predicted by presence of diastolic dysfunction (β=4.36; p &lt; 0.001; R2=21.0%), atrial fibrillation (β=2.29; p &lt; 0.001; R2=3.0%), diabetes mellitus (β=1.35; p = 0.003; R2=0.8%), higher heart rate (β=1.24; p &lt; 0.001; R2=3.1%), and higher age (β=1.19; p &lt; 0.001; R2=1.7%). The lower NT-proBNP was predicted by higher ejection fraction (β=0.70; p &lt; 0.001; R2=16.4%), higher systolic blood pressure (β=0.79; p &lt; 0.001; R2=6.7%), higher haemoglobin level (β=0.81; p &lt; 0.001; R2=4.1%), higher glomerular filtration rate (β=0.83; p &lt; 0.001; R2=6.7%), and higher Body Mass Index (β=0.93; p &lt; 0.001; R2=4.5%). There was no influence of sex, hypertension in medical history and dyslipidaemia. A multivariant linear regression using backward stepwise algorithm of independent predictors of NT-proBNP value was performed. Adjusted R2 was 52.5%. Higher NT-proBNP was predicted again by presence of diastolic dysfunction (β=4.03; p &lt; 0.001), atrial fibrillation (β=2.18; p &lt; 0.001), higher heart rate (β=1.14; p &lt; 0.001), but no longer by diabetes mellitus. The lower NT-proBNP was predicted by higher ejection fraction (β=0.75; p &lt; 0.001), higher systolic blood pressure (β=0.95; p = 0.029), higher haemoglobin level (β=0.87; p &lt; 0.001), higher glomerular filtration rate (β=0.89; p &lt; 0.001), and higher Body Mass Index (β=0.95; p &lt; 0.001). Conclusion: According to FAR NHL registry in stable chronic heart failure NT-proBNP level is mostly influenced by systolic and diastolic ejection fraction of left ventricle and followed by presence of comorbidities like atrial fibrillation, anaemia, renal impairment. The paradox of higher Body Mass Index and higher blood pressure beneficial for heart failure has been demonstrated.

Czech name

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Czech description

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Type

O - Miscellaneous

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů