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Akut Dekompanse Sistolik Kalp Yetersizliği Hastalarında BNP Değişimi ile Korele Ekokardiyografik Parametrelerin Araştırılması

Year 2016, Volume: 19 Issue: 2, 91 - 96, 01.08.2016

Abstract











Giriş: Sistolik kalp yetmezliği hastalarında genellikle değişen
derecelerde diyastolik disfonksiyon da eşlik etmektedir. Akut dekompanse kalp
yetersizliği hastalarında tedavi ile sağlanan B tipi natriüretik peptit (BNP)
düşüşüyle korelasyon gösteren ekokardiyografik parametreler hakkında yeterli
veri yoktur. Bu çalışmanın amacı dekompanse kalp yetersizliği ile başvuran
hastalarda tedavi ile sağlanan BNP değişimleriyle ekokardiyografi
parametrelerinin ilişkisinin değerlendirilmesidir.



Hastalar
ve Yöntem:
Sinüs ritminde olup sistolik
dekompanse kalp yetersizliği tanısıyla hastaneye yatırılan ardışık 30 hasta
çalışmaya dahil edildi. Bütün hastalar optimal medikal tedavi ile tedavi
edildi. Hastaların hastaneye kabulünde ve taburculuk öncesinde BNP düzeyleri
ölçüldü ve transtorasik ekokardiyografi uygulandı. Tedavi ile sağlanan BNP
düzeyindeki düşüş ile korelasyon gösteren transtorasik ekokardiyografi
bulguları, bunların değişimi ve birbirleri ile olan bağıntısı değerlendirildi.



Bulgular: Hastaların ortalama hastanede yatış süresi 4.7 ± 1.3 gün
olarak tespit edildi. Tedavi sonrası sol atriyum çapı ve sol atriyum alanında
azalma ile BNP düşüşü arasında anlamlı bir ilişki izlendi. BNP düzeyindeki
azalma ile LV E dalgası amplitüdündeki değişim, septalden ve lateralden elde
edilen E/E’ oranı değişimleri arasında anlamlı yüksek düzeyde pozitif ilişki
olduğu saptandı. Sol ventrikül lateral mitral anulusundan bakılan Sm’sinde ise
anlamlı, zayıf düzeyde negatif bağıntı olduğu görüldü.



Sonuç: Çalışmamızın sonuçları
göstermektedir ki, ekokardiyografik parametreler akut dekompanse sistolik kalp
yetersizliği ile hastaneye yatırılan hastalarda tıpkı BNP gibi tedaviye yanıtın
değerlendirilmesinde kullanılabilinir.

References

  • 1. Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M, et al. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994;90:195-203.
  • 2. Yoshimura M, Yasue H, Okumura K, Ogawa H, Jougasaki M, Mukoyama M, et al. Different secretion patterns of atriyal natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure. Circulation 1993;87:464-9.
  • 3. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005;112:e154-235
  • 4. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, et al. Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005;26:1115-40.
  • 5. Glassberg H, Kirkpatrick J, Ferrari VA. Imaging studies in patients with heart failure: Current and evolving technologies. Crit Care Med 2008;36:28-36.
  • 6. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 2009;10:165-93.
  • 7. Sanderson JE. Heart failure with a normal ejection fraction. Heart 2007;93:155-8.
  • 8. Heart Failure Society of America (HFSA) practice guidelines. HFSA guidelines for management of patients with heart failure caused by left ventricular systolic dysfunction-pharmacological approaches. J Card Fail 1999;5:357-82.
  • 9. Daniels LB, Maisel AS. Natriuretic peptides J Am Coll Cardiol 2007;50:2357-68.
  • 10. Wasywich CA, Whalley GA, Walsh HA, Gamble GD, Doughty RN. The relationship between BNP and E/Ea in patients hospitalized with acute heart failure. Int J Cardiol 2008;125:280-2.
  • 11. Dokainish H, Zoghbi WA, Lakkis NM, Al-Bakshy F, Dhir M, Quinones MA, et al. Optimal noninvasive assessment of left ventricular filling pressures: a comparison of tissue doppler echocardiography and B-Type natriuretic peptide in patients with pulmonary artery catheters. Circulation 2004;109:2432-9.
  • 12. Gackowski A, Isnard R, Golmard JL, Pousset F, Carayon A, Montalescot G, et al. Comparison of echocardiography and plasma B-type natriuretic peptide for monitoring the response to treatment in acute heart failure. Eur Heart J 2004;25:1788-96.

Investigation of Echocardiographic Parameters Correlated with Changes in BNP Levels in Patients with Acute Decompensated Systolic Heart Failure

Year 2016, Volume: 19 Issue: 2, 91 - 96, 01.08.2016

Abstract











Introduction: Patients
with systolic heart failure usually have concomitant diastolic dysfunction.
There are limited data regarding the association between a decrease in B-type
natriuretic peptide (BNP) levels and echocardiographic parameters after the
treatment of acute decompensated systolic heart failure. The aim of this study
was to investigate the association between echocardiographic parameters and the
changes in BNP levels after the treatment of acute decompensated systolic heart
failure.



Patients and Methods: Thirty
consecutive patients with acute decompensated systolic heart failure and having
sinus rhythm were included in the study. BNP levels were measured before and
after the treatment of acute decompensated systolic heart failure. All patients
underwent a detailed echocardiographic study on admission and before discharge.
We compared the correlation between echocardiographic parameters and BNP levels
after the treatment of acute decompensated systolic heart failure.



Results: The mean
duration of hospital stay was 4.7 ± 1.3 days. There was a statistical
significant relationship between a decrease in the left atrium diameter and
area and a decrease in BNP levels. There was a significant positive correlation
between a change in the LV E wave amplitude and BNP levels. The E/E’ ratio,
measured from the lateral medial mitral annulus, had a significantly positive
and strong correlation with the changes in BNP levels. Sm, measured using
tissue Doppler from the lateral mitral annulus, had a negative significant
correlation with the changes in BNP levels.



Conclusion: Our findings suggest that similar to
the changes in BNP levels, echocardiographic parameters demonstrate a response
to an optimal medical therapy in patients with acute decompensated systolic
heart failure.

References

  • 1. Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M, et al. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994;90:195-203.
  • 2. Yoshimura M, Yasue H, Okumura K, Ogawa H, Jougasaki M, Mukoyama M, et al. Different secretion patterns of atriyal natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure. Circulation 1993;87:464-9.
  • 3. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005;112:e154-235
  • 4. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, et al. Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005;26:1115-40.
  • 5. Glassberg H, Kirkpatrick J, Ferrari VA. Imaging studies in patients with heart failure: Current and evolving technologies. Crit Care Med 2008;36:28-36.
  • 6. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 2009;10:165-93.
  • 7. Sanderson JE. Heart failure with a normal ejection fraction. Heart 2007;93:155-8.
  • 8. Heart Failure Society of America (HFSA) practice guidelines. HFSA guidelines for management of patients with heart failure caused by left ventricular systolic dysfunction-pharmacological approaches. J Card Fail 1999;5:357-82.
  • 9. Daniels LB, Maisel AS. Natriuretic peptides J Am Coll Cardiol 2007;50:2357-68.
  • 10. Wasywich CA, Whalley GA, Walsh HA, Gamble GD, Doughty RN. The relationship between BNP and E/Ea in patients hospitalized with acute heart failure. Int J Cardiol 2008;125:280-2.
  • 11. Dokainish H, Zoghbi WA, Lakkis NM, Al-Bakshy F, Dhir M, Quinones MA, et al. Optimal noninvasive assessment of left ventricular filling pressures: a comparison of tissue doppler echocardiography and B-Type natriuretic peptide in patients with pulmonary artery catheters. Circulation 2004;109:2432-9.
  • 12. Gackowski A, Isnard R, Golmard JL, Pousset F, Carayon A, Montalescot G, et al. Comparison of echocardiography and plasma B-type natriuretic peptide for monitoring the response to treatment in acute heart failure. Eur Heart J 2004;25:1788-96.
There are 12 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Investigations
Authors

Mehmet Akif Ekinci This is me

Mehmet Eyüboğlu

Özer Badak This is me

Publication Date August 1, 2016
Published in Issue Year 2016 Volume: 19 Issue: 2

Cite

Vancouver Ekinci MA, Eyüboğlu M, Badak Ö. Akut Dekompanse Sistolik Kalp Yetersizliği Hastalarında BNP Değişimi ile Korele Ekokardiyografik Parametrelerin Araştırılması. Koşuyolu Heart Journal. 2016;19(2):91-6.