| Neuroendocrine testing in community patients with heart disease: plasma N-terminal proatrial natriuretic peptide predicts morbidity and mortality stronger than catecholamines and heart rate variability. | |
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MedLine Citation:
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PMID: 15513318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with heart disease are at risk of developing congestive heart failure (CHF). Neurohormonal activation may make an important contribution. AIM: In stable heart patients from primary care, to examine neuroendocrine markers of cardiac performance for the association to cardiac dysfunction, morbidity and mortality. METHODS: Plasma N-terminal atrial natriuretic peptide (N-ANP), catecholamines, 24-h ECG and blood pressure, serum urea and creatinine, echocardiography, chest X-ray and physical examination were performed. Death was recorded during 5 to 7 years of follow-up. RESULTS: The study included 56 patients. Mean age was 71 years, 54% were men, 43% had clinical signs of CHF, 39 + 52 + 9% were in NYHA I + II + III, 34% had echocardiographic cardiac dysfunction, and 18 died during follow-up. N-ANP was related to all subtypes of cardiac dysfunction (p < 0.05). Catecholamines and premature ventricular captures (PVC) were related to valvular and systolic dysfunction, but heart rate variability and dipping blood pressure were not (p > 0.05). On multivariate analyses only, N-ANP and PVC were associated with clinical signs of CHF, echocardiographic cardiac dysfunction, and mortality (p < 0.05). CONCLUSIONS: Plasma N-ANP was stronger than catecholamines and variables of 24-h monitoring (blood pressure and electrocardiogram) in predicting morbidity and mortality, thereby supporting the use of cardiac natriuretic peptides (i.e. N-ANP, BNP, or N-BNP) as the most valuable biomarker in community patients at risk of CHF. |
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Authors:
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O W Nielsen; V Rasmussen; N J Christensen; J F Hansen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Scandinavian journal of clinical and laboratory investigation Volume: 64 ISSN: 0036-5513 ISO Abbreviation: Scand. J. Clin. Lab. Invest. Publication Date: 2004 |
Date Detail:
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Created Date: 2004-10-29 Completed Date: 2005-03-08 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0404375 Medline TA: Scand J Clin Lab Invest Country: Norway |
Other Details:
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Languages: eng Pagination: 619-28 Citation Subset: IM |
Affiliation:
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Cardiology Department Y, Bispebjerg Hospital, DK-2200 Copenhagen, Denmark. own@dadlnet.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Atrial Natriuretic Factor / blood* Community Health Services Epinephrine / blood* Female Heart Diseases / diagnosis*, epidemiology*, mortality Heart Failure / diagnosis Heart Rate / physiology Humans Male Middle Aged Morbidity Norepinephrine / blood* Prognosis Protein Precursors / blood* Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
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0/N-terminal proatrial natriuretic peptide; 0/Protein Precursors; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 85637-73-6/Atrial Natriuretic Factor |
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