Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2008, vol. 14, book 1
Subject Collection: Medicine
Page: 89 - 94
Online date: 03 April 2009
J of IMAB 2008; 14(1):89-94
NTProBNP AND HRV AND OUTCOME IN PATIENTS WITH HEART FAILURE WITH REDUCED VS. PRESERVED SYSTOLIC FUNCTION
Nadya Stancheva1, Snezhana Tisheva1, Virginia Jordanova1, Stanimir Kurkchiev2, Assen Goudev3
1) Clinic of Cardiology and Rheumatology, UMHAT “G. Stranski” - Pleven;
2) Institute of Biology and Immunology of Reproduction, Bulgarian Academy of Science - Sofia;
3) Clinic of Cardiology with Intensive care Unit, UMHAT “Tsaritsa Ioanna” – Sofia, Bulgaria
Background: Heart failure /HF/ is usually associated with reduced systolic function. Elevated plasma concentrations of NTproBNP and heart rate variability /HRV/ are predictive of worse outcome in HF patients but there are few data about its predictive value in patients with HF and preserved systolic function.
Purpose and methods: The aim of this study was to determine the prognostic value of predischarge NT-proBNP and heart rate variability (HRV) in patients with reduced vs. preserved systolic function admitted for decompensated congestive HF. One hundred and twenty-seven patients were evaluated at the time of discharge by means of echocardiography, conventional laboratory tests, plasma for NTproBNP and Holter ECG for HRV. The primary endpoints of the study were defined as readmission for HF during the first 6 months after discharge, more than 2 hospitalizations for 1 year, or cardiac death.
Results: One hundred and twenty-one patients /95.3%/ were followed for mean of 387 ± 117 days. Fifty-four patients /44.6%/ had reduced systolic function. Despite of the significant differences in the clinical characteristics of the patients with HF with reduced vs preserved systolic function, prognosis in both groups was poor. Predischarge NTproBNP levels were predictive of worse outcome irrespectively of the systolic function. Kaplan-Meier survival curves showed that NTproBNP > 300 pg/ml was associated with significantly worse outcome in both groups and HRV<20 ms was predictive of event occurrence in the reduced systolic function group. HRV reflected the severity of the systolic dysfunction in the reduced systolic function group.
Conclusions: In hospitalized HF patients predischarge NTproBNP levels are associated with poor prognosis in HF patients irrespective of systolic function while HRV reflects the severity and poor prognosis only of heart failure with reduced systolic function.
Key words: brain natriuretic peptide, heart rate variability, heart failure, prognosis.
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Please cite this article as:
Stancheva N, Tisheva S, Jordanova V, Kurkchiev S, Goudev A. NTProBNP and HRV and outcome in patients with heart failure with reduced vs. preserved systolic function. J of IMAB 2008; 14(1):89-94. DOI: 10.5272/jimab.14-1-2010.89
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