Clinical InvestigationsN-terminal proatrial natriuretic peptide and prognosis in patients with heart failure and preserved systolic function*,**
Section snippets
Patients
The patients studied were selected from an epidemilogical survey of idiopathic congestive heart failure undertaken in 5 counties in southwest Sweden between 1985 and 1988 (13). All hospital records of the 19 hospitals serving the studied region were screened, and patients with a registered diagnosis of congestive heart failure between 1980 and 1987 were identified. Besides a diagnosis of heart failure in the hospital record, one of the following recorded findings was required for inclusion on
Results
A technically satisfactory echocardiogram and a blood sample for analysis of N-terminal proANP level were available in 149 of the 293 patients. Among these, 65 patients were diagnosed as having systolic dysfunction (EF < 0.40). Of the remaining 84 patients, 60 patients had at least 1 sign of compromised cardiac function (abnormal-echo group). Twenty-one patients had echocardiographic data within normal limits (normal-echo group). Three patients could not be accurately classified regarding other
Discussion
Previous studies have shown that plasma concentration of N-terminal proANP is related to long-term prognosis in patients with chronic heart failure 11, 12. The present results confirm these findings in a cohort of patients selected for the diagnosis of idiopathic congestive heart failure. Idiopathic congestive heart failure accounts for 20% to 25% of the clinical heart failure population (20), and our results may be valid only for this group of patients with heart failure. The possibility of
Conclusion
An increased concentration of N-terminal proANP might be a marker of future morbidity and death in patients with normal EFs, and this peptide was an independent predictor of long-term mortality among these patients. This simple blood test might be useful in the difficult assessment of patients with congestive heart failure symptoms and preserved systolic function.
Acknowledgements
The authors thank Ellen Lund Sagen and Hanne Schulz Jensen for performing the immunoassays, and Thomas Karlsson, BSc, for the statistical analyses.
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Cited by (0)
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Supported in part by the Swedish Heart Lung Foundation, Stockholm, Sweden.
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Reprint requests: Bert Andersson, MD, PhD, Department of Cardiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.