Aims: To determine which factors predict outcomes in a group of patients with advanced heart failure, and in particular if NT-proBNP provides additional clinical and prognostic information to other haemodynamic and biochemical data.
Methods And Results: Ninety-one patients were studied who were being evaluated for heart transplantation, with 166 assessments. The patients had advanced heart failure as determined by median cardiac index of 2.0 l/min/m(2), left ventricular end-diastolic diameter of 7.0 mm and levels of NT-proBNP of 2473 pg/ml. Median follow-up time was 359 days. Clinicians were blinded to NT-proBNP levels. NT-proBNP significantly correlated with cardiac index (R = -0.44, p < 0.001), right atrial pressure (R = 0.40, p < 0.001), pulmonary arterial wedge pressure (R = 0.38, p < 0.001) and albumin (R = -0.52, p < 0.001), and total bilirubin with right atrial pressure (R = 0.59, p < 0.001). Cardiac index was the most important independent predictor of outcome (p = 0.0001), although bilirubin (p = 0.001) and NT-proBNP (p < 0.05) were also significant. In patients with a 50% increase in NT-proBNP, 64% had adverse outcomes, whereas those in whom levels were stable, 22% had adverse outcomes (p < 0.05).
Conclusion: Cardiac index is the primary independent predictor of outcome in advanced heart failure when haemodynamic deterioration is evident. In situations where invasive haemodynamics are not available, total bilirubin (reflecting hepatic congestion) and NT-proBNP (related to haemodynamics) also provide important prognostic information.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1742-1241.2010.02388.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Deep learning in 3D cardiac reconstruction: a systematic review of methodologies and dataset.
Med Biol Eng Comput
January 2025
Department of Computer Science and Engineering, Shri Shankaracharya Institute of Professional Management and Technology, Raipur, (C.G.), India.
This study presents an advanced methodology for 3D heart reconstruction using a combination of deep learning models and computational techniques, addressing critical challenges in cardiac modeling and segmentation. A multi-dataset approach was employed, including data from the UK Biobank, MICCAI Multi-Modality Whole Heart Segmentation (MM-WHS) challenge, and clinical datasets of congenital heart disease. Preprocessing steps involved segmentation, intensity normalization, and mesh generation, while the reconstruction was performed using a blend of statistical shape modeling (SSM), graph convolutional networks (GCNs), and progressive GANs.
View Article and Find Full Text PDFCardiac conduction system regeneration prevents arrhythmias after myocardial infarction.
Nat Cardiovasc Res
January 2025
Institute of Developmental and Regenerative Medicine, University of Oxford, Oxford, UK.
Arrhythmias are a hallmark of myocardial infarction (MI) and increase patient mortality. How insult to the cardiac conduction system causes arrhythmias following MI is poorly understood. Here, we demonstrate conduction system restoration during neonatal mouse heart regeneration versus pathological remodeling at non-regenerative stages.
View Article and Find Full Text PDFMaintenance Immunosuppression With Tacrolimus and Everolimus in Heart Transplantation Compared With the Usual Tacrolimus and Micophenolate Protocol: Results From a Retrospective Registry.
Transplant Proc
January 2025
Department of Cardiology, Advanced Heart Failure and Heart Transplant Unit, Hospital Universitario Central de Asturias, Oviedo, Spain; Health Research Institute of Asturias, ISPA, Oviedo, Spain.
Introduction: Real-life data on the long-term use of a maintenance immunosuppressive protocol in heart transplant patients using delayed Everolimus + Tacrolimus are scarce.
Methods: This is a retrospective study that included all heart transplant patients from 2011 to 2021 in two Spanish hospitals. In Hospital A, the preferred immunosuppressive strategy included Everolimus initiation at 2 months post-transplant combined with Tacrolimus and was compared with the results of Hospital B, where a standard Tacrolimus and Mycophenolate mofetil protocol was used.
Management of Pulmonary Embolism: A Single-Center Experience.
South Med J
January 2025
From the University of Kentucky College of Medicine, Lexington.
Objective: Pulmonary embolism (PE) is the third leading cause of cardiovascular death. The objective of this study was to examine the current management of pulmonary embolism at a single academic institution.
Methods: With institutional review board approval, we conducted a retrospective chart review of 805 encounters among 775 patients presenting with acute PE from January 1, 2016 to June 30, 2019.
Cord blood platelet-rich plasma: proteomics analysis for ophthalmic applications.
Clin Proteomics
January 2025
Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 1, 00168, Rome, Italy.
Our objective is to determine the protein and complements constituents of Cord blood Platelet-rich plasma (CB-PRP), based on the hypothesis that it contains beneficial components capable of arresting or potentially decelerating the advancement of atrophic age-related macular degeneration (dry-AMD), with the support of radiomics. Two distinct pools of CB-PRP were assessed, each pool obtained from a total of 15 umbilical cord-blood donors. One aliquot of each pool respectively was subjected to proteomic analysis in order to enhance the significance of our findings, by identifying proteins that are shared between the two sample pools and gaining insights into the pathways they are associated with.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!