THE EFFECTS OF HYPERTENSION STAGES ON N-TERMINAL-PRO BRAIN NATRIURETIC PEPTIDE (NT-PRO-BNP) LEVEL AND LEFT VENTRICULAR EJECTION FRACTION

Kati Sriwiyati

Abstract


Background: Hypertension is the most common risk factor for heart failure causing an increase in N-Terminal-Pro Brain Natriuretic Peptide (NT-proBNP) level and a decrease in left ventricular ejection fraction (LVEF). Objective: To investigate the effect of hypertension on NT-proBNP level and LVEF in patients with chronic heart failure.

Method: This cross sectional study takes 29 people with hypertension stage-1 (HTD-1) and 27 people with hypertension stage-2 (HTD-2) as sample. The left ventricular ejection fraction and NT-proBNP level obtained from medical records are analyzed using independent t test and Mann Withney test, followed with Spearmen correlation between NT-proBNP level and LVEF.

Results: Mann-Whitney test indicates that the mean value of NT-proBNP level of HTD-2 is significantly higher compared to that of HTD-1, p = 0,000. On the contrary, the independent t test shows that LVEF in HTD-2 is lower than that of HDT-1, p = 0.001. The Spearman correlation analysis conducted on the NT-proBNP level and the LVEF results in value of -0.651, p = 0.000. The cut-off-point value of NT-proBNP level is 1511pg/ml (sensitivity 0.82% and specificity 0.80%) and the value of area under the ROC curve > 0.7. The left ventricular ejection fraction has an area under the ROC curve > 0.7 with a cut-off-point value of 39% (sensitivity 0.67% and specificity 0.69%).

Conclusion: The NT-proBNP level and the LVEF of HTD-2 are significant higher and lower respectively compared to those of HTD-1. The NT-proBNP level and LVEF also show a strong negative correlation. The cut-off-point value of NT-proBNP level and LVEF can be utilized to compare the stages of hypertension in patients with chronic heart failure.

Keywords: Hypertension stage, NT-proBNP, left ventricular ejection fraction, chronic heart failure.


Keywords


Hypertension stage, NT-proBNP, left ventricular ejection fraction, chronic heart failure

References


Bielecka-dabrowa, A., Gluba-brzózka, A., Michalska-kasiczak, M., 2015a. The Multi-Biomarker Approach for Heart Failure in Patients with Hypertension. Int. J. Mol. Sci. 16, 10715–10733. https://doi.org/10.3390/ijms160510715

Bielecka-dabrowa, A., Michalska-kasiczak, M., Gluba, A., Ahmed, A., Gerdts, E., Haehling, S. Von, Rysz, J., Banach, M., 2015b. Biomarkers and Echocardiographic Predictors of Myocardial Dysfunction in Patients with Hypertension. Sci. Rep. 5, 8916. https://doi.org/10.1038/srep08916

Drewniak, W., Szybka, W., Bielecki, D., Malinowski, M., Kotlarska, J., Krol-jaskulska, A., Popielarz-grygalewicz, A., Konwicka, A., Marek, D., 2015. Prognostic Significance of NT-proBNP Levels in Patients over 65 Presenting Acute Myocardial Infarction Treated Invasively or Conservatively. Biomed Res. Int. https://doi.org/10.1155/2015/782026

Fu, S., Ping, P., Wang, F., Luo, L., 2018. Synthesis , secretion , function , metabolism and application of natriuretic peptides in heart failure. J. Biol. Eng. 1–21. https://doi.org/10.1186/s13036-017-0093-0

Kang SH, Park JJ, Choi DJ, Yoon CH, Oh IY, Kang SM, Yoo BS, Jeon ES, Kim JJ, Cho MC, Chae SC, Ryu KH, Oh BH, 2015. Prognostic value of NT-proBNP in heart failure with preserved versus reduced EF. Heart 101, 1851–1852. https://doi.org/10.1136/heartjnl-2015-308911

Kattel, S., Memon, S., Saito, K., Narula, J., Saito, Y., 2016. An Effect of Left Ventricular Hypertrophy on Mild to Moderate Left Ventricular Diastolic Dysfunction. Hell. J. Cardiol. 57, 92–98. https://doi.org/10.1016/j.hjc.2016.03.004

Macheret, F., Heublein, D., Costello-boerrigter, L.C., Boerrigter, G., Mckie, P., Bellavia, D., Mangiafico, S., Ikeda, Y., Bailey, K., Scott, C.G., Sandberg, S., Chen, H.H., Malatino, L., Redfield, M.M., Rodeheffer, R., Burnett, J., Cataliotti, A., 2012. Human Hypertension Is Characterized by a Lack of Activation of the Antihypertensive Cardiac Hormones ANP and BNP. J. Am. Coll. Cardiol. 60, 1558–1565. https://doi.org/10.1016/j.jacc.2012.05.049

McKie, P.M., Burnett, J.C., 2016. The Gold Standard Biomarker in Heart Failure. J. Am. Coll. Cardiol. 68, 2437–2439. https://doi.org/10.1016/j.jacc.2016.10.001

Messerli, F.H., Rimoldi, S.F., Bangalore, S., 2017. The Transition From Hypertension to Heart Failure. JACC Hear. Fail. 5, 543–551. https://doi.org/10.1016/j.jchf.2017.04.012

Nadir, M.A., Rekhraj, S., Wei, L., Lim, T.K., Davidson, J., Macdonald, T.M., Lang, C.C., Dow, E., Struthers, A.D., 2012. Improving the Primary Prevention of Cardiovascular Events by Using Biomarkers to Identify Individuals With Silent Heart Disease. J. Am. Coll. Cardiol. 60, 960–968. https://doi.org/10.1016/j.jacc.2012.04.049

Ojji DB, Opie LH, Lecour S, Lacerda L, OM, A., Sliwa K, 2014. The proposed role of plasma NT pro-brain natriuretic peptide in assessing cardiac remodelling in hypertensive African subjects. Cardio Vasc. J. Africa 25, 233–238. https://doi.org/10.5830/CVJA-2014-050

PERKI, 2015. Pedoman Tatalaksana Gagal Jantung. INDONESIAN HEART ASSOCIATION, Jakarta.

Ponikowski, P., Poland, C., Voors, A.A., Germany, S.D.A., Uk, J.G.F.C., Uk, A.J.S.C., Harjola, V., Germany, V.F., Poland, E.A.J., Uk, P.N., Germany, B.P., Uk, J.P.R., Rosano, G.M.C., Rutten, F.H., 2016. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology ( ESC ) Developed with the special contribution. Eur. Heart J. 37, 2129–2200. https://doi.org/10.1093/eurheartj/ehw128

Savarese, G., Lund, L.H., 2017. Epidemiology Global Public Health Burden of Heart Failure. Card. Fail. Rev. 3, 7–11. https://doi.org/10.15420/cfr.2016

Tan, L., Simon, G., Tan, D.K.H., Cohen-solal, A., 2010. So many definitions of heart failure : are they all universally valid ? A critical appraisal. Expert Rev Cardiovasc Ther 8, 217–228. https://doi.org/10.1586/erc.09.187

Vanderheyden, M., Goethals, M., Verstreken, S., Bruyne, B. De, Muller, K., Schuerbeeck, E. Van, Bartunek, J., 2004. Wall Stress Modulates Brain Natriuretic Peptide Production in Pressure Overload Cardiomyopathy. J. Am. Coll. Cardiol. 44, 2349–54. https://doi.org/10.1016/j.jacc.2004.09.038

Volpe, M., Carnovali, M., Mastromarino, V., 2016a. The natriuretic peptides system in the pathophysiology of heart failure : from molecular basis to treatment. Clin. Sci. 57–77. https://doi.org/10.1042/CS20150469

Volpe, M., Santolamazza, C., Tocci, G., 2016b. Hypertension in Patients with Heart Failure with Reduced Ejection Fraction. Curr. Cardiol. Rep. 1–7. https://doi.org/10.1007/s11886-016-0807-9

Weber, M., Mitrovic, V., Hamm, C., Weber, M., Mitrovic, V., B-type, C.H., 2006. natriuretic peptide – Diagnostic role in stable coronary artery disease. Exp. Clin. Cardiol. 11, 99–101.

Zipes, D., Libby, P., Bonow, R.O., Mann, D., GF, T., 2018. Braunwald’s Heart Disease E-Book: A Textbook of Cardiovascular Medicine. Elsevier Health Sciences.




DOI: http://dx.doi.org/10.26532/sainsmed.v10i1.3379

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