The prospects for NT-pro BNP level determining in physical activity conditions in patients during the rehabilitation period after the myocardial infarction, complicated with decompensated heart failure
The aim of the study was to determine the futility of NT-pro BNP level analysis during dosed physical exercise for diagnosing decompensated HF in the postinfarction period and the possibility to determine the HF functional class.
Materials and methods. 160 patients with previous MI were examined, patients’ average age was (56.67±5.72) years. The patients were randomized in 2 groups dependently on the presence of the signs of II А-B according to V. Kh. Vasylenko and M. D. Strazhesko classification and FC III-IV (according to NYHA) decompensated chronic HF. Group I consisted of 120 patients with Q-QS and non-Q MI; group II (the control one) had 40 patients with MI without signs of decompensated HF; 20 healthy people made up a norm group.
Results. Signs of coronary insufficiency such as dizziness and signs of poor peripheral perfusion (cyanosis/paleness) occurred in 104 (86.7 %) and 79 (65.8 %) cases that differ from the same values in the second group 4 (10.0 %) and 14 (35.0 %) respectively. 88 (73.3 %) patients with the signs of decompensated HF felt general weakness, fatigue, and expressed a request to stop the test.
The HR in the postinfarction patients with the signs of decompensated HF was before the exercise (88.2±3.18) bpm (p≤0.05); in the patients with past MI without the signs of decompensated HF, it was (75.32±3.41) bpm (p≤0.05); and in the practically healthy people, it was (77.73±3.02) bpm. We found out a reverse moderate correlation between the distances that had been covered by a patient during the 6MWT NT-proBNP level in blood serum of examined patients.
Conclusions. Inadequate response to dosed physical exercises and increased immunological parameters as quantitative HF markers could be useful not only for diagnostics, but also for the risk stratification for decompensated HF that had occurred in patients on different rehabilitation stages after an acute MI.
Todurov, B. M., Zelenchuk, O. V., Kuzmych, I. M., Ivaniuk, N. B. (2015). Otsinka yakostei zhyttia patsiientiv z ishemichnoiu khvoroboiu sertsii ta systolichnoiu dysfunktsiieiu livoho shlunochka pislei aortokoronarnoho shuntuvannia zalezha vid vidiemu zhyttiezdatnoho miokarda. Ukrainskyi kardiolohichnyi zhurnal, 4, 61–65.
Moe, G. W., Ezekowitz, J. A., O’Meara, E., Lepage, S., Howlett, J. G., Fremes, S. et. al. (2015). The 2014 Canadian Cardiovascular Society Heart Failure Management Guidelines Focus Update: Anemia, Biomarkers, and Recent Therapeutic Trial Implications. Canadian Journal of Cardiology, 31 (1), 3–16. doi: http://doi.org/10.1016/j.cjca.2014.10.022
Tseluiko, V. Yu., Lozova, T. A. (2015). Klinicheskaya i prognosticheskaya rol urovnya mozgovogo natriiureticheskogo peptida u patsientov s infarktom miokarda pravogo zheludochka na fon infarkta miokarda s zubtsom Q zadnie stenki levogo zheludochka pri dlitelnosti. Ukrainskii kardiologicheskii zhurnal, 4, 74–80.
Tanai, E., Frantz, S. (2015). Pathophysiology of Heart Failure. Comprehensive Physiology, 6, 187–214. doi: http://doi.org/10.1002/cphy.c140055
Babyi, L. N., Strohanova, N. P., Savytskyi, S. Yu., Khomenko, Yu. O. (2016). Early and remote cardiac remodeling in post-infarction patients depending on localization of the infarction. Ukraynskyi kardyolohycheskyi zhurnal, 5, 24–33.
Røe, Å. T., Ruud, M., Espe, E. K., Manfra, O., Longobardi, S., Aronsen, J. M. et. al. (2018). Regional diastolic dysfunction in post-infarction heart failure: role of local mechanical load and SERCA expression. Cardiovascular Research, 115 (4), 752–764. doi: http://doi.org/10.1093/cvr/cvy257
Lund, L. H. (2016). Heart Failure With “Mid-Range” Ejection Fraction – New Opportunities. Journal of Cardiac Failure, 22 (10), 769–771. doi: http://doi.org/10.1016/j.cardfail.2016.07.439
Chambela, M. C., Mediano, M. F. F., Ferreira, R. R., Japiassú, A. M., Waghabi, M. C., da Silva, G. M. S., Saraiva, R. M. (2017). Correlation of 6-min walk test with left ventricular function and quality of life in heart failure due to Chagas disease. Tropical Medicine & International Health, 22 (10), 1314–1321. doi: http://doi.org/10.1111/tmi.12939
Nolen-Doerr, E., Crick, K., Saha, C., de Groot, M., Pillay, Y., Shubrook, J. H. et. al. (2018). Six-Minute Walk Test as a Predictive Measure of Exercise Capacity in Adults With Type 2 Diabetes. Cardiopulmonary Physical Therapy Journal, 29 (3), 124–129. doi: http://doi.org/10.1097/cpt.0000000000000080
Du, H., Newton, P. J., Budhathoki, C., Everett, B., Salamonson, Y., Macdonald, P. S., Davidson, P. M. (2017). The Home-Heart-Walk study, a self-administered walk test on perceived physical functioning, and self-care behaviour in people with stable chronic heart failure: A randomized controlled trial. European Journal of Cardiovascular Nursing, 17 (3), 235–245. doi: http://doi.org/10.1177/1474515117729779
Ribeiro-Samora, G. A., Montemezzo, D., Pereira, D. A. G., Tagliaferri, T. L., Vieira, O. A., Britto, R. R. (2017). Could peak oxygen uptake be estimated from proposed equations based on the six-minute walk test in chronic heart failure subjects? Brazilian Journal of Physical Therapy, 21 (2), 100–106. doi: http://doi.org/10.1016/j.bjpt.2017.03.004
Yoshimura, K., Urabe, Y., Maeda, N., Yuguchi, S., Yoshida, T. (2018). Dynamics of cardiorespiratory response during and after the six-minute walk test in patients with heart failure. Physiotherapy Theory and Practice, 36 (4), 476–487. doi: http://doi.org/10.1080/09593985.2018.1489925
Toukhsati, S., Mathews, S., Sheed, A., Freijah, I., Moncur, L., Cropper, P. et. al. (2019). Confirming a beneficial effect of the six-minute walk test on exercise confidence in patients with heart failure. European Journal of Cardiovascular Nursing, 19 (2), 165–171. doi: http://doi.org/10.1177/1474515119876784
Requena-Méndez, A., Aldasoro, E., de Lazzari, E., Sicuri, E., Brown, M., Moore, D. A. J. et. al. (2015). Prevalence of Chagas Disease in Latin-American Migrants Living in Europe: A Systematic Review and Meta-analysis. PLOS Neglected Tropical Diseases, 9 (2), e0003540. doi: http://doi.org/10.1371/journal.pntd.0003540
Bittencourt, H. S., dos Reis, H. F. C., Lima, M. S., Gomes Neto, M. (2017). Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis. Arquivos Brasileiros de Cardiologia, 108 (2), 161–168. doi: http://doi.org/10.5935/abc.20170001
Boman, K., Thormark Fröst, F., Bergman, A.-C. R., Olofsson, M. (2018). NTproBNP and ST2 as predictors for all-cause and cardiovascular mortality in elderly patients with symptoms suggestive for heart failure. Biomarkers, 23 (4), 373–379. doi: http://doi.org/10.1080/1354750x.2018.1431692
Richards, A. M. (2018). N -Terminal B-type Natriuretic Peptide in Heart Failure. Heart Failure Clinics, 14 (1), 27–39. doi: http://doi.org/10.1016/j.hfc.2017.08.004
Seferović, P. M., Polovina, M. M. (2018). When more is less and less is more: Is there an additional value of NT-proBNP in risk stratification in heart failure? European Journal of Preventive Cardiology, 25 (8), 885–888. doi: http://doi.org/10.1177/2047487318767698
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S. et. al. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37 (27), 2129–2200. doi: http://doi.org/10.1093/eurheartj/ehw128
Roberts, E., Ludman, A. J., Dworzynski, K., Al-Mohammad, A., Cowie, M. R. et. al. (2015). The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting. BMJ, 350, h910. doi: http://doi.org/10.1136/bmj.h910
Voors, A. A. (2018). Sense and Sensibility of the Use of NT-proBNP for Eligibility in Clinical Trials. JACC: Heart Failure, 6 (3), 257–259. doi: http://doi.org/10.1016/j.jchf.2018.01.003
Savarese, G., Orsini, N., Hage, C., Vedin, O., Cosentino, F., Rosano, G. M. C. et. al. (2018). Utilizing NT-proBNP for Eligibility and Enrichment in Trials in HFpEF, HFmrEF, and HFrEF. JACC: Heart Failure, 6 (3), 246–256. doi: http://doi.org/10.1016/j.jchf.2017.12.014
Kehmeier, E. S., Sommer, M. H., Galonska, A., Zeus, T., Verde, P., Kelm, M. (2016). Diagnostic value of the six-minute walk test (6MWT) in grown-up congenital heart disease (GUCH): Comparison with clinical status and functional exercise capacity. International Journal of Cardiology, 203, 90–97. doi: http://doi.org/10.1016/j.ijcard.2015.10.074
Kempny, A., Dimopoulos, K., Alonso-Gonzalez, R., Alvarez-Barredo, M., Tutarel, O., Uebing, A. et. al. (2013). Six-minute walk test distance and resting oxygen saturations but not functional class predict outcome in adult patients with Eisenmenger syndrome. International Journal of Cardiology, 168 (5), 4784–4789. doi: http://doi.org/10.1016/j.ijcard.2013.07.227
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