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Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: SA-PO914

Correlation of Raised NT proBNP Levels and Left Ventricular Filling Pressure in CKD Patients with Acute Decompensated Heart Failure (ADHF)

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Zartash, Syeda Huma, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Saleem, Sidra, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Rasool, Zain, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Sarwar, Shahbaz, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Zaman, Nimra Nadeem, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Sheikh, Shahryar Ahmad, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Afshan, Shamila, Punjab Institute of Cardiology, Lahore, Lahore, Pakistan
  • Nawaz, Shahmeer Mohammed, Doctors Hospital and Medical Centre, Lahore, Pakistan
  • Mansur, Abeera, Doctors Hospital and Medical Centre, Lahore, Pakistan
Background

Left ventricular filling pressures (LVFP) and N-Terminal pro brain natriuretic peptide (NT-proBNP), both of which are well known indicators of poor prognosis, are elevated in ADHF. The relationship of NT pro-BNP with LVFP in CKD patients is not well documented. Therefore, the aim of our study is to find integrative utility of measuring NT-pro BNP levels with LVFP in patients with acute dyspnea enabling their utilization as diagnostic and prognostic markers in the management of CKD patients with ADHF.

Methods

From 1st May, 2018 through 30th April, 2019, 450 patients who presented in Emergency department of Doctors Hospital Lahore with acute dyspnea and potential fluid overload were assessed. Out of these, 85 patients who underwent simultaneous echocardiography and NT Pro BNP measurement were included in the study. Charts were analysed by a nephrologist and cardiologist. Both CKD(66) and non CKD(19) patients with reduced LV ejection fraction (LV EF <40%:HFrEF), Midrange (LV EF:40-50%: HFmrEF) and preserved ejection fraction(LV EF >50%:HFpEF) were included. eGFR was measured using the CKD-EPI(Chronic kidney disease Epidemiology collaboration)equation. Data was analysed using SPSS version 25.

Results

Echo parameters were compared with different NT pro-BNP levels in this study group. The mean value of NT pro BNP was much higher(1895.74±10.57 pmol/L) in CKD patients with ADHF as compared to non CKD patients(550.66 pmol/L). As shown in the image, in patients with eGFR<60ml/min with ADHF and NT Pro- BNP > 1000, 51.8% had EF less than 40%(14/27)(p-value :0.014) 74% of patients had increased LVFP(20/27)(p-value:0.028), 85.1% had PCWP more than 15 mmHg (23/27)(p-value:0.031), and 76.9% had Grade II/III Diastolic dysfunction (20/26)(p-value:0.051).

Conclusion

NT pro-BNP is a rapid and reliable marker for accurate and early diagnosis of ADHF since it has a significant correlation with LVEF and LVFP in CKD patients with ADHF.