Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction: an analysis from the Korean Heart Failure (KorHF) Registry

被引：14

作者：

Park, Chan Soon ^{[1
]}

Park, Jin Joo ^{[1
]}

Oh, Il-Young ^{[1
]}

Yoon, Chang-Hwan ^{[1
]}

Choi, Dong-Ju ^{[1
]}

Park, Hyun-Ah ^{[2
]}

Kang, Seok-Min ^{[3
]}

Yoo, Byung-Su ^{[4
]}

Jeon, Eun-Seok ^{[5
]}

Kim, Jae-Joong ^{[6
]}

Cho, Myeong-Chan ^{[7
]}

Chae, Shung Chull ^{[8
]}

Ryu, Kyu-Hyung ^{[9
]}

Oh, Byung-Hee ^{[10
]}

机构：

[1] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Coll Med, Seongnam, South Korea

[2] Inje Univ, Coll Med, Seoul Paik Hosp, Dept Family Med, Seoul, South Korea

[3] Yonsei Univ, Severance Hosp, Div Cardiol, Seoul, South Korea

[4] Yonsei Univ, Wonju Severance Christian Hosp, Div Cardiol, Wonju, South Korea

[5] Sungkyunkwan Univ, Coll Med, Samsung Med Ctr, Dept Internal Med, Seoul, South Korea

[6] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med, Seoul, South Korea

[7] Chungbuk Natl Univ, Coll Med, Dept Internal Med, Cheongju, South Korea

[8] Kyungpook Natl Univ, Coll Med, Dept Internal Med, Daegu, South Korea

[9] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Internal Med, Hwaseong, South Korea

[10] Seoul Natl Univ, Seoul Natl Univ Hosp, Coll Med, Dept Internal Med, Seoul, South Korea

来源：

KOREAN CIRCULATION JOURNAL | 2017年 / 47卷 / 05期

关键词：

Renal dysfunction; Ejection fraction; Pro-brain natriuretic peptide (1-76); Prognosis; Heart failure; BRAIN NATRIURETIC PEPTIDE; EMERGENCY-DEPARTMENT PRIDE; CARDIORENAL SYNDROME; DYSFUNCTION; DISEASE; BNP; INFLAMMATION; MORTALITY; DIAGNOSIS; SURVIVAL;

D O I：

10.4070/kcj.2017.0050

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and Objectives: The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratified by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). Materials and Methods: NT-proBNP, glomerular filtration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defined as EF < 50%, and renal dysfunction as GFR < 60 mL/min/1.73 m(2) (mild renal dysfunction: 30 <= GFR < 60 mL/min/1.73 m(2); severe renal dysfunction: GFR < 30 mL/min/1.73 m(2)). The primary outcome was 12-month all-cause death. Results: There was an inverse correlation between GFR and log NT-proBNP level (r=-0.298, p < 0.001), and between EF and log NT-proBNP (r=-0.238, p < 0.001), but no correlation between EF and GFR (r=0.017, p=0.458). Interestingly, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank p < 0.001). Multivariate analysis showed severe renal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.40-3.11). When stratified according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66-3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52-3.89). Conclusion: In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.

引用

页码：727 / 741

页数：15

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