Neurohormonal profile of patients with heart failure and diabetes

被引:31
作者
van der Horst, I. C. C. [1 ]
de Boer, R. A. [1 ]
Hillege, H. L. [1 ,2 ]
Boomsma, F. [3 ]
Voors, A. A. [1 ]
van Veldhuisen, D. J. [1 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, NL-9700 RB Groningen, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Epidemiol, NL-9700 RB Groningen, Netherlands
[3] Erasmus MC, Sect Vasc Pharmacol, Dept Internal Med, Rotterdam, Netherlands
来源
NETHERLANDS HEART JOURNAL | 2010年 / 18卷 / 04期
关键词
Heart Failure; Neurotransmitter Agents; Diabetes Mellitus; LEFT-VENTRICULAR DYSFUNCTION; NATRIURETIC PEPTIDES; ATRIAL-FIBRILLATION; MELLITUS; DISEASE; IMPACT; MORTALITY; SURVIVAL; HORMONES; PROBNP;
D O I
10.1007/BF03091760
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Neurohormonal activation is generally recognised to play an important role in the pathophysiology, prognosis and treatment of chronic heart failure (HF). While the number of patients with diabetes increases, little if anything is known about neurohormonal activation in HF patients with diabetes. Methods. The study population consisted of 371 patients with advanced HF who were enrolled in a multicentre survival trial. Ten different plasma neurohormones were measured (noradrenaline, adrenaline, dopamine, aldosterone, renin, endothelin, atrial natriuretic peptide [ANP], N-terminal (pro)ANP, brain natriuretic peptide [BNP] and N-terminal (pro)BNP. Comparisons were made between patients with diabetes (n=81) and those without (n=290). Results. At baseline, the two groups were comparable regarding age (mean 68 years), left ventricular ejection fraction (23%), severity and aetiology of HF, while body weight was higher in those with diabetes (77.4 vs. 74.2 kg, p=0.04). Most plasma neurohormones were similar between groups, but patients with diabetes had higher values of BNP (94 vs. 47 pmol/l, p=0.03), while a similar trend was observed for N-terminal (pro)BNP (750 vs. 554 pmol/l, p=0.10). During almost five years of follow-up, 51/81 patients with diabetes died (63%), as compared with 144 of 290 non-diabetic patients (50%) who died (p=0.046). Natriuretic peptides and noradrenaline were the most powerful predictors of mortality in both diabetic and non-diabetic HF patients. Conclusion. HF patients with diabetes have higher (N-terminal (pro)) BNP levels than nondiabetic patients, while other neurohormones are generally similar. Natriuretic peptides are also good prognostic markers in diabetic HF patients. (Neth Heart J 2010;18:190-6.)
引用
收藏
页码:190 / 196
页数:7
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