title: Prognosis of decompensated heart failure patients with preserved systolic function is predicted by NT-proBNP variations during hospitalization.
abstract: BACKGROUND
  Almost half of heart failure (HF) patients have preserved left ventricular systolic function (LVSF). Although morbidity is similar in patients with preserved and depressed LVSF, clinicians have limited information on prognostic factors of patients with preserved LVSF. We aimed to evaluate the prognostic value of NT-proBNP in patients with decompensated HF regardless of LVSF.
  
  
  METHODS
  Patients hospitalised due to decompensated HF were followed for 6 months. The primary endpoint was death or hospital readmission. We evaluated 224 patients with NT-proBNP measured at admission and discharge and an echocardiogram performed. NT-proBNP decreased on average during hospitalization in patients with preserved LVSF (n=63) and in patients with depressed LVSF (n=161). The morbidity was not different between patients with preserved and depressed LVSF. Among patients with preserved LVSF, predictors of adverse events were serum creatinine, haemoglobin, NT-proBNP levels at discharge and the variation in NT-proBNP during hospitalisation. Among patients with depressed LVSF, predictors of adverse events were female gender, atrial fibrillation, non-prescription of ACE-inhibitor at discharge, NT-proBNP levels at discharge and the variation in NT-proBNP during hospitalisation.
  
  
  CONCLUSIONS
  These results suggest that, in HF patients with preserved LVSF as in patients with depressed LVSF, NT-proBNP can play a role as a tool to identify patients at risk of an adverse outcome.
authors.affiliation: Departamento de Medicina Interna-Hospital S. João, Faculdade de Medicina da Universidade do Porto, Unidade I and D Cardiovascular do Porto, Portugal. pbettfer@esoterica.pt
authors.forename: Paulo
authors.initials: P
authors.lastname: Bettencourt
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
authors.forename: Luísa
authors.initials: L
authors.lastname: Fonseca
authors.forename: José P
authors.initials: JP
authors.lastname: Araújo
authors.forename: Susana
authors.initials: S
authors.lastname: Ferreira
authors.forename: Rui
authors.initials: R
authors.lastname: Almeida
authors.forename: Francisco
authors.initials: F
authors.lastname: Rocha-Goncalves
authors.forename: António
authors.initials: A
authors.lastname: Ferreira
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010446:Peptide Fragments / Q000097:blood*; D011174:Portugal / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D016019:Survival Analysis; D013599:Systole; D016276:Ventricular Function
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain