MARCELO VILLACA LIMA
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- Papel dos níveis de BNP no prognóstico da insuficiência cardíaca avançada descompensada(2013) PEREIRA-BARRETTO, Antonio Carlos; CARLO, Carlos Henrique Del; CARDOSO, Juliano Novaes; OCHIAI, Marcelo Eid; LIMA, Marcelo Villaca; CURIATI, Milena Cardoso; SCIPIONI, Airton Roberto; RAMIRES, Jose Antonio FranchiniBackground: Heart failure (HF) is a condition with poor outcome, especially in advanced cases. Determination of B-type natriuretic peptide (BNP) levels is useful in the diagnosis of cardiac decompensation and has also been proving useful in the prognostic evaluation. Objectives: To verify whether BNP levels are able to identify patients with a poorer outcome and whether it is an independent prognostic factor considering age, gender, cardiac and renal functions, as well as the cause of heart disease. Methods: 189 patients in functional class III/IV advanced HF were studied. All had systolic dysfunction and had their BNP levels determined during hospitalization. Variables related to mortality were studied using univariate and multivariate analyses. Results: BNP levels were higher in patients who died in the first year of follow-up (1,861.9 versus 1,408.1 pg/dL; p = 0.044) and in chagasic patients (1,985 versus 1,452 pg/mL; p = 0.001); the latter had a higher mortality rate in the first year of follow-up (56% versus 35%; p = 0.010). The ROC curve analysis showed that the BNP level of 1,400 pg/mL was the best predictor of events; high levels were associated with lower LVEF (0.23 versus 0.28; p = 0.002) and more severe degree of renal dysfunction (mean urea 92 versus 74.5 mg/dL; p = 0.002). Conclusion: In advanced HF, high BNP levels identified patients at higher risk of a poorer outcome. Chagasic patients showed higher BNP levels than those with heart diseases of other causes, and have poorer prognosis (Arq Bras Cardiol. 2013; 100(3): 281-287).