Abstract
Background: Dispne farklı sistemlerden kaynaklanabilen bir bulgu olup N_terminal pro brain natriüretik peptid (NT-proBNP)’in negatif prediktif değeri kalp yetmezliği için yol göstericidir.
Aim: Nefes darlığı şikayeti ile başvuran hastalarda kan gazı ve NT-proBNP arasındaki ilişkiyi değerlendirerek ayırıcı tanıda yol gösterici faktörleri belirlemeyi amaçladık.
Materials and Methods
Çalışmaya dispne ile hastanemize başvuran ve NT-proBNP ve venöz kan gazı tetkikleri aynı zamanda yapılan hastalar alındı. Demografik verileri, eşlik eden hastalıkları ve laboratuvar verileri kaydedildi. NT-proBNP ve venöz kan gazı parametreleri arasındaki ilişki değerlendirildi. p<.05 anlamlı kabul edildi.
Results
Çalışmaya katılan 523 hastanın yaş ortalaması 74±12.83 yıl olup %50.3’ü erkekti. Total grupta NT-proBNP ile yaş (p<.001) arasında pozitif yönde, aktüel bikarbonat (cHCO3) (p<.001), standart bikarbonat (HCO3) (p<.001), pCO2 (p=.022) ve BE (p<.001) ile negatif yönde anlamlı korelasyon bulundu. Kronik böbrek hastalığı (CKD) olanlarda NT-proBNP ile cHCO3 (p=.008), HCO3 (p=.019), BE (p=.010) orta düzeyde negatif yönde ilişki vardı. Kalb yetmezliği (HF) olanlarda NT-proBNP ile cHCO3 (p=.002), HCO3 (p=.001), BE (p=.001) arasında orta düzeyde negatif yönde ilişki vardı.
Conclusion
Dispneik hastanın NT-proBNP ve kan gazları değerleri kesin kalp yetmezliğine işaret etmiyorsa, böbrek fonksiyonlarındaki bozulmanın değerlendirme denklemine katılması uygun görünmektedir.
Keywords
References
- 1. Su Q, Liu H, Zhang X, Dang W, Liu R, Zhao X, et al. Diagnostic values of NT-proBNP in acute dyspnea among elderly patients. Int J Clin Exp Pathol 2015;8(10):13471-13476.
- 2. Palazzuoli A, Gallotta M, Quatrini I and Nuti R. Natriuretic peptides (BNP and NT-proBNP): measurement and relevance in heart failure. Vasc. Health Risk Manag 2010; 6: 411-418.
- 3. Karakiliç E, Kepez A, Abali G, Coşkun F, Kunt M and Tokgözoğlu L. The relationship between Btype natriuretic peptide levels and echocardiographic parameters in patients with heart failure admitted to the emergency department. Anadolu Kardiyol Derg 2010; 10: 143-149.
- 4. Wang S, Li M, Wang X, Luo J, Zou Y, Hu Y, et al. The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease Front. Cardiovasc. Med. 2021;8
- 5. Byrne AL, Bennett M, Chatterji R, et al. Peripheral venous and arterial blood gas analysis in adults: are the comparable? A systematic review and meta-analysis. Respirology 2014; 19:168.
- 6. Kelly AM, Klim S, Rees SE. Agreemet between mathematically arterialised venous versus arterial blood gas values in patients undergoing non-invasive ventilation: a cohort study. Emerg Med J 2014; 31: e46.
- 7. Saberian L, Sharif M, Aarabi M, Broumand B, et al. Arterial Versus Venous Blood Gas Analysis Comparisons, Appropriateness and Alternatives in Different Acid/Base Clinical Settings: A systematic Review. Cureus 2023;15(7)e41707.
- 8. Prasad H, Vempalli N, Agrawal N, Ajun UN, et al. Correlation and agrement arterial and venous blood gas analysis in patients with hypotension an emergency deparment based cross-sectional study. Int J Emerg Med 2023;16(1):18.
- 9. Galic K, Pravdie D, Prskalo Z, Kukulj S, et al. Prognostic value of lactates in relation to gas analysis and acid-base status in patients with pulmonary embolism. Croatian Medical Journal 2018;59(4):149-155
- 10. Patel MP, Ahmed A, Gunapalan T, Hesselbacher. Use of sodium bicarbonate and blood gas monitoring in diabetic ketoasidosis: A review. World J Diabetes 2018;9(11):199-205.
- 11. Long B, Lentz S, Koyfman A, Gottlieb M. Euglycemic diabetic ketoasidosis: Etiologies, evaluation and management. Am J Emerg Med 2021; 44:157-160.
- 12. Su X, Lei T, Yu H, Zhang L, et al. NT-proBNP in Different Patient Groups of COPD: A Systematic Review and Meta-Analysis. IntJ Chron Obstruct Pulmon Dis 2023; 18:811-825.
- 13. Liu HH, Cao YX, Jin JL, Gou YL, et al. Prognostic value of NT_proBNP in patients with chronic coronary syndrom and normal left ventricular systolic function according to glucose status: a prospective cohort study. Cardiovasc Diabetol 2021;20(1):84.
- 14. Mueller C, McDonald K, Boer RA, Maisel A, et al. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. European Journal of Heart Failure 2019; 21: 715–731. 15. Bayes-Genis A, Docherty KF, Petrie MC, Januzzi JL, et al. Practical algorithms for early diagnosis of heart failure and heart stress using NT-proBNP: A clinical consensus statement from the Heart Failure Association of the ESC. European Journal of Heart Failure 2023; 25: 1891–1898.
- 16. Sarzani R, Spannella F, Giulietti F, Fedecostante M, et al. NT-proBNP and Its Correlation with In-Hospital Mortality in the Very Elderly without an Admission Diagnosis of Heart Failure. PLoS One 2016; 14:11(4): e0153759.
- 17. Januzzi Jr JL , Chen-Tournoux AA, Christenson RH, Doros G, et al. N-Terminal Pro-B-Type Natriuretic Peptide in the Emergency Department: The ICON-RELOADED Study. J Am Coll Cardiol 2018;71(11):1191-1200.
Abstract
Background: Dyspnea can be caused by different systems, and the negative predictive value of N_terminal pro-brain natriuretic peptide (NT-proBNP) is indicative of heart failure. We aimed to evaluate the relationship between blood gases and NT-proBNP in patients presenting with dyspnea and to determine the guiding factors in the differential diagnosis.
Methods: Patients admitted to our hospital with dyspnea and who underwent NT-proBNP and venous blood gas tests at the same time were included in the study. Demographic data, comorbidities, and laboratory data were recorded. The relationship between NT-proBNP and venous blood gas parameters was evaluated. p<0.05 was considered significant.
Results: The mean age of the 523 patients was 74±12.83 years, with 50.3% of the patient population identified as male. In the total group, NT-proBNP demonstrated a positive correlation with age (p < 0.001) and a negative correlation with current bicarbonate (cHCO3) (p < 0.001), standard bicarbonate (HCO3) (p < 0.001), pCO2 (p = 0.022), and BE (p < 0.001). In patients with chronic kidney disease (CKD), NT-proBNP demonstrated a moderately negative correlation with cHCO3 (p = 0.008), HCO3 (p = 0.019), and BE (p = 0.010). In patients with heart failure (HF), there was a moderate negative association between NT-proBNP and cHCO3 (p = 0.002), HCO3 (p = 0.001), and BE (p = 0.001).
Conclusion: In the absence of definitive evidence of heart failure in a dyspneic patient, it is reasonable to consider the potential contribution of impaired renal function to the overall evaluation.
Ethical Statement
This retrospective study was conducted with the decision number 24.06.07.07.02/09 dated 07.06.2024 of the Ufuk University Non-Interventional Clinical Research Evaluation Ethics Committee.
Supporting Institution
None
References
- 1. Su Q, Liu H, Zhang X, Dang W, Liu R, Zhao X, et al. Diagnostic values of NT-proBNP in acute dyspnea among elderly patients. Int J Clin Exp Pathol 2015;8(10):13471-13476.
- 2. Palazzuoli A, Gallotta M, Quatrini I and Nuti R. Natriuretic peptides (BNP and NT-proBNP): measurement and relevance in heart failure. Vasc. Health Risk Manag 2010; 6: 411-418.
- 3. Karakiliç E, Kepez A, Abali G, Coşkun F, Kunt M and Tokgözoğlu L. The relationship between Btype natriuretic peptide levels and echocardiographic parameters in patients with heart failure admitted to the emergency department. Anadolu Kardiyol Derg 2010; 10: 143-149.
- 4. Wang S, Li M, Wang X, Luo J, Zou Y, Hu Y, et al. The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease Front. Cardiovasc. Med. 2021;8
- 5. Byrne AL, Bennett M, Chatterji R, et al. Peripheral venous and arterial blood gas analysis in adults: are the comparable? A systematic review and meta-analysis. Respirology 2014; 19:168.
- 6. Kelly AM, Klim S, Rees SE. Agreemet between mathematically arterialised venous versus arterial blood gas values in patients undergoing non-invasive ventilation: a cohort study. Emerg Med J 2014; 31: e46.
- 7. Saberian L, Sharif M, Aarabi M, Broumand B, et al. Arterial Versus Venous Blood Gas Analysis Comparisons, Appropriateness and Alternatives in Different Acid/Base Clinical Settings: A systematic Review. Cureus 2023;15(7)e41707.
- 8. Prasad H, Vempalli N, Agrawal N, Ajun UN, et al. Correlation and agrement arterial and venous blood gas analysis in patients with hypotension an emergency deparment based cross-sectional study. Int J Emerg Med 2023;16(1):18.
- 9. Galic K, Pravdie D, Prskalo Z, Kukulj S, et al. Prognostic value of lactates in relation to gas analysis and acid-base status in patients with pulmonary embolism. Croatian Medical Journal 2018;59(4):149-155
- 10. Patel MP, Ahmed A, Gunapalan T, Hesselbacher. Use of sodium bicarbonate and blood gas monitoring in diabetic ketoasidosis: A review. World J Diabetes 2018;9(11):199-205.
- 11. Long B, Lentz S, Koyfman A, Gottlieb M. Euglycemic diabetic ketoasidosis: Etiologies, evaluation and management. Am J Emerg Med 2021; 44:157-160.
- 12. Su X, Lei T, Yu H, Zhang L, et al. NT-proBNP in Different Patient Groups of COPD: A Systematic Review and Meta-Analysis. IntJ Chron Obstruct Pulmon Dis 2023; 18:811-825.
- 13. Liu HH, Cao YX, Jin JL, Gou YL, et al. Prognostic value of NT_proBNP in patients with chronic coronary syndrom and normal left ventricular systolic function according to glucose status: a prospective cohort study. Cardiovasc Diabetol 2021;20(1):84.
- 14. Mueller C, McDonald K, Boer RA, Maisel A, et al. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. European Journal of Heart Failure 2019; 21: 715–731. 15. Bayes-Genis A, Docherty KF, Petrie MC, Januzzi JL, et al. Practical algorithms for early diagnosis of heart failure and heart stress using NT-proBNP: A clinical consensus statement from the Heart Failure Association of the ESC. European Journal of Heart Failure 2023; 25: 1891–1898.
- 16. Sarzani R, Spannella F, Giulietti F, Fedecostante M, et al. NT-proBNP and Its Correlation with In-Hospital Mortality in the Very Elderly without an Admission Diagnosis of Heart Failure. PLoS One 2016; 14:11(4): e0153759.
- 17. Januzzi Jr JL , Chen-Tournoux AA, Christenson RH, Doros G, et al. N-Terminal Pro-B-Type Natriuretic Peptide in the Emergency Department: The ICON-RELOADED Study. J Am Coll Cardiol 2018;71(11):1191-1200.
Details
| Primary Language | English |
|---|---|
| Subjects | Nefroloji |
| Journal Section | Original Research |
| Authors | |
| Early Pub Date | May 24, 2025 |
| Publication Date | May 31, 2025 |
| Submission Date | March 11, 2025 |
| Acceptance Date | April 20, 2025 |
| Published in Issue | Year 2025 Volume: 15 Issue: 3 |
