J 2022

Relation between Mid-Regional Pro-Adrenomedullin in Patients with Chronic Heart Failure and the Dose of Diuretics in 2-Year Follow-Up-Data from FAR NHL Registry

ŠPINAROVÁ, Monika, Jindřich ŠPINAR, Lenka ŠPINAROVÁ, Jan KREJČÍ, Monika PÁVKOVÁ GOLDBERGOVÁ et. al.

Basic information

Original name

Relation between Mid-Regional Pro-Adrenomedullin in Patients with Chronic Heart Failure and the Dose of Diuretics in 2-Year Follow-Up-Data from FAR NHL Registry

Authors

ŠPINAROVÁ, Monika (203 Czech Republic, belonging to the institution), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Lenka ŠPINAROVÁ (203 Czech Republic, belonging to the institution), Jan KREJČÍ (203 Czech Republic, belonging to the institution), Monika PÁVKOVÁ GOLDBERGOVÁ (203 Czech Republic, belonging to the institution), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), Ondřej LUDKA (203 Czech Republic, belonging to the institution), Filip MALEK (203 Czech Republic), Petr OSTADAL (203 Czech Republic), Klára BENEŠOVÁ (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution) and Karel LÁBR (203 Czech Republic, guarantor, belonging to the institution)

Edition

Medicina-Lithuania, Basel, MDPI, 2022, 1010-660X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.600

RIV identification code

RIV/00216224:14110/22:00128072

Organization unit

Faculty of Medicine

UT WoS

000873135400001

Keywords in English

chronic heart failure; mid-regional pro-adrenomedullin; diuretics; furosemide; prognosis

Tags

International impact, Reviewed
Změněno: 18/1/2023 09:47, Mgr. Tereza Miškechová

Abstract

V originále

Background and Objectives: The aim of this paper is to evaluate the impact of humoral substance mid-regional pro-adrenomedullin (MR-proADM) on the two-year survival of patients with chronic heart failure and relate it to the dosage of furosemide. Materials and Methods: The data is taken from the stable systolic heart failure (EF < 50%) FAR NHL registry (FARmacology and NeuroHumoraL activation). The primary endpoint at two-year follow-up was death, heart transplantation, or LVAD implantation. Results: A total of 1088 patients were enrolled in the FAR NHL registry; MR-proADM levels were available for 569 of them. The mean age was 65 years, and 81% were male. The aetiology of HF was ischemic heart disease in 53% and dilated cardiomyopathy in 41% of patients. The mean EF was 31 ± 9%. Statistically significant differences (p < 0.001) were obtained in several parameters: patients with higher MR-proADM levels were older, rated higher in NYHA class, suffered more often from lower limb oedema, and had more comorbidities such as hypertension, atrial fibrillation, diabetes, and renal impairment. MR-proADM level was related to furosemide dose. Patients taking higher doses of diuretics had higher MR-proADM levels. The mean MR-proADM level without furosemide (n = 122) was 0.62 (±0.55) nmol/L, with low dose (n = 113) 1–39 mg/day was 0.67 (±0.30) nmol/L, with mid dose (n = 202) 40–79 mg/day was 0.72 (±0.34) nmol/L, with high dose (n = 58) 80–119 mg/day was 0.85 (±0.40) nmol/L, and with maximum dose (n = 74) ≥120 mg/day was 1.07 (±0.76) nmol/L, p < 0.001. Patients with higher MR-proADM levels were more likely to achieve the primary endpoint at a two-year follow-up (p < 0.001) according to multivariant analysis. Conclusions: Elevated plasma MR-proADM levels in patients with chronic heart failure are associated with an increased risk of death and hospitalization. Higher MR-proADM levels in combination with increased use of loop diuretics reflect residual congestion and are associated with a higher risk of severe disease progression.