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@article{2247542,
author = {Špinarová, Monika and Špinar, Jindřich and Špinarová, Lenka and Krejčí, Jan and Pávková Goldbergová, Monika and Pařenica, Jiří and Ludka, Ondřej and Malek, Filip and Ostadal, Petr and Benešová, Klára and Jarkovský, Jiří and Lábr, Karel},
article_location = {Basel},
article_number = {10},
doi = {http://dx.doi.org/10.3390/medicina58101477},
keywords = {chronic heart failure; mid-regional pro-adrenomedullin; diuretics; furosemide; prognosis},
language = {eng},
issn = {1010-660X},
journal = {Medicina-Lithuania},
title = {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},
url = {https://www.mdpi.com/1648-9144/58/10/1477},
volume = {58},
year = {2022}
}
TY - JOUR
ID - 2247542
AU - Špinarová, Monika - Špinar, Jindřich - Špinarová, Lenka - Krejčí, Jan - Pávková Goldbergová, Monika - Pařenica, Jiří - Ludka, Ondřej - Malek, Filip - Ostadal, Petr - Benešová, Klára - Jarkovský, Jiří - Lábr, Karel
PY - 2022
TI - 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
JF - Medicina-Lithuania
VL - 58
IS - 10
SP - 1-10
EP - 1-10
PB - MDPI
SN - 1010660X
KW - chronic heart failure
KW - mid-regional pro-adrenomedullin
KW - diuretics
KW - furosemide
KW - prognosis
UR - https://www.mdpi.com/1648-9144/58/10/1477
N2 - 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.
ER -
ŠPINAROVÁ, Monika, Jindřich ŠPINAR, Lenka ŠPINAROVÁ, Jan KREJČÍ, Monika PÁVKOVÁ GOLDBERGOVÁ, Jiří PAŘENICA, Ondřej LUDKA, Filip MALEK, Petr OSTADAL, Klára BENEŠOVÁ, Jiří JARKOVSKÝ and Karel LÁBR. 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. \textit{Medicina-Lithuania}. Basel: MDPI, 2022, vol.~58, No~10, p.~1-10. ISSN~1010-660X. Available from: https://dx.doi.org/10.3390/medicina58101477.
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