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首页> 外文期刊>Journal of the American College of Cardiology >Lowered B-type natriuretic peptide in response to levosimendan or dobutamine treatment is associated with improved survival in patients with severe acutely decompensated heart failure.
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Lowered B-type natriuretic peptide in response to levosimendan or dobutamine treatment is associated with improved survival in patients with severe acutely decompensated heart failure.

机译：严重急性失代偿性心力衰竭患者对左西孟旦或多巴酚丁胺治疗的反应中B型利钠钠肽水平降低与存活率提高相关。

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OBJECTIVES: The purpose of this analysis was to examine whether decreases in B-type natriuretic peptide (BNP) levels during the first few days of hospitalization were associated with greater survival in patients with severe acutely decompensated heart failure (ADHF). BACKGROUND: BNP level is a prognostic marker for all-cause mortality (ACM) in ADHF; whether early BNP changes can also help predict outcome in patients who need inotropes for treatment of severe ADHF is not known. METHODS: We retrospectively assessed the association between changes in BNP levels and ACM in patients from the SURVIVE (Survival of Patients with Acute Heart Failure in Need of Intravenous Inotropic Support) trial--a randomized, controlled trial comparing levosimendan to dobutamine treatment in patients hospitalized with ADHF. BNP levels were measured at baseline and at days 1, 3, and 5. A patient was classified as a "responder" if the follow-up BNP level was >or=30% lower than baseline BNP. The relationship between early BNP response and subsequent ACM over short- (31-day) and long-term (180-day) intervals was evaluated. RESULTS: Of 1,327 SURVIVE patients, this analysis included 1,038 who had BNP samples at both baseline and day 5. Responders at days 1, 3, and 5 had lower ACM than did nonresponders (p
机译：目的：该分析的目的是检查住院初期几天内B型利钠肽（BNP）水平的降低是否与严重急性失代偿性心力衰竭（ADHF）患者的更长生存期相关。背景：BNP水平是ADHF全因死亡率（ACM）的预后指标。目前尚不清楚早期BNP变化是否还可以帮助预测需要正性肌力药物治疗严重ADHF的患者的预后。方法：我们回顾性评估了生存（需要静脉正性肌力支持的急性心力衰竭患者的生存）试验中患者的BNP水平变化与ACM之间的关联性。该试验是一项随机对照试验，比较了左西孟旦和多巴酚丁胺治疗的住院患者与ADHF。在基线以及第1、3和5天测量BNP水平。如果随访的BNP水平比基线BNP低>或= 30％，则将患者分类为“反应者”。评估了短期（31天）和长期（180天）间隔内早期BNP反应与随后的ACM之间的关系。结果：在1,327例存活患者中，该分析包括1,038名在基线和第5天都有BNP样本的患者。第1、3和5天的应答者的ACM低于无应答者（p <或0.001），为第5天的水平显示出卓越的区分价值。第5天BNP缓解者的短期ACM（31天）风险降低了67％，而长期（180天）ACM风险降低了47％。结论：与没有或几乎没有BNP降低的患者相比，接受ADHF治疗的BNP降低的患者具有降低的死亡风险（31天和180天）。这些结果表明，早期降低BNP可以预测短期和长期的死亡风险。因此，BNP降低可作为ACM的合适预后指标。

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