Objective:Early identification of acute kidney injury(AKI)is essential to improve the prognosis of patients with acute heart failure(AHF).We aimed to determine the utility of neutrophil/lymphocyte ratio(NLR),N-termina...Objective:Early identification of acute kidney injury(AKI)is essential to improve the prognosis of patients with acute heart failure(AHF).We aimed to determine the utility of neutrophil/lymphocyte ratio(NLR),N-terminal prohormone of brain natriuretic peptide(NT-proBNP),urea,and creatinine(Cr),as well as combinations of these,for the prediction of AKI in patients with AHF.Methods:A total of 153 patients with AHF under the care of Sun Yat-sen Memorial Hospital,Sun Yat-sen University from October 2009 to October 2019 were included in this retrospective observational study.Their NLR,NT-proBNP,urea,and Cr concentrations were measured on admission.AKI was defined using the Acute Kidney Injury Network criteria.Receiver operating characteristic(ROC)curves,the areas under the curves(AUCs),sensitivity,and specificity were employed to evaluate the ability of each biomarker and their combinations to identify AKI.This study was approved by the Ethics Committee of Sun Yat-sen Memorial Hospital,Sun Yat-sen University(approval No.SYSEC-KY-KS-2021-126)on June 22,2021.Results:Forty-six(30.1%)participants developed AKI during hospitalization.The NLR and NT-proBNP of the participants with AKI were higher than those without(NLR:median 7.886 vs 4.717,P<0.0001;NT-proBNP,median 6774 vs 2786pg/mL,P<0.0001).ROC analyses demonstrated that high NLR and NT-proBNP were associated with higher incidences of AKI(NLR:cut-off 5.681,AUC 0.716,sensitivity 58.9%,specificity 80.4%;NT-proBNP:cut-off 5320pg/mL,AUC 0.700,sensitivity 72.9%,specificity 65.2%).Moreover,a combination of NLR,NT-proBNP,urea,and Cr yielded an AUC of 0.815,sensitivity 80.4%,and specificity of 74.8%.In addition,the AUCs for the prediction of AKI in the participants with New York Heart Association(NYHA)classes II,III,and IV were 0.936,0.860,and 0.772,respectively,using this combination.Conclusion:A combination of NLR,NT-proBNP,urea,and Cr,measured at admission,may represent a promising tool for the prediction of AKI in patients with AHF.This method performs best for AKI risk assessment in patients with NYHA II,followed by those with NYHA III or IV.展开更多
Objective:Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive target organ damage and cardiovascular events,but its association with readmission risk in patients with heart fa...Objective:Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive target organ damage and cardiovascular events,but its association with readmission risk in patients with heart failure with preserved ejection fraction(HFpEF)remains unknown.We conducted a retrospective study to explore the relationship between circadian blood pressure rhythm and readmission risk in HFpEF patients.Methods:We retrospectively collected baseline and follow-up data on HFpEF patients who underwent ambulatory blood pressure monitoring(ABPM)from May 2015 to October 2019.Patient circadian blood pressure rhythms defi ned by ABPM were grouped as dipper,nondipper,or riser patterns.Univariate and multivariate linear regression analyses were performed to assess the association between circadian blood pressure rhythm and readmission risk.Results:A total of 122 patients were enrolled in this study.The mean age and ejection fraction were 69.87 years and 61.44%,respectively,with mean the N-terminal pro-B-type natriuretic peptide(NT-proBNP)level being 1048.15 pg/mL.There were signifi cant differences in the 24-hour systolic blood pressure(SBP),sleep SBP,and sleep diastolic blood pressure(DBP)among the three groups,where the 24-hour SBP,sleep SBP,and sleep DBP in the riser pattern group were markedly higher than in the dipper pattern group.Notably,serum NT-proBNP levels,the proportion of patients readmitted for heart failure and the mean number of admissions differed markedly among three groups.Instructively,multivariate linear regression analysis showed that the riser pattern was a signifi cant and independent risk factor for increased serum NT-proBNP level(β=929.16,95%confi dence interval 178.79–1679.53,P=0.016).In multivariate logistic regression analysis,the riser pattern was demonstrated to be a signifi cant risk factor for readmission(odds ratio 11.23,95%confi dence interval 2.01–62.67,P=0.006)in HFpEF patients.Conclusion:The riser blood pressure pattern is a potential risk factor for elevated serum NT-proBNP level and readmission in HFpEF patients.展开更多
基金supported by grants from Guangdong Science and Technology Department(No.2020B1212060018)National Key Program of the Ministry of Science and Technology Foundation of China(No.2020YFC2004505)+2 种基金Guangdong Provincial Natural Science Foundation(No.2020A1515011467)Guangzhou City Science and Technology Project Plan Foundation(No.202002030149)National Natural Science Foundation of China(No.82002203).
文摘Objective:Early identification of acute kidney injury(AKI)is essential to improve the prognosis of patients with acute heart failure(AHF).We aimed to determine the utility of neutrophil/lymphocyte ratio(NLR),N-terminal prohormone of brain natriuretic peptide(NT-proBNP),urea,and creatinine(Cr),as well as combinations of these,for the prediction of AKI in patients with AHF.Methods:A total of 153 patients with AHF under the care of Sun Yat-sen Memorial Hospital,Sun Yat-sen University from October 2009 to October 2019 were included in this retrospective observational study.Their NLR,NT-proBNP,urea,and Cr concentrations were measured on admission.AKI was defined using the Acute Kidney Injury Network criteria.Receiver operating characteristic(ROC)curves,the areas under the curves(AUCs),sensitivity,and specificity were employed to evaluate the ability of each biomarker and their combinations to identify AKI.This study was approved by the Ethics Committee of Sun Yat-sen Memorial Hospital,Sun Yat-sen University(approval No.SYSEC-KY-KS-2021-126)on June 22,2021.Results:Forty-six(30.1%)participants developed AKI during hospitalization.The NLR and NT-proBNP of the participants with AKI were higher than those without(NLR:median 7.886 vs 4.717,P<0.0001;NT-proBNP,median 6774 vs 2786pg/mL,P<0.0001).ROC analyses demonstrated that high NLR and NT-proBNP were associated with higher incidences of AKI(NLR:cut-off 5.681,AUC 0.716,sensitivity 58.9%,specificity 80.4%;NT-proBNP:cut-off 5320pg/mL,AUC 0.700,sensitivity 72.9%,specificity 65.2%).Moreover,a combination of NLR,NT-proBNP,urea,and Cr yielded an AUC of 0.815,sensitivity 80.4%,and specificity of 74.8%.In addition,the AUCs for the prediction of AKI in the participants with New York Heart Association(NYHA)classes II,III,and IV were 0.936,0.860,and 0.772,respectively,using this combination.Conclusion:A combination of NLR,NT-proBNP,urea,and Cr,measured at admission,may represent a promising tool for the prediction of AKI in patients with AHF.This method performs best for AKI risk assessment in patients with NYHA II,followed by those with NYHA III or IV.
基金supported by grants from the Medical Research Projects of the Chongqing Science and Technology Commission and Chongqing Health Committee(2020FYYX047).
文摘Objective:Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive target organ damage and cardiovascular events,but its association with readmission risk in patients with heart failure with preserved ejection fraction(HFpEF)remains unknown.We conducted a retrospective study to explore the relationship between circadian blood pressure rhythm and readmission risk in HFpEF patients.Methods:We retrospectively collected baseline and follow-up data on HFpEF patients who underwent ambulatory blood pressure monitoring(ABPM)from May 2015 to October 2019.Patient circadian blood pressure rhythms defi ned by ABPM were grouped as dipper,nondipper,or riser patterns.Univariate and multivariate linear regression analyses were performed to assess the association between circadian blood pressure rhythm and readmission risk.Results:A total of 122 patients were enrolled in this study.The mean age and ejection fraction were 69.87 years and 61.44%,respectively,with mean the N-terminal pro-B-type natriuretic peptide(NT-proBNP)level being 1048.15 pg/mL.There were signifi cant differences in the 24-hour systolic blood pressure(SBP),sleep SBP,and sleep diastolic blood pressure(DBP)among the three groups,where the 24-hour SBP,sleep SBP,and sleep DBP in the riser pattern group were markedly higher than in the dipper pattern group.Notably,serum NT-proBNP levels,the proportion of patients readmitted for heart failure and the mean number of admissions differed markedly among three groups.Instructively,multivariate linear regression analysis showed that the riser pattern was a signifi cant and independent risk factor for increased serum NT-proBNP level(β=929.16,95%confi dence interval 178.79–1679.53,P=0.016).In multivariate logistic regression analysis,the riser pattern was demonstrated to be a signifi cant risk factor for readmission(odds ratio 11.23,95%confi dence interval 2.01–62.67,P=0.006)in HFpEF patients.Conclusion:The riser blood pressure pattern is a potential risk factor for elevated serum NT-proBNP level and readmission in HFpEF patients.
