Diurnal Variations in Natriuretic Peptide Levels: Clinical Implications for the Diagnosis of Acute Heart Failure.

Atrial Natriuretic Factor Biomarkers Circadian Rhythm Dyspnea / complications Heart Failure / complications Humans Natriuretic Peptide, Brain Natriuretic Peptides Peptide Fragments Vasodilator Agents
circadian rhythm diagnostic techniques, cardiovascular dyspnea heart failure natriuretic peptides

Journal

Circulation. Heart failure
ISSN: 1941-3297
Titre abrégé: Circ Heart Fail
Pays: United States
ID NLM: 101479941

Informations de publication

Date de publication:
06 2022
Historique:
pubmed: 8 6 2022
medline: 24 6 2022
entrez: 7 6 2022
Statut: ppublish

Résumé

Current guidelines recommend interpreting concentrations of NPs (natriuretic peptides) irrespective of the time of presentation to the emergency department. We hypothesized that diurnal variations in NP concentration may affect their diagnostic accuracy for acute heart failure. In a secondary analysis of a multicenter diagnostic study enrolling patients presenting with acute dyspnea to the emergency department and using central adjudication of the final diagnosis by 2 independent cardiologists, the diagnostic accuracy for acute heart failure of BNP (B-type NP), NT-proBNP (N-terminal pro-B-type NP), and MR-proANP (midregional pro-atrial NP) was compared among 1577 daytime presenters versus 908 evening/nighttime presenters. In a validation study, the presence of a diurnal rhythm in BNP and NT-proBNP concentrations was examined by hourly measurements in 44 stable individuals. Among patients adjudicated to have acute heart failure, BNP, NT-proBNP, and MR-proANP concentrations were comparable among daytime versus evening/nighttime presenters (all BNP and NT-proBNP, but not MR-proANP, exhibit a diurnal rhythm that results in even higher diagnostic accuracy among evening/nighttime presenters versus daytime presenters. URL: https://www. gov; Unique identifiers: NCT01831115, NCT02091427, and NCT02210897.

Sections du résumé

BACKGROUND
Current guidelines recommend interpreting concentrations of NPs (natriuretic peptides) irrespective of the time of presentation to the emergency department. We hypothesized that diurnal variations in NP concentration may affect their diagnostic accuracy for acute heart failure.
METHODS
In a secondary analysis of a multicenter diagnostic study enrolling patients presenting with acute dyspnea to the emergency department and using central adjudication of the final diagnosis by 2 independent cardiologists, the diagnostic accuracy for acute heart failure of BNP (B-type NP), NT-proBNP (N-terminal pro-B-type NP), and MR-proANP (midregional pro-atrial NP) was compared among 1577 daytime presenters versus 908 evening/nighttime presenters. In a validation study, the presence of a diurnal rhythm in BNP and NT-proBNP concentrations was examined by hourly measurements in 44 stable individuals.
RESULTS
Among patients adjudicated to have acute heart failure, BNP, NT-proBNP, and MR-proANP concentrations were comparable among daytime versus evening/nighttime presenters (all
CONCLUSIONS
BNP and NT-proBNP, but not MR-proANP, exhibit a diurnal rhythm that results in even higher diagnostic accuracy among evening/nighttime presenters versus daytime presenters.
REGISTRATION
URL: https://www.
CLINICALTRIALS
gov; Unique identifiers: NCT01831115, NCT02091427, and NCT02210897.

Identifiants

DOI: 10.1161/CIRCHEARTFAILURE.121.009165 PMID: 35670217 PMC: PMC10004748
pubmed: 35670217
doi: 10.1161/CIRCHEARTFAILURE.121.009165
pmc: PMC10004748
doi:

Substances chimiques

Biomarkers 0
Natriuretic Peptides 0
Peptide Fragments 0
Vasodilator Agents 0
Natriuretic Peptide, Brain 114471-18-0
Atrial Natriuretic Factor 85637-73-6

Banques de données

ClinicalTrials.gov
['NCT02210897', 'NCT01831115', 'NCT02091427']

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e009165

Références

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Auteurs

Tobias Breidthardt (T)

Divison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.
Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0003-2671-6456

William P T M van Doorn (WPTM)

General Clinical Chemistry and Hematology, Central Diagnostic Laboratory Maastricht University Medical Center, the Netherlands (W.P.T.M.v.D., N.v.d.L., S.J.R.M.).

Noreen van der Linden (N)

General Clinical Chemistry and Hematology, Central Diagnostic Laboratory Maastricht University Medical Center, the Netherlands (W.P.T.M.v.D., N.v.d.L., S.J.R.M.).

Matthias Diebold (M)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0002-6914-9132

Desiree Wussler (D)

Divison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0002-1793-5297

Isabelle Danier (I)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.

Tobias Zimmermann (T)

Divison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.
Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0002-6862-5205

Samyut Shrestha (S)

Divison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.
Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.

Nikola Kozhuharov (N)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
and Department of Cardiology (N.K., C.M.), University Hospital Basel, Basel University, Switzerland.
Liverpool Heart and Chest Hospital, United Kingdom (N.K.).
ORCID: 0000-0003-2086-3690

Maria Belkin (M)

Divison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.
Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0003-4643-8473

Caroline Porta (C)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.

Ivo Strebel (I)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0001-9976-4112

Eleni Michou (E)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.

Danielle M Gualandro (DM)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.

Albina Nowak (A)

Division of Endocrinology, University Hospital Zurich, University of Zurich, Switzerland (A.N.).

S J R Meex (SJR)

General Clinical Chemistry and Hematology, Central Diagnostic Laboratory Maastricht University Medical Center, the Netherlands (W.P.T.M.v.D., N.v.d.L., S.J.R.M.).

Christian Mueller (C)

Cardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
and Department of Cardiology (N.K., C.M.), University Hospital Basel, Basel University, Switzerland.
ORCID: 0000-0002-1120-6405

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Classifications MeSH

questionsmedicales.fr › Acides aminés, peptides et protéines › Peptides › Hormones peptidiques › Peptides natriurétiques › Facteur atrial natriurétique › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Phénomènes physiologiques › Phénomènes chronobiologiques › Périodicité › Rythme circadien › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Signes et symptômes respiratoires › Dyspnée › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Défaillance cardiaque › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines de tissu nerveux › Peptide natriurétique cérébral › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Acides aminés, peptides et protéines › Peptides › Hormones peptidiques › Peptides natriurétiques › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Acides aminés, peptides et protéines › Peptides › Fragments peptidiques › Diurnal Variations in Natriuretic Peptide...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents cardiovasculaires › Vasodilatateurs › Diurnal Variations in Natriuretic Peptide...