Article Sidebar

Submitted
11 August 2017
Accepted
11 August 2017
Published
14 August 2017
Download
PDF
Statistic
Read Counter : 1212 Download : 1094

Main Article Content

Abstract

BNP secreted by left ventricle as response to wall stress in patient with heart failure. Elevated concentration of NT-pro-BNP correlate with severity of heart failure across all stages of the condition and left ventricle ejection fraction in patient. Several clinical trials have demonstrated that neurohormonal modulation on the RAAS decreases NT-proBNP level and results in favorable outcomes. One of the drug used for blocked RAAS system is ACE inhibitor, decrease of NT-proBNP level show response to therapy include therapy with ACE inhibitors. To analize changes in the levels serum NT-proBNP levels after ace inhibitor therapy in patients with heart failure and monitoring creatinine serum. This study was a observational, prospective, non-randomized trial involving patient age 21-75 years, with NYHA class II-III HF, using ACE inhibitor therapy plus other therapy maximum 3 months before study without ARB or beta blocker. We compared serum NT-pro-BNP and creatinin serum parameters before and after two months treatment with ACE inhibitor. This study conducted in cardiovascular ambulatory patient dr. Soetomo hospital Surabaya. Between August-November 2015, 13 patient (38-63 years, 6 woman, 7 men) include in this study. The mean baseline level of NT-proBNP is 2166.92±1236.73 pg/ml, and creatinin serum 1.023±0.601 mg/dL. The NT-pro-BNP were significantly decreased after two months of treatment with ACE inhibitors 1508.23±651 pg/mL (p=0.025), there were no significant differences creatinin serum between two groups 0.951±0.0365 mg/dL (p=0.111). The results demonstrated the benefits of ACE inhibitor on the neurohormonal profile in patients with HF. If necessary we could measure NT-proBNP level to support prognosis data and monitoring effectivity therapy especially ACE inhibitor which had antiremodelling effect towards patients with HF.

Keywords

Natriuretic peptide NT-proBNP heart failure angiotensin-converting enzyme inhibitors

Article Details

License

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Hartoto, H. H., Zulkarnain, B. S., & Aminuddin, M. (2017). ANALYSIS OF CHANGES IN THE SERUM LEVEL NT-proBNP AFTER ACE INHIBITORS THERAPY IN PATIENTS WITH HEART FAILURE. Folia Medica Indonesiana, 52(3), 193–197. https://doi.org/10.20473/fmi.v52i3.5451
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. deBoer RA and van Veldhuisen DJ (2008). ACE-inhibitors, Beta-blockers or the combination in heart failure: is it just an A-B-C?. Cardiovasc Drugs Ther 22, 261–263
  2. Januzzi JL, Rehman SU, Mohammed AA, Bhardwaj A, Barajas L, Barajas J, Kim HN, Baggish AL, Weiner RB, Chen-Tournoux A, Marshall JE (2011). Use of amino-terminal pro-B-type natriuretic peptide to guide outpatient therapy of patients with chronic left ventricular systolic dysfunction. Journal of the American College of Cardiology 58, 1881-1889
  3. Kim HN and Januzzi JL (2011). Natriuretic peptide testing in heart failure. Circulation 123, 2015-2019
  4. Loscalzo J (2010). Harrison's: Cardiovascular Medicine, New York, McGraw-Hill Comp, p 178-197
  5. Morrow DA (2006). Cardiovascular Biomarkers: Pathophysiology And Disease Management, New Jersey, Humana Press Inc, p 345-370
  6. Mueller T, Gegenhuber A, Dieplinger B, Poelz W, Haltmayer M (2004). Long-term stability of endogenous B-type natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP) in frozen plasma samples. Clin Chem Lab Med 42, 942-944
  7. Savioli NF, Magalhí£es HM, Batlouni M, Piegas LS (2009). ACE inhibitors and plasma B-type natriuretic peptide levels in elderly patients with heart failure. Arquivos Brasileiros de Cardiologia 92, 349-356
  8. Srisawasdi P, Vanavanan S, Charoenpanichkit C, Kroll MH (2010). The effect of renal dysfunction on BNP, NT-proBNP, and their ratio. American Journal of Clinical Pathology 133, 14-23
  9. Tsutamoto T, Sakai H, Ishikawa C, Fujii M, Tanaka T, Yamamoto T, Takashima H, Ohnishi M, Wada A, Horie M (2007). Direct comparison of transcardiac difference between brain natriuretic peptide (BNP) and N-terminal pro-BNP in patients with chronic heart failure. European Journal of Heart Failure 9, 667-673
  10. Tsutamoto T, Wada A, Maeda K, Mabuchi N, Hayashi M, Tsutsui T, Ohnishi M, Sawaki M, Fujii M, Matsumoto T, Matsui T, Kinoshita M (2001). Effect of spironolactone on plasma brain natriuretic peptide and left ventricular remodeling in patients with congestive heart failure. Journal of the American College of Cardiology 37, 1228–1233
  11. Tsutamoto T, Wada A, Sakai H, Ishikawa C, Tanaka T, Hayashi M, Fujii M, Yamamoto T, Dohke T, Ohnishi M, Takashima H, Kinoshita M, Horie M (2006). Relationship between renal function and plasma brain natriuretic peptide in patients with heart failure. Journal of the American College of Cardiology 47, 582-586