Advanced HFrEF patient with very low NT PRO BNP AND LOW VO2
J. Am. Coll. Cardiol
; 81(8_Suppl): 2548-2548, Mar 7, 2023.
Article
em En
| CONASS, SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-1435044
Biblioteca responsável:
BR79.1
ABSTRACT
BACKGROUND:
Advanced heart failure with reduced ejection fraction is rarely (HFrEF) associated with very low values of NT-pro-BNP, and its evidence poses a challenge to the true cause of the dysphnea and fatigue experienced by the patients. CASE 48 year old male, BMI 25,17, with dilated cardiomiopathy, presented with NYHA class III, ecocardiography demonstrating EF of 34%, diastolic dysfunction grade 1 and a normal right ventricule function. His EKG showed a sinus rythm with a left bundle branch block, with QRS duration of 150 ms. Despite optimized medical therapy, patient maintained symptoms to a minimum effort, and his NT-pro-BNP blood levels were never higher than 60 pg/ml. DECISION-MAKING Patient underwent a cardiac resynchronization therapy (CRT) after one year follow up. A recent cardiopulmonary exercise testing (CPET) showed a VO2max of 12 ml/kg/min, RER = 1,1, a VE/VCO2 slope of 37,8 and no evidence of pulmonary disfunction. Right heart catheterization (RHC) without the usage of inotropes demonstrated a cardiac output of 3,79 liters/minute and a pulmonary resistence of 1,85 Wood. Due to the persistence of symptoms, without clinical improvement, the patient was placed on the waiting list for heart transplantation despite his low blood levels of NT-pro-BNP.CONCLUSION:
Heart transplantation in HFrEF requires an individual approach and the patientʼs clinical presentation must not be overlooked independently of NT-pro-BNP values. Further controlled trials are still needed to provide clear guidelines on the management of HFrEF patients presenting very low values of NT-proBNP.
Texto completo:
1
Coleções:
06-national
/
BR
Base de dados:
CONASS
/
SES-SP
/
SESSP-IDPCPROD
Assunto principal:
Guia de Prática Clínica
/
Insuficiência Cardíaca Sistólica
Tipo de estudo:
Guideline
/
Prognostic_studies
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article
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Congress and conference