Soluble ST2 and Diuretic Efficiency in Acute Heart Failure and Concomitant Renal Dysfunction.
Por:
Espriella R, Bayés-Genis A, Revuelta-LóPEZ E, Miñana G, Santas E, Llàcer P, García-Blas S, Fernández-Cisnal A, Bonanad C, Ventura S, Sánchez R, Bodí V, Cordero A, Fácila L, Mollar A, Sanchis J, Núñez J and IMPROVE-HF Investigators
Publicada:
1 abr 2021
Ahead of Print:
8 oct 2020
Categoría:
Cardiology and cardiovascular medicine
Resumen:
BACKGROUND: Identifying patients at risk of poor diuretic response in acute heart failure (AHF) is critical to make prompt adjustments in therapy. The objective of this study was to investigate whether the circulating levels of soluble ST2 predict the cumulative diuretic efficiency (DE) at 24 and 72 hours in patients with AHF and concomitant renal dysfunction. METHODS AND RESULTS: This is a post hoc analysis of the IMPROVE-HF trial, in which we enrolled 160 patients with AHF and renal dysfunction (estimated glomerular filtrate rate of <60 mL/min/1.73 m(2)). DE was calculated as the net fluid output produced per 40 mg of furosemide equivalents. The association between sST2 and DE was evaluated by using multivariate linear regression analysis. The median cumulative DE at 24 and 72 hour was 747 mL (interquartile range 490-1167 mL) and 1844 mL (interquartile range 1142-2625 mL), respectively. The median sST2 and mean estimated glomerular filtrate rate were 72 ng/mL (interquartile range 47-117 ng/mL), and 34.0 ± 8.5 mL/min/1.73 m(2), respectively. In a multivariable setting, higher sST2 were significant and nonlinearly related to lower DE both at 24 and 72 hours (P?=?.002 and P?=?.019, respectively). CONCLUSIONS: In patients with AHF and renal dysfunction at presentation, circulating levels of sST2 were independently and negatively associated with a poor diuretic response, both at 24 and 72 hours.
Filiaciones:
Espriella R:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
Bayés-Genis A:
CIBER Cardiovascular, Madrid, Spain
Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
Revuelta-LóPEZ E:
Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
Miñana G:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
CIBER Cardiovascular, Madrid, Spain
Santas E:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
Llàcer P:
Internal Medicine Department, Hospital Ramón y Cajal, Madrid, Spain
García-Blas S:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
CIBER Cardiovascular, Madrid, Spain
Fernández-Cisnal A:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
Bonanad C:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
:
Internal Medicine Department, Hospital de La Plana, Villa-Real, Castellón, Spain
:
Internal Medicine Department, Hospital Virgen de Los Lirios, Alcoy, Spain
Bodí V:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
CIBER Cardiovascular, Madrid, Spain
:
Cardiology Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
Fácila L:
Cardiology Department, Hospital General Universitario de Valencia, Valencia, Spain
Mollar A:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
Sanchis J:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
CIBER Cardiovascular, Madrid, Spain
Núñez J:
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de València, INCLIVA, Valencia, Spain
CIBER Cardiovascular, Madrid, Spain. Electronic address:
|