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Right catheterization parameters prediction in the first year after heart transplant using BNP
Session:
Painel 10 - Doença Valvular 8
Speaker:
António Valentim Gonçalves
Congress:
CPC 2020
Topic:
P. Other
Theme:
37. Miscellanea
Subtheme:
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Session Type:
Posters
FP Number:
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Authors:
António Valentim Gonçalves; Tiago Pereira Da Silva; Rui M. Soares; Lidia De Sousa; Pedro Rio; Rita Ilhão Moreira; André Grazina; Isabel Gonçalves Machado Cardoso; João Pedro Reis; Tiago Mendonça; Tânia Branco Mano; Pedro Garcia Brás; Vera Ferreira; Alexandra Castelo; Rui Cruz Ferreira
Abstract
<p><strong>Introduction</strong></p> <p>Despite being the gold-standard for hemodynamic assessment, right heart catheterization (RHC) was overcome by plasma B-Type Natriuretic Peptide (BNP) levels in daily clinical routine. However, in the first year after heart transplantation (HT), the relationship between BNP and adverse hemodynamics have yielded conflicting results.</p> <p> </p> <p><strong>Purpose</strong></p> <p>The aim of this study was to evaluate whether BNP values can be used to estimate adverse hemodynamics in the first year after HT.</p> <p> </p> <p><strong>Methods</strong></p> <p>Prospective study of consecutive RHC performed in the first year after HT (according to the endomyocardial biopsies program). Plasma BNP was measured at the same day. </p> <p>The area under the curve (AUC) was analysed to find the BNP values with higher sensitivity and specificity to detect adverse hemodynamics. Linear regression was made to study the association between BNP and pulmonary capillary wedge pressure (PCWP).</p> <p> </p> <p><strong>Results</strong></p> <p>From 2017 to 2018, 50 RHC were performed. Mean age was 49 ± 8 years, with mean BNP value of 964 ± 1115 pg/ml.</p> <p>Prediction of adverse hemodynamics by AUC results are represented in the table 1. BNP values were significantly increased in patients with PCWP >12mmHg (p<0.001), cardiac index <2.5L/min/m<sup>2</sup> (p=0.001), mean pulmonary artery pressure (mPAP) ≥25mmHg (p<0.001), pulmonary vascular resistance > 1,5WU (p=0.044) and right atrial pressure >5mmHg (p=0.003).</p> <p>BNP >500pg/ml had a sensitivity of 78% and 88% and a specificity of 76% and 68% to detect PCWP >12mmHg and mPAP ≥25mmHg, respectively.</p> <p>Linear regression analysis revealed that BNP could significantly predict PCWP (PCWP= 10.2 + BNPx0.04; p<0.001) with a R<sup>2</sup> of 0.32.</p> <p> </p> <p><strong>Conclusion</strong></p> <p>Significant associations were found between BNP values and adverse hemodynamics in RHC, supporting the clinical utility of BNP in the first year after HT. </p>
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