Relation of renal function with left ventricular systolic function and NT-proBNP level and its prognostic implication in heart failure with preserved versus reduced ejection fraction

An analysis from the Korean Heart Failure (KorHF) registry

Chan Soon Park, Jin Joo Park, Il Young Oh, Chang Hwan Yoon, Dong Ju Choi, Hyun Ah Park, seokmin kang, Byungsu Yoo, Eun Seok Jeon, Jae Joong Kim, Myeong Chan Cho, Shung Chull Chae, Kyu Hyung Ryu, Byung Hee Oh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Objectives: The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratifed by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). Materials and Methods: NT-proBNP, glomerular fltration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defned as EF<50%, and renal dysfunction as GFR<60 mL/min/1.73 m2 (mild renal dysfunction: 30=GFR<60 mL/min/1.73 m2; severe renal dysfunction: GFR<30 mL/min/1.73 m2). The primary outcome was 12-month all-cause death. Results: There was an inverse correlation between GFR and log NT-proBNP level (r=-0.298, p<0.001), and between EF and log NT-proBNP (r=-0.238, p<0.001), but no correlation between EF and GFR (r=0.017, p=0.458). Interestingly, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank p<0.001). Multivariate analysis showed severe renal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confdence interval [CI], 1.40'3.11). When stratifed according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66'3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52'3.89). Conclusion: In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.

Original languageEnglish
Pages (from-to)727-741
Number of pages15
JournalKorean Circulation Journal
Volume47
Issue number5
DOIs
Publication statusPublished - 2017 Sep 1

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Brain Natriuretic Peptide
Left Ventricular Function
Registries
Heart Failure
Kidney
Mortality
Cause of Death
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Park, Chan Soon ; Park, Jin Joo ; Oh, Il Young ; Yoon, Chang Hwan ; Choi, Dong Ju ; Park, Hyun Ah ; kang, seokmin ; Yoo, Byungsu ; Jeon, Eun Seok ; Kim, Jae Joong ; Cho, Myeong Chan ; Chae, Shung Chull ; Ryu, Kyu Hyung ; Oh, Byung Hee. / Relation of renal function with left ventricular systolic function and NT-proBNP level and its prognostic implication in heart failure with preserved versus reduced ejection fraction : An analysis from the Korean Heart Failure (KorHF) registry. In: Korean Circulation Journal. 2017 ; Vol. 47, No. 5. pp. 727-741.
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title = "Relation of renal function with left ventricular systolic function and NT-proBNP level and its prognostic implication in heart failure with preserved versus reduced ejection fraction: An analysis from the Korean Heart Failure (KorHF) registry",
abstract = "Background and Objectives: The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratifed by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). Materials and Methods: NT-proBNP, glomerular fltration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defned as EF<50{\%}, and renal dysfunction as GFR<60 mL/min/1.73 m2 (mild renal dysfunction: 30=GFR<60 mL/min/1.73 m2; severe renal dysfunction: GFR<30 mL/min/1.73 m2). The primary outcome was 12-month all-cause death. Results: There was an inverse correlation between GFR and log NT-proBNP level (r=-0.298, p<0.001), and between EF and log NT-proBNP (r=-0.238, p<0.001), but no correlation between EF and GFR (r=0.017, p=0.458). Interestingly, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF (49{\%} vs. 52{\%}, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9{\%} vs. 15.2{\%}, log-rank p=0.008) and HFrEF (8.6{\%} vs. 16.8{\%}, log-rank p<0.001). Multivariate analysis showed severe renal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95{\%} confdence interval [CI], 1.40'3.11). When stratifed according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95{\%} CI, 0.66'3.21) contrary to HFrEF patients (HR, 2.43; 95{\%} CI, 1.52'3.89). Conclusion: In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.",
author = "Park, {Chan Soon} and Park, {Jin Joo} and Oh, {Il Young} and Yoon, {Chang Hwan} and Choi, {Dong Ju} and Park, {Hyun Ah} and seokmin kang and Byungsu Yoo and Jeon, {Eun Seok} and Kim, {Jae Joong} and Cho, {Myeong Chan} and Chae, {Shung Chull} and Ryu, {Kyu Hyung} and Oh, {Byung Hee}",
year = "2017",
month = "9",
day = "1",
doi = "10.4070/kcj.2017.0050",
language = "English",
volume = "47",
pages = "727--741",
journal = "Korean Circulation Journal",
issn = "1738-5520",
publisher = "Korean Society of Circulation",
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Relation of renal function with left ventricular systolic function and NT-proBNP level and its prognostic implication in heart failure with preserved versus reduced ejection fraction : An analysis from the Korean Heart Failure (KorHF) registry. / Park, Chan Soon; Park, Jin Joo; Oh, Il Young; Yoon, Chang Hwan; Choi, Dong Ju; Park, Hyun Ah; kang, seokmin; Yoo, Byungsu; Jeon, Eun Seok; Kim, Jae Joong; Cho, Myeong Chan; Chae, Shung Chull; Ryu, Kyu Hyung; Oh, Byung Hee.

In: Korean Circulation Journal, Vol. 47, No. 5, 01.09.2017, p. 727-741.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relation of renal function with left ventricular systolic function and NT-proBNP level and its prognostic implication in heart failure with preserved versus reduced ejection fraction

T2 - An analysis from the Korean Heart Failure (KorHF) registry

AU - Park, Chan Soon

AU - Park, Jin Joo

AU - Oh, Il Young

AU - Yoon, Chang Hwan

AU - Choi, Dong Ju

AU - Park, Hyun Ah

AU - kang, seokmin

AU - Yoo, Byungsu

AU - Jeon, Eun Seok

AU - Kim, Jae Joong

AU - Cho, Myeong Chan

AU - Chae, Shung Chull

AU - Ryu, Kyu Hyung

AU - Oh, Byung Hee

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Background and Objectives: The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratifed by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). Materials and Methods: NT-proBNP, glomerular fltration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defned as EF<50%, and renal dysfunction as GFR<60 mL/min/1.73 m2 (mild renal dysfunction: 30=GFR<60 mL/min/1.73 m2; severe renal dysfunction: GFR<30 mL/min/1.73 m2). The primary outcome was 12-month all-cause death. Results: There was an inverse correlation between GFR and log NT-proBNP level (r=-0.298, p<0.001), and between EF and log NT-proBNP (r=-0.238, p<0.001), but no correlation between EF and GFR (r=0.017, p=0.458). Interestingly, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank p<0.001). Multivariate analysis showed severe renal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confdence interval [CI], 1.40'3.11). When stratifed according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66'3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52'3.89). Conclusion: In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.

AB - Background and Objectives: The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratifed by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). Materials and Methods: NT-proBNP, glomerular fltration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defned as EF<50%, and renal dysfunction as GFR<60 mL/min/1.73 m2 (mild renal dysfunction: 30=GFR<60 mL/min/1.73 m2; severe renal dysfunction: GFR<30 mL/min/1.73 m2). The primary outcome was 12-month all-cause death. Results: There was an inverse correlation between GFR and log NT-proBNP level (r=-0.298, p<0.001), and between EF and log NT-proBNP (r=-0.238, p<0.001), but no correlation between EF and GFR (r=0.017, p=0.458). Interestingly, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank p<0.001). Multivariate analysis showed severe renal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confdence interval [CI], 1.40'3.11). When stratifed according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66'3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52'3.89). Conclusion: In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.

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