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Deepak Verma
Jeevandeep Heart Care Centre, IndiaPresentation Title:
Prognostic utility of B-type natriuretic peptide and 6-minute walk test in patients with acute decompensated heart failure
Abstract
Background: B-type natriuretic peptide (BNP) is a cardiac hormone and a known marker of volume overload. The 6-minute walk test (6MWT) is a test for performance capacity. We aimed to assess the utility of BNP and 6MWT together as predictors of rehospitalization and mortality in acute decompensated heart failure (ADHF) patients.
Methods: This prospective, observational, comparative study was conducted at a tertiary care center in India. Patients (aged ≥ 18 years) with ADHF and left ventricular (LV) systolic dysfunction were included in this study. All patients underwent BNP testing at admission. The study group (N=100 patients) consisted of patients undergoing a second BNP test along with the 6MWT at the time of discharge and at three months of discharge. The control group (N=100 patients) consisted of patients who did not undergo these tests at discharge and/or at three months of discharge. Study endpoints were rehospitalization within six months, and in-patient and sixmonth mortality.
Results: This study included 200 patients diagnosed with ADHF out of which 146 (73%) were male. The mean age of patients was 53.46 ± 10.12 years in the study group and 52.98 ± 9.88 years in the control group. At six months follow-up, 21 (21%) patients from study group and 28 (28%) patients from control group were rehospitalized once, and 4 (4%) patients from each group were re-hospitalized twice and death occurred in 4 (4%) patients in study group and 4 (4%) patients in control group at six months follow-up. ROC analysis of BNP level to predict re-hospitalization revealed AUC of 0.935 (P<0.001) at admission, 0.915 (P<0.001) at discharge, and 0.783 (P<0.001) at three months.
Conclusion: BNP levels and the 6MWT have good prognostic utility in ADHF patients, and thus may be beneficial in making therapeutic adjustments and taking precautionary measures in these patients.
Biography
Deepak Verma is a Senior Consultant Interventional Cardiologist and Director of the Jeevandeep Heart Care Centre in Gorakhpur, India. He completed his MBBS, MD, DM (Cardiology) from Prestigious Colleges in India, post graduate institutes of medical education and research & Dr. Ram Manohar Lohia hospital New Delhi. He has performed more than 2,500 PTCA. Complex Interventions Including Left Main stenting and Bifurcation stenting, among other procedures. He has good experience in treating heart failure patients, electrophysiology procedures, ICD, CRTs, pacemaker implantation, device/lead extraction, coronary and peripheral angioplasty, renal and carotid angioplasty, radial artery route angiograms, balloon valvotomy, etc
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