Plasma Levels of Brain Natriuretic Peptides and Cardiac Troponin in Hemodialysis Patients

摘要

Patients with End-Stage Renal Disease (ESRD) are at high risk of death as a result of the cardiovascular disease (CVD), which cannot be explained by the conventional risk factors only. Haemodialysis patients frequently have elevated serum concentrations of the cardiac troponins T, specifi c markers of myocardial injury. Plasma levels of brain natriuretic peptide (BNP) are elevated in fl uid volume overload and heart failure, and decreased during dialysis. Currently, LV hypertrophy and LV dysfunction are considered the strongest predictors of cardiovascular mortality in dialysis population, and the synthesis of cardiac natriuretic peptides is high in the presence of alterations in the left ventricular (LV) mass and function. Th e aim of this study was to investigate the factors associated with the increased serum levels of BNP and CTN in haemodialysis patients, and their impact on cardiovascular morbidity. In this cross-sectional study we included ?? patients with ESRD, without coronary symptoms, who were subjected to regular dialysis treatment three times a week for the duration of four hours. Heart failure was defi ned as an ejection fraction (EF) of < ???, and dyspnoea associated with either elevated jugular pressure or interstitial oedema evidenced in chest X-ray. All patients were in sinus rhythm at the time of the study. Twenty-fi ve patients were on erythropoietin treatment. Blood samples were taken before and after the dialysis session. Our study included ?? patients (?? males, ?? females). Th e average age was ??,? years (total range ??-??) divided into two groups: euvolemic and hypervolemic. Th e average dialysis time was ??,?±??,?? months. All haemodialysis patients had excessively high levels of BNP ????,??±????,?? ng/cm?. Plasma cTnT was found to be increased in ??,?? of patients. Patients with hypervolemia had signifi cantly higher cTnT levels (?,????±?,????), as compared to the euvolemic patients ?,????±?,???? p