Papel do Peptídeo Natriurético NT pro-BNP no diagnóstico da insuficiência cardíaca em idosos

Abstract

Introduction: Heart failure (HF) is the final pathway of most diseases affecting the heart. It is estimated that this syndrome, with high mortality rate, affects 80% of the elderly people in the world within five years of disease evolution. Objective:The objective was to evaluate the role of natriuretic peptide NT - proBNP in the diagnosis of HF in the elderly. Method: Cross-sectional study of diagnosis to determine the accuracy (sensitivity, specificity and predictive value) in serum BNP level, checking if there is a correlation between the serum BNP level and severity of heart failure. While testing patients, in the NT-proBNP study, the NT-proBNP serum level was determinedby the blood. Chest X-rays, transthoracic echocardiography and clinical examination were used to define groups with and without HF. A total of 74 elderly were researched in this group, 46 had HF and 28 had noHF. Results: Female gender was more prevalent 92,9% (p = 0.001), the age range was 60-69 years old (with/HF=37%) (without/HF=57.1%) (p=0.025). They had no active physical activities (95.7% w/HF) (p < 0.001 ), both groups had hypertension (p<0.001); dyslipidemic ( 10.9 % with HF ) and ( 39.3 % without HF ) ( p = 0.004 ), diabetic ( 47.8 % w/HF) and (21.4 % without/HF) (p=0.023); acute myocardial infarction, coronary artery disease (87% w/HF) (p < 0.001). Ejection fraction > 50% (average 363.2) and < 50 % (average 678.2). Ranked using the New York Heart Association I (20 to 344.2 average), IV (12 to 664.9 average) (p=0.412), with sensitivity 58.7 % and specificity 82.1 %, linear regression (r=-0.291, p=0.05) between BNP andEF. Conclusion: The NT-proBNP serum level was useful in aiding the diagnosis of HF in the elderly, with prediction capacity approximately 74%, according to the area under the ROC curve. A low correlation between the NT-proBNP serum level and the ejection fraction in patients with HF was observed. Further clinical studies are necessary so as to define the role of NT-proBNP in the clinical practice with elderly patients