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Effect of Angiotensin Receptor-neprilysin Inhibitor on acute Kidney Injury in Patients With acute decompensated heart failure

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Cardiology Discovery 2024年第1期4卷 23-29页

作者： Gonghao Li Yanli Zhao Zhongxing Peng Kun Liu Delu Yin Yunfeng Zhao Department of Cardiology Nanjing Medical University Kangda College First Affiliated Hospitalthe First People’s Hospital of LianyungangLianyungangJiangsu 222061China

Objective:The risk of acute kidney injury(AKI)is high in patients with acute decompensated heart failure(ADHF).The aim of this study is to analyze the role of urinary neutrophil gelatinase-associated lipocalin(uNGAL)in diagnosing AKI in patients with ADHF and evaluate the therapeutic effect of angiotensin receptor-neprilysin inhibitor(ARNI)on ***:Sixty patients with ADHF were enrolled at the First Affiliated Hospital of Kangda College of Nanjing Medical University from January 2020 to June 2021,and randomized into 2 groups(ARNI group:30 patients treated with tablets of sacubitril valsartan sodium;and angiotensin-converting enzyme inhibitor(ACEI)group:30 patients treated with benazepril).The uNGAL level was measured immediately after as well as 1,2,3,and 7 d after hospital *** serum creatinine(sCr)level and estimated glomerular filtration rate(eGFR)were measured immediately as well as 2 and 7 d after hospital *** urine volume,dose of loop diuretics,and duration of hospital stay(DoHS)were ***:The most valuable diagnostic metric for AKI in patients with ADHF was the uNGAL level 1 d after hospital admission,which had a sensitivity of 0.94,specificity of 0.84,and optimal cutoff of 125.62μg/*** the presence of AKI,during the first 2 d,patients in the ARNI-AKI and ACEI-AKI groups showed an increase in the sCr level and a reduction in the eGFR level,but there was no significant difference between the 2 groups(P>0.05).After 7 d of treatment,the sCr level decreased and the eGFR level increased in both groups,with a significantly greater changes being observed in the ARNI-AKI group than in the ACEI-AKI group(P<0.05,respectively).In the absence of AKI,the difference in the sCr level and eGFR between the 2 groups was not *** DoHS((11.25±2.38)d vs.(14.11±2.89)d),urinary microalbumin level((22.95±6.04)mg/L vs.(31.91±2.18)mg/L),and daily dose of loop diuretics((19.03±3.04)mg/d vs.(23.62±4.46)mg/d)were significantly lower in patien

关键词： acute kidney injury acute decompensated heart failure Angiotensin receptor-neprilysin inhibitor Angiotensin-converting enzyme inhibitor Sacubitril valsartan Benazepril

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Effi cacy and Renal Tolerability of Ultrafi ltration in acute decompensated heart failure: A Meta-analysis and Systematic Review of 19 Randomized Controlled Trials

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Cardiovascular Innovations and Applications 2021年第3期6卷 1-16页

作者： Yajie Liu Xin Yuan Department of Cardiology the Second Affi liated Hospital of Chongqing Medical UniversityChongqingChina Department of Nephrology the Second Affi liated Hospital of Chongqing Medical UniversityChongqingChina

Background:acute decompensated heart failure(ADHF)is a life-threatening and costly *** re-mains regarding the effi cacy and renal tolerability of ultrafi ltration for treating *** therefore performed this meta-analysis to evaluate this clinical ***:A search of PubMed,EMBASE,and the Cochrane database of controlled trials was performed from in-ception to March 2021 for relevant randomized controlled *** quality of the included trials and outcomes was evaluated with the use of the risk of bias assessment tool and the Grading of Recommendations,Assessment,Develop-ment and Evaluation(GRADE)approach,*** risk ratio and the standardized mean difference(SMD)or weighted mean difference(WMD)were computed and pooled with fi xed-effects or random-effects ***:This meta-analysis included 19 studies involving 1281 *** ltration was superior to the control treatments for weight loss(WMD 1.24 kg,95%confi dence interval[CI]0.38-2.09 kg,P=0.004)and fl uid removal(WMD 1.55 L,95%CI 0.51-2.59 l,P=0.003)and was associated with a signifi cant increase in serum creatinine level compared with the control treatments(SMD 0.15 mg/dL,95%CI 0.00-0.30 mg/dL,P=0.04).However,no signifi cant effects were found for serum N-terminal prohormone of brain natriuretic peptide level,length of hospital stay,all-cause mortality,or all-cause rehospitalization in the ultrafi ltration ***:The use of ultrafi ltration in patients with ADHF is superior to the use of the control treatments for weight loss and fl uid removal,but has adverse renal effects and lacks signifi cant effects on long-term prognosis,in-dicating that this approach to decongestion in ADHF patients is effi cient for fl uid management but less safe renally.

关键词： Ultrafi ltration diuretic acute decompensated heart failure meta-analysis

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Correlation of Ceruloplasmin with Biomarkers of Cardiac Remodelling and Myofibrosis in Patients with acute decompensated heart failure Referred to a Tertiary Nurse Lead heart failure Clinic

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Open Journal of Nursing 2015年第11期5卷 971-975页

作者： Filip Malek Dagmar Vondrakova Oxana Komendova Dana Ríhova Jana Vranova Lenka Sedlackova Tana Andreasova Petr Neuzil Department of Cardiology Na Homolce HospitalPragueCzech Republic Third School of Medicine Charles UniversityPragueCzech Republic Department of Clinical Biochemistry Haematology and ImmunologyNa Homolce HospitalPragueCzech Republic

Background: Ceruloplasmin is an acute phase protein with plasma copper binding properties, and is a potent extracellular antioxidative enzyme. Inflammation and oxidative stress might explain the role of ceruloplasmin in the pathophysiology of heart failure. Study objective: The objective is to assess the correlation of ceruloplasmin levels with biomarkers of cardiac remodelling and myofibrosis in patients with acute decompensated heart failure. Patients and methods: Blood samples were taken and serum levels of soluble ST2, galectin-3, NT-proBNP and ceruloplasmin were analysed in 31 consecutive patients with systolic HF referred to tertiary care nurse lead heart failure clinic with acute decompensated CHF requiring i.v. diuretics. The mean patients’ age was 68 years, mean left ventricular ejection fraction (LV EF) was 29%, 66% patients had ischemic aetilogy of CHF and 33% had atrial fibrillation. Results: The mean ceruloplasmin level was 0.243 g/l, mean galectin-3 level was 1.26 ng/ml, mean sST2 level was 38.15 ng/ml, and mean NT-proBNP was 1927 pg/ml. The ceruloplasmin level correlated with NT-proBNP (r = 0.58, p acute decompensated heart failure.

关键词： acute decompensated heart failure Ceruloplasmin NT-proBNP sST2 Galectin-3

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