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Wertigkeit des Biomarkers BNP bei HIV-infizierten Patienten

BNP in HIV-Infected Patients

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Zusammenfassung

Hintergrund und Fragestellung:

HIV-infizierte Personen stellen aufgrund des zunehmenden Lebensalters, eines erhöhten kardialen Risikoprofils sowie metabolischer Medikamenteneffekte eine Gruppe von Patienten mit erhöhtem Risiko für das Auftreten kardialer Erkrankungen dar. Die vorliegende Studie untersucht die Wertigkeit des Biomarkers B-Typ-natriuretisches Peptid (BNP) hinsichtlich kardialer Erkrankungen bei HIV-infizierten Patienten.

Patienten und Methodik:

Die vorliegenden Auswertungen basieren auf den Daten der HIV-HEART-Studie. Der Patienteneinschluss in die prospektive, multizentrische Studie erfolgte über einen Zeitraum von 20 Monaten. Die Bestimmung der BNP-Konzentration wurde unmittelbar bei Studieneinschluss mittels Bedside-Testing vorgenommen.

Ergebnisse:

In die Studie wurden 802 Patienten (83,4% Männer; Alter: 44,2 ± 10,3 Jahre) eingeschlossen. Die BNP-Konzentration (Median 11,3 pg/ml; BNP ≤ 100 pg/ml: 96,2%) korrelierte bei Patienten mit echokardiographischen Parametern einschließlich des rechtsventrikulären Durchmessers (p = 0,02) und des systolischen Pulmonalarteriendrucks (p = 0,01). Patienten mit einer BNP-Konzentration > 50 pg/ml wiesen signifikant häufiger eine kardiale Insuffizienz (p < 0,001), eine Kardiomyopathie (p < 0,001) oder eine koronare Herzerkrankung (p < 0,001) auf.

Schlussfolgerung:

Die Ergebnisse weisen auf eine hohe Bedeutung von BNP zur Erkennung kardialer Manifestationen bei HIV-infizierten Patienten hin. BNP kann damit zur Detektion einer kardialen Miterkrankung im Rahmen von Screeningprogrammen beitragen.

Abstract

Background and Purpose:

HIV-infected patients exhibit an increased rate of cardiac diseases, due to an elevated rate of cardiac risk factors and side effects of antiretroviral therapy. The aim of the present study was to analyze the impact of B-type natriuretic peptide (BNP) in this patient population.

Patients and Methods:

The HIV-HEART (HIV infection and HEART disease) study is a prospective and multicenter cohort study. Outpatients with a known HIV infection were included over a 20-month recruiting period. BNP values were determined by a standardized laboratory test at study inclusion.

Results:

802 HIV-infected patients (male: 83.4%, mean age: 44.2 ± 10.3 years) were included. The BNP concentrations (median 11.3 pg/ml; BNP ≤ 100 pg/ml: 96.2%) were associated with echocardiographic parameters and with the right ventricular diameter (p = 0.02) and the systolic pulmonary arterial pressure (p = 0.01). Patients with a BNP concentration of > 50 pg/ml had a significantly higher rate of heart failure (p < 0.001), cardiomyopathy (p < 0.001), and coronary artery disease (p < 0.001).

Conclusion:

The data demonstrate that BNP is suitable for the detection of cardiac disorders in HIV-infected subjects. Therefore, BNP could be an appropriate tool for a screening program for HIV-associated disorders in this patient population.

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Authors and Affiliations

  1. Klinik für Kardiologie, Zentrum für Innere Medizin, Universitätsklinikum, Essen, Germany

    Till Neumann FESC, Nico Reinsch, Kathrin Neuhaus & Raimund Erbel

  2. Klinik für Dermatologie und Allergologie, Ruhr-Universität, Bochum, Germany

    Norbert Brockmeyer & Anja Potthoff

  3. Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum, Essen, Germany

    Stefan Esser

  4. Klinik für Innere Medizin, Pneumologie und Infektiologie, Klinikum, Dortmund, Germany

    Martin Hower

  5. Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Campus Essen, Essen, Germany

    Anja Neumann & Sarah Mostardt

  6. Zentrum für klinische Studien Leipzig (ZKS), Universität Leipzig, Leipzig, Germany

    Götz Gelbrich

  7. Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Germany

    Till Neumann FESC

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  1. Till Neumann FESC
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  2. Nico Reinsch
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  4. Norbert Brockmeyer
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  6. Stefan Esser
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  7. Martin Hower
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  8. Anja Neumann
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  9. Sarah Mostardt
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  10. Götz Gelbrich
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  11. Raimund Erbel
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für die HIV-HEART-Studie sowie die Kompetenznetze Herzinsuffizienz und HIV/AIDS

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Correspondence to Till Neumann FESC.

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Neumann, T., Reinsch, N., Neuhaus, K. et al. Wertigkeit des Biomarkers BNP bei HIV-infizierten Patienten. Herz 34, 634–640 (2009). https://doi.org/10.1007/s00059-009-3313-7

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  • DOI: https://doi.org/10.1007/s00059-009-3313-7

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