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Previous issue date: 2014-07-25 / 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 / Introdu??o: A insufici?ncia card?aca (IC) ? a via final da maioria das doen?as que acometem o cora??o. Estima-se que 80% de idosos do mundo sejam afetados por essa s?ndrome, com taxa de mortalidade elevada entre um e cinco anos do diagn?stico da doen?a. Objetivo: Avaliar o papel do Pept?deo Natriur?tico NT proBNP no diagn?stico da IC em idosos. M?todo: Estudo transversal de diagn?stico, para determinar a acur?cia (sensibilidade, especificidade e valor preditivo) do n?vel s?rico NT proBNP, verificando se existe correla??o entre o n?vel s?rico do NT proBNP e a gravidade da IC, neste estudo. Na realiza??o dos exames dos pacientes do estudo, o n?vel s?rico do pept?deo foi dosado atrav?s do sangue. Radiografia do t?rax, ecocardiograma transtor?cico e exame cl?nico foram utilizados para definir grupos com e sem a IC. O total de 74 idosos, 46 com IC e 28 sem IC, foi estudado neste grupo. Resultados: O sexo feminino foi mais prevalente 92,9% (p=0,001), a faixa et?ria 60 a 69 anos, (c/ IC= 37%) (s/IC=57,1%) (p=0,025). N?o praticavam atividade f?sica (95,7% c/IC) (p <0,001), hipertens?o ambos os grupos (p <0,001); dislip?micos (10,9% com IC) e (39,3% sem IC) (p=0,004), diab?ticos (47,8% c/IC) e (21,4% s/IC) (p=0,023); IAM/DAC (87% c/IC) (p<0,001). Fra??o de Eje??o>50% (m?dia de 363,2) e <50% (m?dia de 678,2). Classificados usando a NYHA I(20-344,2 m?dia), IV(12-664,9 m?dia) (p=0,412) com sensibilidade 58,7% e especificidade de 82,1%, regress?o linear (r= -0,291 e p=0,05) entre BNP e FE. Conclus?o: O n?vel s?rico de NT-proBNP se mostrou ?til no aux?lio ao diagn?stico de IC em idosos, com capacidade de predi??o de aproximadamente 74%, segundo a ?rea sob a curva ROC. Foi observada uma correla??o fraca entre o n?vel s?rico de NT-proBNP e a fra??o de eje??o nos pacientes com IC. Estudos cl?nicos adicionais s?o necess?rios para definir o papel do NT-proBNP na pr?tica cl?nica em pacientes idosos
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2751 |
| Date | 25 July 2014 |
| Creators | Ara?jo, Angela Amorim de |
| Contributors | Silva Filho, Irenio Gomes da |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
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