TY  - THES
AU  - Đorđević, Tea
PY  - 2023
UR  - https://eteze.bg.ac.rs/application/showtheses?thesesId=9611
UR  - https://fedorabg.bg.ac.rs/fedora/get/o:33682/bdef:Content/download
UR  - https://plus.cobiss.net/cobiss/sr/sr/bib/129233929
UR  - https://nardus.mpn.gov.rs/handle/123456789/22457
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5668
AB  - Uvod: Ishemijska bolest srca izaziva srčanu slabost (HF) i predstavlja jedan od značajnih uzrokavisokog sveukupnog morbiditeta i mortaliteta, uprkos napretku u dijagnozi i lečenju. Povišenavrednost N-terminalnog-pro-B-tip natriuretskog peptida (NT-pro-BNP) u miru je prepoznata kaoznačajni pokazatelj kompromitovanog minutnog volumena (MV) srca i dijagnoze srčane slabostisa smanjenom ejekcionom frakcijom leve komore srca (LVEF) (HFrEF), a predstavlja iprognostički marker ove bolesti. Značaj ovog parametra je još uvek nedovoljno ispitan kodpacijenata sa srčanom slabošću sa očuvanom (HFpEF) i srednje očuvanom LVEF (HFmrEF).Kako je nedovoljno povećanje MV tokom napora zajedničko za sve fenotipove HF, cilj je bio dase evaluira dinamika i prognostički značaj plazma nivoa NT-pro-BNP tokom napora, kao ioporavka od napora, kod bolesnika sa ishemijskom HFrEF i HFmrEF/HFpEF.Materijal i metode: Ukupno 213 pacijenata (123 pacijenta sa ishemijskom HFrEF i 90 pacijenatasa ishemijskom HFmrEF/HFpEF) je bilo uključeno u studijsku kohortu. Pacijenti koji su biliuključeni su bili podvrgnuti 2-D i dopler ehokardiografiji, u cilju procene sistolnog pritiskaplućne arterije (PASP) u miru i amplitude sistolne pokretljivosti anulusa trikuspidne valvule(TAPSE), kao i kardiopulmonalnom testu opterećenja (CPET) sa uzorkovanjem krvi u trivremenske odrednice: 1) u miru, 2) u piku napora, i 3) nakon prvog minuta oporavka nakonnapora, a iz njih su bile merene vrednosti plazma nivoa NT-pro-BNP. Pacijenti su bili praćeninakon momenta uzorkovanja krvi u cilju procene otkrivanja ozbiljnih srčanih neželjenihdogađaja, kao što su smrt kao posledica srčanih uzroka i transplantacija srca, odnosno ugradnjamehaničke pumpe za pomoć levoj komori (LVAD).Rezultati: TAPSE/PASP je bio veći kod pacijenata sa HFmrEF/HFpEF u odnosu na one saHFrEF. Srčana frekvenca (HR) u mirovanju i maksimalnom opterećenju se nije razlikovala međubolesnicima sa HF. Pacijenti sa HFrEF su imali lošiji CPET odgovor, uključujući nižu rezervuHR u 1. minutu oporavka, toleranciju napora (pik VO2) i parcijalni pritisak CO2 na krajuizdisaja; ventilatorna efikasnost je bila lošija i češća pojava oscilatorne ventilacije. Pacijenti saHFrEF su imali više plazma nivoe NT-pro-BNP u miru, piku napora i oporavku od napora, uodnosu na HFmrEF/HFpEF (p<0.001), dok je porast tokom napora (ΔNT-pro-BNP pik/mir) i padnivoa ovog hormona u oporavku od napora (ΔNT-pro-BNP oporavak/pik) bio sličan. Pacijenatisa zaravnjenom VO2/HR krivom tokom CPET, koja je pokazatelj porasta udarnog volumena, suimali više nivoe NT-pro-BNP u plazmi u miru, piku napora i oporavku od napora, kao i većiporast plazma nivoa ovog hormona tokom napora. Tokom perioda praćenja (22.4±20.3 meseca)34 pacijenta su umrla, izvršene su 2 srčane transplantacije, 3 LVAD implantacije. ROC analizaje pokazala snažnu prediktivnu vrednost ΔNT-pro-BNP pik/mir i NT-pro-BNP oporavak zanastanak kardiovaskularnih događaja (površina ispod ROC 0.82, 0.86; SE=0.04, 0.03; p<0.001,respektivno). Optimalna vrednost praga ΔNT-pro-BNP pik/mir i NT-pro-BNP u oporavku zaidentifikaciju pacijenata sa rizikom za pojavu neželjnih srčanih događaja je bila ≥108 pg/ml i≥1115 pg/ml, respektivno, kod svih fenotipova HF...
AB  - Background: Ischemic heart disease leading heart failure (HF) portends a high overall morbidityand mortality despite considerable improvements in diagnosis and treatment. A higher Nterminal-pro-B-type natriuretic peptide (NT-pro-BNP) values at rest is a significant indicator ofcompromised cardiac output and a HF diagnosis, most likely secondary to reduced ejectionfraction (HFrEF), as well as prognostic marker, however its value in patient with HF of midranged/preserved left ventricular ejection fraction (LVEF) (HFmrEF/HFpEF) is not wellestablished. As an insufficient increase in cardiac output during exertion is common in all HFphenotypes, we examined the value of NT-pro-BNP during exercise testing as a risk stratificationindex for ischemic HF secondary to either reduced (HFrEF) or mid-ranged/preserved LVEF(HFmrEF/HFpEF). We also examined the prognostic value of NT-pro-BNP during recoveryfrom exercise in patients with ischemic HF of any LVEF.Matherials and Methods: In total, 213 patients with ischemic HF (123 HFrEF and 90HFmrEF/HFpEF) were included in study cohort. Patients who were included underwent Dopplerechocardiography which was used to estimate resting pulmonary artery systolic pressure (PASP)and tricuspid annular plane systolic excursion (TAPSE), as well as cardiopulmonary test (CPET)with three blood sampling: 1) at rest, 2) at peak execise, and 3) after first minute of recovery inorder to measure NT-pro-BNP levels. Follow-up of all patients was performed in order ofdetecting any cardiac adverse events, such as death due to cardiac reasons, heart transplantationand left ventricular assist device (LVAD).Results: TAPSE/PASP was lower in patients with HFmrEF/HFpEF than in HFrEF. Heart rate(HR) at rest and peak did not diferentiate significantly between patients with HF, while the oneswith HFrEF had worse CPET response, including lower values of HR reserve during first minuteof recovery, exercise tolerance (peak VO2) and end-tidal partial pressure CO2. Ventilatoryefficancy was lower and more frequent oscilatory breathing. Patients with HFrEF had higherplasma levels of NT-pro-BNP at rest, peak exercise and recovery than those withHFmrEF/HFpEF (p<0.001), whereas the increase of this hormone during exercise and decreaseduring recovery (ΔNT-pro-BNP peak/rest and ΔNT-pro-BNP recovery/peak) were similar.Patients with flattening of VO2 trajectory showed higher levels of NT-pro-BNP at rest, peak andrecovery, as well as higher increase of it during exercise. During the tracking period (22.4±20.3mo), 34 patients died, 2 underwent cardiac transplantation, and 3 LVAD implantation. ROCanalysis demonstrated strong predictve value of ΔNT-pro-BNP peak/rest and NT-pro-BNP inrecovery for adverse cardiac events (surface under the ROC 0.82, 0.86; SE=0.04, 0.03; p<0.001,respectively). Optimal value of ΔNT-pro-BNP peak/rest and NT-pro-BNP in recovery foridentification of patients with increased risk of cardiac adverse events was ≥108 pg/ml and≥1115 pg/ml, respectively, in all HF phenotypes...
PB  - Универзитет у Београду, Фармацеутски факултет
T2  - Универзитет у Београду
T1  - Evaluacija dinamike i prognostičke vrednostI N-terminalnog-pro-B tip natriuretskog peptida tokom napora i oporavka kod ishemijom izazvane srčane slabosti
UR  - https://hdl.handle.net/21.15107/rcub_nardus_22457
ER  - 

@phdthesis{
author = "Đorđević, Tea",
year = "2023",
abstract = "Uvod: Ishemijska bolest srca izaziva srčanu slabost (HF) i predstavlja jedan od značajnih uzrokavisokog sveukupnog morbiditeta i mortaliteta, uprkos napretku u dijagnozi i lečenju. Povišenavrednost N-terminalnog-pro-B-tip natriuretskog peptida (NT-pro-BNP) u miru je prepoznata kaoznačajni pokazatelj kompromitovanog minutnog volumena (MV) srca i dijagnoze srčane slabostisa smanjenom ejekcionom frakcijom leve komore srca (LVEF) (HFrEF), a predstavlja iprognostički marker ove bolesti. Značaj ovog parametra je još uvek nedovoljno ispitan kodpacijenata sa srčanom slabošću sa očuvanom (HFpEF) i srednje očuvanom LVEF (HFmrEF).Kako je nedovoljno povećanje MV tokom napora zajedničko za sve fenotipove HF, cilj je bio dase evaluira dinamika i prognostički značaj plazma nivoa NT-pro-BNP tokom napora, kao ioporavka od napora, kod bolesnika sa ishemijskom HFrEF i HFmrEF/HFpEF.Materijal i metode: Ukupno 213 pacijenata (123 pacijenta sa ishemijskom HFrEF i 90 pacijenatasa ishemijskom HFmrEF/HFpEF) je bilo uključeno u studijsku kohortu. Pacijenti koji su biliuključeni su bili podvrgnuti 2-D i dopler ehokardiografiji, u cilju procene sistolnog pritiskaplućne arterije (PASP) u miru i amplitude sistolne pokretljivosti anulusa trikuspidne valvule(TAPSE), kao i kardiopulmonalnom testu opterećenja (CPET) sa uzorkovanjem krvi u trivremenske odrednice: 1) u miru, 2) u piku napora, i 3) nakon prvog minuta oporavka nakonnapora, a iz njih su bile merene vrednosti plazma nivoa NT-pro-BNP. Pacijenti su bili praćeninakon momenta uzorkovanja krvi u cilju procene otkrivanja ozbiljnih srčanih neželjenihdogađaja, kao što su smrt kao posledica srčanih uzroka i transplantacija srca, odnosno ugradnjamehaničke pumpe za pomoć levoj komori (LVAD).Rezultati: TAPSE/PASP je bio veći kod pacijenata sa HFmrEF/HFpEF u odnosu na one saHFrEF. Srčana frekvenca (HR) u mirovanju i maksimalnom opterećenju se nije razlikovala međubolesnicima sa HF. Pacijenti sa HFrEF su imali lošiji CPET odgovor, uključujući nižu rezervuHR u 1. minutu oporavka, toleranciju napora (pik VO2) i parcijalni pritisak CO2 na krajuizdisaja; ventilatorna efikasnost je bila lošija i češća pojava oscilatorne ventilacije. Pacijenti saHFrEF su imali više plazma nivoe NT-pro-BNP u miru, piku napora i oporavku od napora, uodnosu na HFmrEF/HFpEF (p<0.001), dok je porast tokom napora (ΔNT-pro-BNP pik/mir) i padnivoa ovog hormona u oporavku od napora (ΔNT-pro-BNP oporavak/pik) bio sličan. Pacijenatisa zaravnjenom VO2/HR krivom tokom CPET, koja je pokazatelj porasta udarnog volumena, suimali više nivoe NT-pro-BNP u plazmi u miru, piku napora i oporavku od napora, kao i većiporast plazma nivoa ovog hormona tokom napora. Tokom perioda praćenja (22.4±20.3 meseca)34 pacijenta su umrla, izvršene su 2 srčane transplantacije, 3 LVAD implantacije. ROC analizaje pokazala snažnu prediktivnu vrednost ΔNT-pro-BNP pik/mir i NT-pro-BNP oporavak zanastanak kardiovaskularnih događaja (površina ispod ROC 0.82, 0.86; SE=0.04, 0.03; p<0.001,respektivno). Optimalna vrednost praga ΔNT-pro-BNP pik/mir i NT-pro-BNP u oporavku zaidentifikaciju pacijenata sa rizikom za pojavu neželjnih srčanih događaja je bila ≥108 pg/ml i≥1115 pg/ml, respektivno, kod svih fenotipova HF..., Background: Ischemic heart disease leading heart failure (HF) portends a high overall morbidityand mortality despite considerable improvements in diagnosis and treatment. A higher Nterminal-pro-B-type natriuretic peptide (NT-pro-BNP) values at rest is a significant indicator ofcompromised cardiac output and a HF diagnosis, most likely secondary to reduced ejectionfraction (HFrEF), as well as prognostic marker, however its value in patient with HF of midranged/preserved left ventricular ejection fraction (LVEF) (HFmrEF/HFpEF) is not wellestablished. As an insufficient increase in cardiac output during exertion is common in all HFphenotypes, we examined the value of NT-pro-BNP during exercise testing as a risk stratificationindex for ischemic HF secondary to either reduced (HFrEF) or mid-ranged/preserved LVEF(HFmrEF/HFpEF). We also examined the prognostic value of NT-pro-BNP during recoveryfrom exercise in patients with ischemic HF of any LVEF.Matherials and Methods: In total, 213 patients with ischemic HF (123 HFrEF and 90HFmrEF/HFpEF) were included in study cohort. Patients who were included underwent Dopplerechocardiography which was used to estimate resting pulmonary artery systolic pressure (PASP)and tricuspid annular plane systolic excursion (TAPSE), as well as cardiopulmonary test (CPET)with three blood sampling: 1) at rest, 2) at peak execise, and 3) after first minute of recovery inorder to measure NT-pro-BNP levels. Follow-up of all patients was performed in order ofdetecting any cardiac adverse events, such as death due to cardiac reasons, heart transplantationand left ventricular assist device (LVAD).Results: TAPSE/PASP was lower in patients with HFmrEF/HFpEF than in HFrEF. Heart rate(HR) at rest and peak did not diferentiate significantly between patients with HF, while the oneswith HFrEF had worse CPET response, including lower values of HR reserve during first minuteof recovery, exercise tolerance (peak VO2) and end-tidal partial pressure CO2. Ventilatoryefficancy was lower and more frequent oscilatory breathing. Patients with HFrEF had higherplasma levels of NT-pro-BNP at rest, peak exercise and recovery than those withHFmrEF/HFpEF (p<0.001), whereas the increase of this hormone during exercise and decreaseduring recovery (ΔNT-pro-BNP peak/rest and ΔNT-pro-BNP recovery/peak) were similar.Patients with flattening of VO2 trajectory showed higher levels of NT-pro-BNP at rest, peak andrecovery, as well as higher increase of it during exercise. During the tracking period (22.4±20.3mo), 34 patients died, 2 underwent cardiac transplantation, and 3 LVAD implantation. ROCanalysis demonstrated strong predictve value of ΔNT-pro-BNP peak/rest and NT-pro-BNP inrecovery for adverse cardiac events (surface under the ROC 0.82, 0.86; SE=0.04, 0.03; p<0.001,respectively). Optimal value of ΔNT-pro-BNP peak/rest and NT-pro-BNP in recovery foridentification of patients with increased risk of cardiac adverse events was ≥108 pg/ml and≥1115 pg/ml, respectively, in all HF phenotypes...",
publisher = "Универзитет у Београду, Фармацеутски факултет",
journal = "Универзитет у Београду",
title = "Evaluacija dinamike i prognostičke vrednostI N-terminalnog-pro-B tip natriuretskog peptida tokom napora i oporavka kod ishemijom izazvane srčane slabosti",
url = "https://hdl.handle.net/21.15107/rcub_nardus_22457"
}

Đorđević, T.. (2023). Evaluacija dinamike i prognostičke vrednostI N-terminalnog-pro-B tip natriuretskog peptida tokom napora i oporavka kod ishemijom izazvane srčane slabosti. in Универзитет у Београду
Универзитет у Београду, Фармацеутски факултет..
https://hdl.handle.net/21.15107/rcub_nardus_22457

Đorđević T. Evaluacija dinamike i prognostičke vrednostI N-terminalnog-pro-B tip natriuretskog peptida tokom napora i oporavka kod ishemijom izazvane srčane slabosti. in Универзитет у Београду. 2023;.
https://hdl.handle.net/21.15107/rcub_nardus_22457 .

Đorđević, Tea, "Evaluacija dinamike i prognostičke vrednostI N-terminalnog-pro-B tip natriuretskog peptida tokom napora i oporavka kod ishemijom izazvane srčane slabosti" in Универзитет у Београду (2023),
https://hdl.handle.net/21.15107/rcub_nardus_22457 .

TY  - JOUR
AU  - Popović, Dejana
AU  - Đorđević, Tea
AU  - Jakovljević, Đorđe
AU  - Ristić, Arsen
AU  - Lasica, Ratko
AU  - Arena, Ross
AU  - Guazzi, Marco
PY  - 2020
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3580
AB  - Ischemic heart disease leading to heart failure (HF) portends a high overall morbidity and mortality. A higher N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) at rest reflects HF severity and impaired cardiac output, most often secondary to reduced ejection fraction (EF). As an insufficient increase in cardiac output during exertion is common in all HF phenotypes, we examined the value of NT-pro-BNP during exercise testing as a risk stratification index for ischemic HF secondary to either reduced (HFrEF) or mid-ranged/preserved EF (HFmrEF/HFpEF). 213 patients (123 HFrEF; 90 HFmrEF/HFpEF) underwent cardiopulmonary exercise testing (CPET). NT-pro-BNP was determined at rest and peak exercise. The distribution of HFrEF and HFmrEF/HFpEF etiology in subjects with and without oxygen consumption trajectory flattening during CPET was similar (p > 0.05). Patients with HFrEF had higher plasma levels of NT-pro-BNP at rest and peak exercise than those with HFmrEF/HFpEF (984 vs. 780; 1012 vs. 845 pg/mL, p < 0.01, respectively), whereas ΔNT-pro-BNPpeak/rest was similar (60 vs. 50 pg/mL, p > 0.05). During the tracking period (22.4 ± 20.3 months) 34 patients died, and there were 2 cardiac transplantations and 3 LVAD implantations. In a multivariate regression model only the NT-pro-BNPpeak and ΔNT-pro-BNPpeak/rest were retained in the regression for the prediction of adverse events (Chi-square:8.97, p = 0.003). ROC analysis demonstrated that NT-pro-BNPpeak ≥1506 pg/mL and ΔNT-pro-BNPpeak/rest ≥108 pg/mL were optimal for identifying patients with a risk (Sn = 76.9, 74.4 %; Sp = 84.7, 80.9 %, respectively). NT-pro-BNP changes during effort and absolute peak values reached provide novel insights emerging as new and strong predictors of adverse events in HF of any EF.
PB  - Elsevier
T2  - Peptides
T1  - N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction
VL  - 129
DO  - 10.1016/j.peptides.2020.170315
DO  - 10.1016/j.peptides.2020.170315
ER  - 

@article{
author = "Popović, Dejana and Đorđević, Tea and Jakovljević, Đorđe and Ristić, Arsen and Lasica, Ratko and Arena, Ross and Guazzi, Marco",
year = "2020",
abstract = "Ischemic heart disease leading to heart failure (HF) portends a high overall morbidity and mortality. A higher N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) at rest reflects HF severity and impaired cardiac output, most often secondary to reduced ejection fraction (EF). As an insufficient increase in cardiac output during exertion is common in all HF phenotypes, we examined the value of NT-pro-BNP during exercise testing as a risk stratification index for ischemic HF secondary to either reduced (HFrEF) or mid-ranged/preserved EF (HFmrEF/HFpEF). 213 patients (123 HFrEF; 90 HFmrEF/HFpEF) underwent cardiopulmonary exercise testing (CPET). NT-pro-BNP was determined at rest and peak exercise. The distribution of HFrEF and HFmrEF/HFpEF etiology in subjects with and without oxygen consumption trajectory flattening during CPET was similar (p > 0.05). Patients with HFrEF had higher plasma levels of NT-pro-BNP at rest and peak exercise than those with HFmrEF/HFpEF (984 vs. 780; 1012 vs. 845 pg/mL, p < 0.01, respectively), whereas ΔNT-pro-BNPpeak/rest was similar (60 vs. 50 pg/mL, p > 0.05). During the tracking period (22.4 ± 20.3 months) 34 patients died, and there were 2 cardiac transplantations and 3 LVAD implantations. In a multivariate regression model only the NT-pro-BNPpeak and ΔNT-pro-BNPpeak/rest were retained in the regression for the prediction of adverse events (Chi-square:8.97, p = 0.003). ROC analysis demonstrated that NT-pro-BNPpeak ≥1506 pg/mL and ΔNT-pro-BNPpeak/rest ≥108 pg/mL were optimal for identifying patients with a risk (Sn = 76.9, 74.4 %; Sp = 84.7, 80.9 %, respectively). NT-pro-BNP changes during effort and absolute peak values reached provide novel insights emerging as new and strong predictors of adverse events in HF of any EF.",
publisher = "Elsevier",
journal = "Peptides",
title = "N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction",
volume = "129",
doi = "10.1016/j.peptides.2020.170315, 10.1016/j.peptides.2020.170315"
}

Popović, D., Đorđević, T., Jakovljević, Đ., Ristić, A., Lasica, R., Arena, R.,& Guazzi, M.. (2020). N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction. in Peptides
Elsevier., 129.
https://doi.org/10.1016/j.peptides.2020.170315

Popović D, Đorđević T, Jakovljević Đ, Ristić A, Lasica R, Arena R, Guazzi M. N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction. in Peptides. 2020;129.
doi:10.1016/j.peptides.2020.170315 .

Popović, Dejana, Đorđević, Tea, Jakovljević, Đorđe, Ristić, Arsen, Lasica, Ratko, Arena, Ross, Guazzi, Marco, "N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction" in Peptides, 129 (2020),
https://doi.org/10.1016/j.peptides.2020.170315 . .