The American journal of cardiology · 2026
Temporal Profiles of Natriuretic Peptides and Echocardiographic Indices During Decongestion: Insights from a Cardio-Renal Hemodialysis Model.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yoshikawa Hisao, Iwasaki Masaki, Amemiya Katsushi, Kujime Shingo, Yoshikawa Masao
Аннотация
AIMS: The temporal behavior of natriuretic peptides and echocardiographic indices during hemodialysis (HD) remains incompletely characterized. We aimed to delineate their dynamic profiles and rank the timing of changes within a single HD session.
METHODS AND RESULTS: In a cohort of 75 HD patients, time points at pre, 1 hour, 2 hours, 3 hours, and post HD were assessed for B-type natriuretic peptide (BNP), human atrial natriuretic peptide (hANP), and echocardiographic indices of diastolic function (E/A, E/e'), cardiac structure (left atrial volume index [LAVI], left ventricular mass index), venous load (tricuspid regurgitation pressure gradient [TRPG], inferior vena cava collapsibility index [IVC-CI]), and myocardial deformation (global longitudinal strain [GLS]). Using normalized time (0-1) and linear mixed-effects models, we derived t20, t50, and Lag (t_peak - t20). BNP and hANP declined early. BNP showed the earliest t20, followed by hANP; E/e' and E/A clustered early, LAVI and TRPG mid-session, GLS and LVMI later, and IVC-CI latest. BNP had the longest Lag; hANP, E/e', LAVI, and TRPG formed an intermediate cluster, left ventricular mass index and GLS were slightly shorter, and IVC-CI was the shortest. For t50, the ranking was broadly similar, with BNP reaching 50% of its total change earlier than hANP (p < 0.0001).
CONCLUSIONS: A temporal hierarchy emerged-from immediate peptide responses, through chamber and pressure changes, to late structural adaptation-providing a framework to interpret intradialytic cardiac responses and guide volume control in HD. The t50 metric quantifies response speed without requiring an arbitrary absolute cut-off and may inform decongestion strategies beyond HD, including heart failure care.
METHODS AND RESULTS: In a cohort of 75 HD patients, time points at pre, 1 hour, 2 hours, 3 hours, and post HD were assessed for B-type natriuretic peptide (BNP), human atrial natriuretic peptide (hANP), and echocardiographic indices of diastolic function (E/A, E/e'), cardiac structure (left atrial volume index [LAVI], left ventricular mass index), venous load (tricuspid regurgitation pressure gradient [TRPG], inferior vena cava collapsibility index [IVC-CI]), and myocardial deformation (global longitudinal strain [GLS]). Using normalized time (0-1) and linear mixed-effects models, we derived t20, t50, and Lag (t_peak - t20). BNP and hANP declined early. BNP showed the earliest t20, followed by hANP; E/e' and E/A clustered early, LAVI and TRPG mid-session, GLS and LVMI later, and IVC-CI latest. BNP had the longest Lag; hANP, E/e', LAVI, and TRPG formed an intermediate cluster, left ventricular mass index and GLS were slightly shorter, and IVC-CI was the shortest. For t50, the ranking was broadly similar, with BNP reaching 50% of its total change earlier than hANP (p < 0.0001).
CONCLUSIONS: A temporal hierarchy emerged-from immediate peptide responses, through chamber and pressure changes, to late structural adaptation-providing a framework to interpret intradialytic cardiac responses and guide volume control in HD. The t50 metric quantifies response speed without requiring an arbitrary absolute cut-off and may inform decongestion strategies beyond HD, including heart failure care.