Heart : official journal of the British Cardiac Society
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We assessed the prognostic significance of absolute and percentage change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients hospitalised for acute decompensated heart failure with preservedejection fraction (HFpEF) versus heart failure with reduced ejection fraction (HFrEF). ⋯ Our study highlights-after demonstrating that NT-proBNP levels confer the same relative risk information in HFpEF as in HFrEF-the possibility that comorbidities contribute relatively more to prognosis in patients with HFpEF with lower NT-proBNP levels than in patients with HFrEF.
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A 59-year-old male patient presented with acute onset shortness of breath and intermittent chest pain. His medical history included squamous cell carcinoma of the left upper lobe of the lung (tumour, node, metastases T3N2M0), which was treated with radical radiotherapy with concurrent vinorelbine/cisplatin chemotherapy 6 months ago, hypertension, type 2 diabetes mellitus and hypercholesterolaemia. A 12-lead ECG on arrival is shown in figure 1A which has led to the patient undergoing emergency coronary angiography (figure 1B and online supplementary video). ⋯ Compression of left circumflex artery due to metastatic disease. Acute pericarditis. Takotsubo syndrome. heartjnl;105/15/1189/F1F1F1Figure 1(A) Admission ECG, (B) coronary angiogram and (C,D) four-chamber view of cardiac MRI.