PMID- 12957614
OWN - NLM
STAT- MEDLINE
DCOM- 20050421
LR  - 20190922
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 22
IP  - 9
DP  - 2003 Sep
TI  - Prognostic power of neurohumoral parameters in chronic heart failure depends on 
      clinical stage and observation period.
PG  - 1037-45
AB  - BACKGROUND: Endothelin (ET) and natriuretic peptides have prognostic significance 
      in chronic heart failure (CHF). Because stimuli for forming these neurohormones 
      differ, this study investigates whether their prognostic power depends on 
      clinical stage and on length of the observation period. METHODS: Plasma big ET, 
      B-type natriuretic peptide (BNP), N-terminal BNP (N-BNP), and N-terminal atrial 
      natriuretic peptide (N-ANP), in addition to 11 clinical and hemodynamic 
      variables, were obtained from 452 patients with left ventricular ejection 
      fraction (LVEF) </=35%. According to their New York Heart Association class and 
      LVEF, patients were stratified into Group A, mild CHF (n = 114); Group B, 
      moderate CHF (n = 210); and Group C, severe CHF (n = 128). To predict the 
      combined end-point of death or urgent heart transplantation, a multivariate 
      analysis was performed after an observation period of up to 1, 2, and 3 years in 
      all patients and in each sub-group. RESULTS: Best independents predictors were as 
      follows: All patients: up to 1 year, big ET (p < 0.0001, chi-square = 59); and 2 
      and 3 years, log N-ANP (p < 0.0001, chi-square = 68; p < 0.0001, chi-square = 
      89). Group A: up to 2 and 3 years, log N-ANP (p < 0.001, chi-square = 12; p < 
      0.0001, chi-square = 25). Group B: up to 1 and 3 years, log N-ANP (p < 0.0001, 
      chi-square = 16; p < 0.0001, chi-square = 22); and 2 years, log N-BNP (p < 
      0.0001, chi-square = 19). Group C: up to 1, 2, and 3 years, big ET (p < 0.0001, 
      chi-square = 23; p < 0.0001, chi-square = 22; p < 0.0001, chi-square = 20). 
      CONCLUSION: Big ET was the best independent marker for 1-year prognosis in severe 
      CHF, whereas natriuretic peptides (especially N-ANP) were better markers for 2- 
      and 3-year prognoses in mild and moderate CHF.
FAU - Berger, Rudolf
AU  - Berger R
AD  - Department of Cardiology, Ludwig Boltzman Institute of Experimental 
      Endocrinology, University of Vienna, Vienna, Austria. rberger@gmx.at
FAU - Strecker, Karin
AU  - Strecker K
FAU - Huelsmann, Martin
AU  - Huelsmann M
FAU - Moser, Petra
AU  - Moser P
FAU - Frey, Bernhard
AU  - Frey B
FAU - Bojic, Anja
AU  - Bojic A
FAU - Stanek, Brigitte
AU  - Stanek B
FAU - Pacher, Richard
AU  - Pacher R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Biomarkers)
RN  - 0 (Endothelin-1)
RN  - 0 (Natriuretic Peptides)
SB  - IM
MH  - Biomarkers
MH  - Cardiac Output, Low/blood/classification/*diagnosis/mortality
MH  - Chronic Disease
MH  - Endothelin-1/*blood
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Natriuretic Peptides/blood
MH  - Prognosis
MH  - Risk Factors
MH  - Ventricular Dysfunction, Left/blood/diagnosis
EDAT- 2003/09/06 05:00
MHDA- 2005/04/22 09:00
CRDT- 2003/09/06 05:00
PHST- 2003/09/06 05:00 [pubmed]
PHST- 2005/04/22 09:00 [medline]
PHST- 2003/09/06 05:00 [entrez]
AID - S1053249802005600 [pii]
AID - 10.1016/s1053-2498(02)00560-0 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2003 Sep;22(9):1037-45. doi: 
      10.1016/s1053-2498(02)00560-0.