PMID- 14564330
OWN - NLM
STAT- MEDLINE
DCOM- 20031103
LR  - 20151119
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 146
IP  - 4
DP  - 2003 Oct
TI  - Combination of B-type natriuretic peptide and peak oxygen consumption improves 
      risk stratification in outpatients with chronic heart failure.
PG  - 729-35
AB  - BACKGROUND: Peak oxygen consumption is a cornerstone for prognostic determination 
      in patients with congestive heart failure. The purpose of this study was to 
      assess whether plasma B-type natriuretic peptide (BNP) provided any additional 
      prognostic information. METHODS: Plasma concentrations of atrial natriuretic 
      peptide, N terminal pro-atrial natriuretic peptide, BNP, endothelin-1, 
      norepinephrine, and peak VO2 were measured in 250 consecutive outpatients with 
      mild to moderate heart failure (96% in New York Heart Association [NYHA] class II 
      or III) and left ventricular ejection fraction (LVEF) <45%. RESULTS: During a 
      median follow-up of 584 days, 42 patients died (19 from sudden death) and 5 
      underwent urgent heart transplantation. Multivariate stepwise regression analysis 
      showed that, among 13 variables including NYHA and LVEF, plasma BNP (chi2 = 11.9, 
      P =.0001) was the strongest independent predictor of death or urgent 
      transplantation, followed by serum sodium (chi2 = 8, P =.0046), resting heart 
      rate (chi2 = 7.5, P =.0062), plasma endothelin-1 (chi2 = 7.2, P =.007), and peak 
      VO2 (chi2 = 6.2, P =.012). Patients with plasma BNP above the upper quartile 
      value (260 pg/mL) had a 1-year rate of death or urgent transplantation of 31%. 
      The 1- and 2-year survival rates without urgent transplantation in patients with 
      a peak VO2 < or =14 mL x kg(-1) x min(-1) were 71% and 59%, respectively, when 
      plasma BNP was >137 pg/mL (median value), compared with 100% and 89%, 
      respectively, when plasma BNP was < or =137 pg/mL (P =.008). Furthermore, plasma 
      BNP was the only independent predictor of sudden death (chi2 = 19.9, P =.00001). 
      CONCLUSIONS: Plasma BNP provides additive independent prognostic information 
      compared to peak VO2 alone in outpatients with mild to moderate heart failure.
FAU - Isnard, Richard
AU  - Isnard R
AD  - Service de Cardiologie, Institut Federatif de Recherche 14 Heart, vessels, muscle 
      UPRES EA 2390, Hopital Pitie-Salpetriere, AP-HP, Paris, France. 
      richard.isnard@psl.ap-hop-paris.fr
FAU - Pousset, Francoise
AU  - Pousset F
FAU - Chafirovskaia, Olga
AU  - Chafirovskaia O
FAU - Carayon, Alain
AU  - Carayon A
FAU - Hulot, Jean Sebastien
AU  - Hulot JS
FAU - Thomas, Daniel
AU  - Thomas D
FAU - Komajda, Michel
AU  - Komajda M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Biomarkers)
RN  - 0 (Endothelin-1)
RN  - 0 (N-terminal proatrial natriuretic peptide)
RN  - 0 (Protein Precursors)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
RN  - X4W3ENH1CV (Norepinephrine)
SB  - IM
MH  - Aged
MH  - Atrial Natriuretic Factor/*blood
MH  - Biomarkers/blood
MH  - Endothelin-1/blood
MH  - Heart Failure/*blood/mortality/physiopathology
MH  - Heart Transplantation
MH  - Humans
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Norepinephrine/blood
MH  - *Oxygen Consumption
MH  - Prognosis
MH  - Protein Precursors/blood
MH  - Regression Analysis
MH  - Risk
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/blood/physiopathology
MH  - Ventricular Function, Left
EDAT- 2003/10/18 05:00
MHDA- 2003/11/05 05:00
CRDT- 2003/10/18 05:00
PHST- 2003/10/18 05:00 [pubmed]
PHST- 2003/11/05 05:00 [medline]
PHST- 2003/10/18 05:00 [entrez]
AID - S000287030300365X [pii]
AID - 10.1016/S0002-8703(03)00365-X [doi]
PST - ppublish
SO  - Am Heart J. 2003 Oct;146(4):729-35. doi: 10.1016/S0002-8703(03)00365-X.