PMID- 15477114
OWN - NLM
STAT- MEDLINE
DCOM- 20050202
LR  - 20121115
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 23
IP  - 10
DP  - 2004 Oct
TI  - Aminoterminal pro type B natriuretic peptide as a predictive and prognostic 
      marker in patients with chronic heart failure.
PG  - 1189-97
AB  - BACKGROUND: B-type natriuretic peptide (BNP) is released from the cardiac 
      ventricles in response to increased wall tension. We studied the relation of 
      NT-proBNP to Heart Failure Survival Score (HFSS) and New York Heart Association 
      (NYHA) class in patients with chronic heart failure (CHF). We also studied the 
      impact for recipient selection for cardiac transplant and assessed it as a 
      predictive and prognostic marker of CHF. METHODS: A total of 550 patients with 
      dilative cardiomyopathy (n = 323), and coronary artery disease (n = 227) were 
      prospectively examined. All patients underwent spiroergometry, echocardiography, 
      right heart catheterization, and electrocardiogram. Routine blood levels and 
      NT-proBNP were measured. The clinical selection for cardiac transplant candidates 
      was adjudicated by 2 independent cardiologists who were blinded to the results of 
      NT-proBNP assays. Clinical outcome and predictive power of NT-proBNP were 
      analyzed. RESULTS: NT-proBNP levels in patients clinically considered for cardiac 
      transplantation were significantly higher (2293 ng/ml vs 493 ng/ml; p < 0.001). 
      The receiver operating characteristic (ROC) analysis regarding transplant 
      candidacy showed an area under the ROC curve (AUC) of 0.84 +/- 0.01 for HFSS, 
      0.86 +/- 0.001 for NYHA, and 0.96 +/- 0.01 for NT-proBNP. Patients with 
      increasing NT-proBNP levels or remaining elevated levels despite adequate heart 
      insufficiency treatment were maintained with left ventricular assist device 
      implantation (n = 10) or urgent heart transplantation (n = 2). Patients with 
      NT-proBNP levels above 5000 pg/ml had a mortality rate of 28.4% per year. 
      Twenty-eight patients died during the observation period; all these patients were 
      within NYHA Classes 3 and 4 (NT-proBNP 5423 +/- 423 ng/ml). CONCLUSIONS: 
      NT-proBNP discriminates patients at high likelihood of being a candidate for 
      transplantation and provides prognostic informations in patients with CHF. 
      NT-proBNP levels above 5000 pg/ml at admission were associated with death, and 
      these levels markedly discriminated candidates for left ventricular assist 
      devices or urgent transplantation.
FAU - Rothenburger, Markus
AU  - Rothenburger M
AD  - Department of Thoracic Surgery, University Hospital Muenster, Muenster, Germany. 
      markus.rothenburger@ukmuenster.de
FAU - Wichter, Thomas
AU  - Wichter T
FAU - Schmid, Christof
AU  - Schmid C
FAU - Stypmann, Jorg
AU  - Stypmann J
FAU - Tjan, Tonny D T
AU  - Tjan TD
FAU - Berendes, Elmar
AU  - Berendes E
FAU - Etz, Christian
AU  - Etz C
FAU - Pioux, Aurelien
AU  - Pioux A
FAU - Loher, Andreas
AU  - Loher A
FAU - Wenzelburger, Frauke
AU  - Wenzelburger F
FAU - Drees, Gabriele
AU  - Drees G
FAU - Hoffmeier, Andreas
AU  - Hoffmeier A
FAU - Breithardt, Gonter
AU  - Breithardt G
FAU - Scheld, Hans Heinrich
AU  - Scheld HH
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 (Nerve Tissue Proteins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Protein Precursors)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Cardiac Catheterization
MH  - Cardiomyopathy, Dilated/blood
MH  - Coronary Artery Disease/blood
MH  - Echocardiography
MH  - Female
MH  - Heart Failure/*blood/diagnosis/epidemiology
MH  - Heart Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain
MH  - Nerve Tissue Proteins/*blood
MH  - Patient Selection
MH  - Peptide Fragments/*blood
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Protein Precursors/blood
MH  - ROC Curve
MH  - Spirometry
EDAT- 2004/10/13 09:00
MHDA- 2005/02/03 09:00
CRDT- 2004/10/13 09:00
PHST- 2004/04/28 00:00 [received]
PHST- 2004/07/08 00:00 [revised]
PHST- 2004/07/19 00:00 [accepted]
PHST- 2004/10/13 09:00 [pubmed]
PHST- 2005/02/03 09:00 [medline]
PHST- 2004/10/13 09:00 [entrez]
AID - S1053-2498(04)00395-X [pii]
AID - 10.1016/j.healun.2004.07.006 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2004 Oct;23(10):1189-97. doi: 
      10.1016/j.healun.2004.07.006.