PMID- 17675057
OWN - NLM
STAT- MEDLINE
DCOM- 20070925
LR  - 20220330
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 13
IP  - 6
DP  - 2007 Aug
TI  - Baseline and serial neurohormones in patients with congestive heart failure 
      treated with and without bucindolol: results of the neurohumoral substudy of the 
      Beta-Blocker Evaluation of Survival Study (BEST).
PG  - 437-44
AB  - BACKGROUND: Serial neurohormones may serve as markers of efficacy of congestive 
      heart failure (CHF) therapy. We measured serial plasma big-endothelin (Big-ET), 
      ET-1, N-terminal atrial natriuretic peptide, and brain natriuretic peptide (BNP) 
      in 206 patients randomized to bucindolol or placebo in Beta-Blocker Evaluation of 
      Survival Trial (BEST). METHODS AND RESULTS: Neurohormones were measured at 
      baseline and 3 and 12 months. At baseline, BNP and Big-ET levels were greater in 
      New York Heart Association (NYHA) Class IV than in Class III patients (median 122 
      pg/mL versus 447 pg/mL, P = .001; and 20.0 pg/mL versus 9.9 pg/mL, P = .003), and 
      in patients with left ventricular ejection fraction (LVEF) < or = 20% compared 
      with LVEF > 20% (median 211 pg/mL versus 99.1 pg/mL; and 12.9 pg/mL versus 8.0 
      pg/mL, both P = .003). Big-ET and BNP were the strongest predictors of the 
      composite end point of CHF hospitalization or death. LVEF at 12 months correlated 
      inversely with 12-month BNP levels (r = -0.41, P = .0001). Bucindolol had no 
      effect on neurohormones except that bucindolol treated patients had lower Big-ET 
      levels at 3 months than patients receiving placebo (median 9.1 pg/mL versus 10.9 
      pg/mL, P = .05). A decline in ET-1 was associated with increased risk of the 
      composite endpoint. CONCLUSIONS: Lack of effect of bucindolol on natriuretic 
      peptide levels appears consistent with its overall lack of efficacy in BEST.
FAU - Frantz, Robert P
AU  - Frantz RP
AD  - Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Mayo 
      Foundation, Rochester, Minnesota 55905, USA.
FAU - Lowes, Brian D
AU  - Lowes BD
FAU - Grayburn, Paul A
AU  - Grayburn PA
FAU - White, Michel
AU  - White M
FAU - Krause-Steinrauf, Heidi
AU  - Krause-Steinrauf H
FAU - Krishnan, Vaishali
AU  - Krishnan V
FAU - Uyeda, Lauren
AU  - Uyeda L
FAU - Burnett, John C
AU  - Burnett JC
CN  - BEST Neurohumoral Substudy Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Biomarkers)
RN  - 0 (Endothelin-1)
RN  - 0 (Endothelins)
RN  - 0 (Propanolamines)
RN  - 0 (big-endothelin (1-22))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
RN  - E9UO06K7CE (bucindolol)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Aged
MH  - Atrial Natriuretic Factor/*blood
MH  - Biomarkers/blood
MH  - Endothelin-1/*blood
MH  - Endothelins/*blood
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/blood/*drug therapy/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Propanolamines/*therapeutic use
MH  - Radioimmunoassay
MH  - Stroke Volume
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2007/08/07 09:00
MHDA- 2007/09/26 09:00
CRDT- 2007/08/07 09:00
PHST- 2006/09/29 00:00 [received]
PHST- 2007/03/06 00:00 [revised]
PHST- 2007/03/16 00:00 [accepted]
PHST- 2007/08/07 09:00 [pubmed]
PHST- 2007/09/26 09:00 [medline]
PHST- 2007/08/07 09:00 [entrez]
AID - S1071-9164(07)00098-X [pii]
AID - 10.1016/j.cardfail.2007.03.007 [doi]
PST - ppublish
SO  - J Card Fail. 2007 Aug;13(6):437-44. doi: 10.1016/j.cardfail.2007.03.007.