PMID- 21807423
OWN - NLM
STAT- MEDLINE
DCOM- 20131022
LR  - 20151119
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 162
IP  - 3
DP  - 2013 Jan 20
TI  - Combination of B-type natriuretic peptide and minute ventilation/carbon dioxide 
      production slope improves risk stratification in patients with diastolic heart 
      failure.
PG  - 193-8
LID - S0167-5273(11)00703-0 [pii]
LID - 10.1016/j.ijcard.2011.07.017 [doi]
AB  - BACKGROUND: Recent studies demonstrated that the minute ventilation/carbon 
      dioxide production (VE/VCO(2)) slope more powerfully predicted mortality, 
      hospitalization, or both than peak oxygen consumption (VO(2)) in systolic heart 
      failure. However, the prognostic values of these two parameters in diastolic 
      heart failure remained unclear. METHODS: The patients with diastolic heart 
      failure were recruited from April 2006 to May 2007, and underwent cardiopulmonary 
      exercise testing. Plasma BNP concentration was measured using Triage BNP 
      immunoassay method. RESULTS: Of the 224 patients enrolled, mean values for age 
      and New York Heart Association (NYHA) class were 68.8 +/- 9.0 years and 2.38 +/- 
      0.53, respectively. During the mean follow-up of 30 months, 57 patients died (36 
      from cardiovascular death). Univariate Cox regression analysis showed that age, 
      NYHA class, atrial fibrillation, diabetes mellitus, left ventricular diastolic 
      dysfunction, peak VO(2), VE/VCO(2) slope, and plasma BNP were significantly 
      associated with mortality. Multivariate analysis revealed that plasma BNP, 
      VE/VCO(2) slope, and age remained independent predictors for cardiovascular and 
      all-cause mortalities, with the strongest prognostic power of plasma BNP (chi(2) >/= 
      31.4, P < 0.001). In addition to plasma BNP and clinical predictors, the 
      VE/VCO(2) slope could provide independent and incremental prognostic value of 
      cardiovascular (chi(2) = 60.6 vs 51.7; P = 0.009) and all-cause mortalities (chi(2) = 
      62.8 vs 54.2; P = 0.015) with increased chi(2) value of Cox regression model. 
      CONCLUSION: In diastolic heart failure, plasma BNP is the strongest predictor of 
      mortality, and VE/VCO(2) slope provides independent and additive prognostic 
      information, which suggests that combination of plasma BNP and VE/VCO(2) slope 
      can improve risk stratification.
CI  - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved.
FAU - Yan, Jing
AU  - Yan J
AD  - Intensive Care Unit, Zhejiang Hospital, Lingyin Road 12, Hangzhou 310013, China. 
      yanjing2011@yahoo.com.cn
FAU - Gong, Shi-Jin
AU  - Gong SJ
FAU - Li, Li
AU  - Li L
FAU - Yu, Hai-Yan
AU  - Yu HY
FAU - Dai, Hai-Wen
AU  - Dai HW
FAU - Chen, Jin
AU  - Chen J
FAU - Tan, Cheng-Wu
AU  - Tan CW
FAU - Xv, Qiang-Hong
AU  - Xv QH
FAU - Cai, Guo-Long
AU  - Cai GL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110731
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Carbon Dioxide/*blood
MH  - Exercise Test/trends
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Diastolic/*blood/*diagnosis/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Predictive Value of Tests
MH  - Pulmonary Ventilation/*physiology
MH  - Risk Assessment/trends
EDAT- 2011/08/03 06:00
MHDA- 2013/10/23 06:00
CRDT- 2011/08/03 06:00
PHST- 2011/03/06 00:00 [received]
PHST- 2011/05/20 00:00 [revised]
PHST- 2011/07/03 00:00 [accepted]
PHST- 2011/08/03 06:00 [entrez]
PHST- 2011/08/03 06:00 [pubmed]
PHST- 2013/10/23 06:00 [medline]
AID - S0167-5273(11)00703-0 [pii]
AID - 10.1016/j.ijcard.2011.07.017 [doi]
PST - ppublish
SO  - Int J Cardiol. 2013 Jan 20;162(3):193-8. doi: 10.1016/j.ijcard.2011.07.017. Epub 
      2011 Jul 31.