PMID- 28764220
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2249-782X (Print)
IS  - 0973-709X (Electronic)
IS  - 0973-709X (Linking)
VI  - 11
IP  - 6
DP  - 2017 Jun
TI  - To Evaluate the Change in Brain Natriuretic Peptide Levels in Outpatients with 
      Ischemic Cardiomyopathy and Its Association with Functional Capacity: A Pilot 
      Study.
PG  - OC26-OC28
LID - 10.7860/JCDR/2017/26546.10031 [doi]
AB  - INTRODUCTION: Literature is sparse on the clinical correlation of six minute walk 
      test (6MWT) and Brain Natriuretic Peptide (BNP) levels in ischemic Cardiomyopathy 
      (Ischemic CMP) patients. New York Heart Association (NYHA) classification is most 
      commonly used for functional assessment of Heart Failure (HF), which is very 
      subjective. This limitation is overcome by 6MWT which has prognostic significance 
      in addition to assessment of level of functional impairment. Serum BNP correlate 
      with clinical severity of HF as assessed by NYHA class. AIM: To evaluate the 
      change in BNP levels in outpatients with ischemic CMP and its association with 
      functional capacity. MATERIAL AND METHODS: Sixty seven patients of established 
      ischemic CMP by coronary angiography With Left Ventricular Ejection Fraction 
      (LVEF) <40%, were recruited on an Outpatients Department (OPD) basis and assessed 
      for baseline BNP levels and functional capacity (NYHA class and 6MWT). These 
      patients were managed on OPD basis and the treatment was optimised and all the 
      aggravating factors like uncontrolled diabetes, hypertension and anaemia were 
      corrected. Patients were also advised life style modifications and cessation of 
      smoking and alcohol consumption. All these patients were followed up for six 
      months with optimum medical treatment and repeat 6MWT and BNP levels. Primary end 
      point was change in the functional class and the BNP levels at six months. 
      Statistical analysis was done with paired t-test and Pearson correlation for BNP 
      levels and 6MWT/NYHA class. RESULTS: A total of 67 patients were enrolled, out of 
      which 48 patients had six months follow up. Thirty two patients were in NYHA 
      Class II and remaining was in NYHA Class III at the time of enrollment. At six 
      months, 37 were in NYHA Class II and 11 in Class III. At enrollment, 37 cases 
      were able to walk >300 m in six minutes and 11 cases walked < 300 m where as at 
      six months 43 walked >300 m and five walked <300 m. As compared to baseline the 
      mean distance covered in 6MWT showed significant improvement and with reduction 
      in BNP levels at six months (p<0.001). Mean BNP levels correlated better with 
      6MWT (p <0.001) than NYHA class (p<0.67). CONCLUSION: In patients with 
      established ischemic CMP with LVEF <40%, there is a significant reduction in BNP 
      levels and improvement in 6MWT at six months with optimum medical therapy. A 6MWT 
      correlated better with BNP levels than with NYHA class with a significant 
      p-value. However, larger such studies and a longer duration of follow up is 
      desirable to prove this association.
FAU - Jayachandra, Amarapalli
AU  - Jayachandra A
AD  - Specialist, Department of Cardiology, Command Hospital Northern Command, 
      Udhampur, Jammu and Kashmir, India.
FAU - Aggarwal, Vivek
AU  - Aggarwal V
AD  - Assistant Professor, Deparment of Internal Medicine, AFMC, Pune, Maharashtra, 
      India.
LA  - eng
PT  - Journal Article
DEP - 20170601
PL  - India
TA  - J Clin Diagn Res
JT  - Journal of clinical and diagnostic research : JCDR
JID - 101488993
PMC - PMC5535412
OTO - NOTNLM
OT  - Cardiac biomarkers
OT  - Heart failure
OT  - New York Heart Association class
OT  - Six minute walk test
EDAT- 2017/08/03 06:00
MHDA- 2017/08/03 06:01
PMCR- 2017/08/01
CRDT- 2017/08/03 06:00
PHST- 2017/01/04 00:00 [received]
PHST- 2017/03/10 00:00 [accepted]
PHST- 2017/08/03 06:00 [entrez]
PHST- 2017/08/03 06:00 [pubmed]
PHST- 2017/08/03 06:01 [medline]
PHST- 2017/08/01 00:00 [pmc-release]
AID - 10.7860/JCDR/2017/26546.10031 [doi]
PST - ppublish
SO  - J Clin Diagn Res. 2017 Jun;11(6):OC26-OC28. doi: 10.7860/JCDR/2017/26546.10031. 
      Epub 2017 Jun 1.