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B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure.
J Am Coll Cardiol. 2004 May 05; 43(9):1584-9.JACC

Abstract

OBJECTIVES

The aim of this study was to compare the prognostic value of peak oxygen consumption (VO(2)) and B-type natriuretic peptide (BNP) in patients with stable congestive heart failure (CHF).

BACKGROUND

Previous studies have demonstrated that both peak VO(2) and BNP are useful for risk stratification in patients with CHF. No study has compared the respective prognostic value of these two parameters in a large series of patients receiving a combination of angiotensin-converting enzyme inhibitors and of beta-blockers.

METHODS

Patients with stable CHF underwent radionuclide angiography, echocardiography, 24-h Holter monitoring, and a cardiopulmonary exercise test. Blood samples were drawn for standard measurements and for hormonal determinations.

RESULTS

After a median follow-up period of 787 days, there were 75 cardiac-related deaths and three urgent transplantations. Independent predictors of cardiac survival were percent of maximal predicted VO(2) (%VO(2), relative risk [RR] = 2.84 [95% confidence interval, CI = 1.73 to 4.65], p < 0.00001), BNP (RR = 3.17 [95% CI 1.68 to 5.96], p = 0.0004), left atrial diameter (LAD) (RR = 2.04 [95% CI 1.25 to 3.34], p = 0.004), age (RR = 1.93 [95% CI 1.22 to 3.05], p = 0.005), and aldosterone (RR = 1.84 [95% CI 1.12 to 3.00], p = 0.015). In patients with infra-median levels of BNP (<109 pg/ml), age was the only independent predictor of cardiac survival. However, in patients with supra-median levels of BNP, independent predictors of cardiac survival were %VO(2) (RR = 3.76 [95% CI 2.19 to 6.45], p < 0.00001) and LAD (RR = 1.90 [95% CI 1.10 to 3.28], p = 0.02).

CONCLUSIONS

B-type natriuretic peptide, in combination with %VO(2), improves risk stratification of patients with stable CHF.

Authors+Show Affiliations

Service de Cardiologie C, Hôpital Cardiologique, CHRU de Lille, France. pdegroote@chru-lille.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

15120815

Citation

de Groote, Pascal, et al. "B-type Natriuretic Peptide and Peak Exercise Oxygen Consumption Provide Independent Information for Risk Stratification in Patients With Stable Congestive Heart Failure." Journal of the American College of Cardiology, vol. 43, no. 9, 2004, pp. 1584-9.
de Groote P, Dagorn J, Soudan B, et al. B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure. J Am Coll Cardiol. 2004;43(9):1584-9.
de Groote, P., Dagorn, J., Soudan, B., Lamblin, N., McFadden, E., & Bauters, C. (2004). B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure. Journal of the American College of Cardiology, 43(9), 1584-9.
de Groote P, et al. B-type Natriuretic Peptide and Peak Exercise Oxygen Consumption Provide Independent Information for Risk Stratification in Patients With Stable Congestive Heart Failure. J Am Coll Cardiol. 2004 May 5;43(9):1584-9. PubMed PMID: 15120815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure. AU - de Groote,Pascal, AU - Dagorn,Joël, AU - Soudan,Benoit, AU - Lamblin,Nicolas, AU - McFadden,Eugene, AU - Bauters,Christophe, PY - 2003/10/13/received PY - 2003/11/12/accepted PY - 2004/5/4/pubmed PY - 2004/6/21/medline PY - 2004/5/4/entrez SP - 1584 EP - 9 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 43 IS - 9 N2 - OBJECTIVES: The aim of this study was to compare the prognostic value of peak oxygen consumption (VO(2)) and B-type natriuretic peptide (BNP) in patients with stable congestive heart failure (CHF). BACKGROUND: Previous studies have demonstrated that both peak VO(2) and BNP are useful for risk stratification in patients with CHF. No study has compared the respective prognostic value of these two parameters in a large series of patients receiving a combination of angiotensin-converting enzyme inhibitors and of beta-blockers. METHODS: Patients with stable CHF underwent radionuclide angiography, echocardiography, 24-h Holter monitoring, and a cardiopulmonary exercise test. Blood samples were drawn for standard measurements and for hormonal determinations. RESULTS: After a median follow-up period of 787 days, there were 75 cardiac-related deaths and three urgent transplantations. Independent predictors of cardiac survival were percent of maximal predicted VO(2) (%VO(2), relative risk [RR] = 2.84 [95% confidence interval, CI = 1.73 to 4.65], p < 0.00001), BNP (RR = 3.17 [95% CI 1.68 to 5.96], p = 0.0004), left atrial diameter (LAD) (RR = 2.04 [95% CI 1.25 to 3.34], p = 0.004), age (RR = 1.93 [95% CI 1.22 to 3.05], p = 0.005), and aldosterone (RR = 1.84 [95% CI 1.12 to 3.00], p = 0.015). In patients with infra-median levels of BNP (<109 pg/ml), age was the only independent predictor of cardiac survival. However, in patients with supra-median levels of BNP, independent predictors of cardiac survival were %VO(2) (RR = 3.76 [95% CI 2.19 to 6.45], p < 0.00001) and LAD (RR = 1.90 [95% CI 1.10 to 3.28], p = 0.02). CONCLUSIONS: B-type natriuretic peptide, in combination with %VO(2), improves risk stratification of patients with stable CHF. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/15120815/B_type_natriuretic_peptide_and_peak_exercise_oxygen_consumption_provide_independent_information_for_risk_stratification_in_patients_with_stable_congestive_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735109704003584 DB - PRIME DP - Unbound Medicine ER -