Failing heart—medical aspectIncremental Value of N-terminal Pro–Brain Natriuretic Peptide Over Left Ventricle Ejection Fraction and Aerobic Capacity for Estimating Prognosis in Heart Failure Patients
Section snippets
Methods
All patients included in this study were recruited from a single center (Onassis Cardiac Surgery Center, Athens, Greece) during the period from September 2003 to March 2007. We prospectively studied 160 patients (130 men and 30 women) diagnosed with LV dysfunction due to coronary artery disease, dilated cardiomyopathy and valvular heart disease. Patients were either post-operative cases or being evaluated for cardiac surgery during entry into our heart failure program. For the patients with
Results
From a total of 160 patients, 11 dropped out due to poor attendance. Thus, a total of 149 subjects, 122 men and 27 women, were included in the analysis.
During the follow-up period (median 30 months, range 3 to 50), 5 subjects underwent heart transplantation and 22 died. Patients' demographic and clinical characteristics are shown in Table 1.
Discussion
Peak Vo2 derived from treadmill cardiopulmonary exercise testing is an objective estimator of severity of heart failure. In our study NT-proBNP correlated strongly with Vo2 peak. Moreover, we found that NT-proBNP levels can be used to identify CHF patients traditionally considered candidates for HT (peak Vo2 <14 ml/kg/min, peak Vo2 <10 ml/kg/min, LVEF <28%17, 18). Recent studies are consistent with our findings with regard to the ability of BNP to predict functional capacity and ventilatory
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Neurohormonal activation and exercise tolerance in patients supported with a continuous-flow left ventricular assist device
2016, International Journal of CardiologyCitation Excerpt :Although CF-LVADs improve survival, several studies have shown that exercise capacity remains reduced after device implantation [1]. It is widely accepted that neurohormones play a key role in the regulation of hemodynamics in HF both at rest and during exercise [2–7]. In contrast, little is known about the importance of neurohormonal regulation for exercise capacity in HF patients supported with CF-LVADs.
Exercise oscillatory breathing and NT-proBNP levels in stable heart failure provide the strongest prediction of cardiac outcome when combining biomarkers with cardiopulmonary exercise testing
2012, Journal of Cardiac FailureCitation Excerpt :The clinical impact of these observations seems to be straightforward, considering the broad standardized use of natriuretic peptides in clinical practice and the increasing use of CPET as a fundamental technique to properly assess and follow ambulatory HF patients.2 Reports that have been looking at a combined analysis of established serum biomarkers with CPET-derived variables are surprisingly few, and most of them analyzed peak VO2 as the leading reference parameter.12–14 To our knowledge, Scardovi et al27 are the only earlier investigators addressing the question of whether VE/VCO2 slope and BNP are synergistic prognosticators.
Serum glutathione S-transferase P1 1 in prediction of cardiac function
2012, Journal of Cardiac FailureCitation Excerpt :Although, proBNP is an established tool for HF diagnosis,19 the greatest clinical utility of proBNP is the monitoring of HF-related hemodynamic decompensation and disease progression rather than LV function and EF.20,21 On the other hand, proBNP is recommended to be mainly used for exclusion of HF with normal EF in patients with symptoms attributed to HF.22 However, given that gender and older age are associated with higher proBNP levels,7 the proposed diagnostic properties of proBNP18 might be too unspecific to serve as a predictor for LV function.
Selecting patients for heart transplantation: Comparison of the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM)
2011, Journal of Heart and Lung TransplantationCitation Excerpt :This suggests that the multiple factors that go into a clinician's assigning an NYHA class are also important. There are some reports that addition of other variables, such as natriuretic peptides and renal function, may improve the predictive ability of peak VO2, HFSS and SHFM,13,18,20–23 but the utility of these risk markers for transplant selection remains to be determined. The HFSS and SHFM were strong predictors independent of one another.
Effect of BNP on risk assessment in cardiac surgery patients, in addition to EuroScore II
2020, Scientific ReportsProtective effects of salidroside on chronic heart failure in rats and the underlying mechanisms
2019, Brazilian Journal of Pharmaceutical Sciences