Brain natriuretic peptide response is heterogeneous during beta-blocker therapy for congestive heart failure.
BACKGROUND
Plasma brain natriuretic peptide (BNP) levels are useful marker to guide medical treatment in patients with congestive heart failure (CHF). We tested the hypothesis that the plasma BNP concentration would be a useful marker of beta-blocker therapy for CHF.


RESULTS
Eighty-four patients with New York Heart Association class II-IV CHF and a left ventricular ejection fraction (LVEF) <40% were treated with beta-blockers, including metoprolol and carvedilol, for at least 16 weeks. End-diastolic and end-systolic dimensions decreased, and radionuclide LVEF increased 4 weeks after introduction of beta-blockers (early phase). LV end-diastolic and end-systolic dimensions both decreased, and LVEF increased 16 to 48 weeks after the therapy (late phase). However, the BNP concentration did not change during the observation period. Overall LV function improved in all 4 subgroups divided according to the baseline BNP levels.


CONCLUSIONS
Plasma BNP concentration is not a sensitive marker of successful beta-blocker therapy for CHF.
Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Akihiro
A
Yoshizawa
Tsutomu
T
Yoshikawa
Iwao
I
Nakamura
Toru
T
Satoh
Kazunori
K
Moritani
Masahiro
M
Suzuki
Akiyasu
A
Baba
Shiro
S
Iwanaga
Hideo
H
Mitamura
Satoshi
S
Ogawa
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000008:administration & dosage / Q000627:therapeutic use; D000077261:Carvedilol; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000187:drug effects*; D011412:Propanolamines / Q000008:administration & dosage / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D015415:Biomarkers; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D020097:Natriuretic Peptide, Brain; D008790:Metoprolol