Prognostic value of plasma brain natriuretic peptide combined with left ventricular dimensions in predicting sudden death of patients with chronic heart failure.
BACKGROUND
We evaluated a combined assessment of brain natriuretic peptide (BNP) with left ventricular dimensions as a prognostic marker for sudden death in patients with chronic heart failure (CHF). Ventricular dimensions and BNP are separately recognized as prognostic markers for sudden death in patients with CHF.


RESULTS
CHF patients at Stage C and B were registered for a prospective study. From the database, we analyzed 417 patients with coronary arterial disease (CAD) or primary/secondary dilated cardiomyopathy (DCM). Main effects of BNP, left ventricular ejection fraction (EF), LV diastolic dimension (LVDD), and interaction of BNP with the EF and LVDD were tested with Cox's proportional hazard model. BNP in sudden death patients was significantly higher than that in event-free patients. Although multivariate analysis revealed that BNP by itself was not an independent risk factor for sudden death after adjustments, it was revealed that BNP entered the model via interaction with EF as a risk factor associating with sudden death. On the other hand, BNP was an independent risk factor associating with heart failure events (death and hospitalization), and BNP did not enter the model via an interaction with EF.


CONCLUSIONS
BNP by itself was an independent risk factor for the heart failure events, but not for sudden death in CHF patients of the present study. However, BNP should be important in predicting sudden death when measured with EF.
Watanabe
Jun
J
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Shiba
Nobuyuki
N
Shinozaki
Tsuyoshi
T
Koseki
Yoshito
Y
Karibe
Akihiko
A
Komaru
Tatsuya
T
Miura
Masahito
M
Fukuchi
Mitsumasa
M
Fukahori
Kouhei
K
Sakuma
Masahito
M
Kagaya
Yutaka
Y
Shirato
Kunio
K
D000368:Aged; D016757:Death, Sudden, Cardiac; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis
D020097:Natriuretic Peptide, Brain