title: Prognostic value of plasma brain natriuretic peptide combined with left ventricular dimensions in predicting sudden death of patients with chronic heart failure.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shiba
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Koseki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Karibe
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Komaru
authors.forename: Masahito
authors.initials: M
authors.lastname: Miura
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Kouhei
authors.initials: K
authors.lastname: Fukahori
authors.forename: Masahito
authors.initials: M
authors.lastname: Sakuma
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kagaya
authors.forename: Kunio
authors.initials: K
authors.lastname: Shirato
mesh_terms: 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
chemical_list: D020097:Natriuretic Peptide, Brain