NT-ProBNP in acute heart failure: correlation with invasively measured hemodynamic parameters during recompensation.
BACKGROUND
N-terminal brain natriuretic peptide (NT-proBNP) level is elevated in patients with acute and chronic heart failure. This study addresses whether NT-proBNP correlates with invasively measured hemodynamic parameters and whether a decrease of NT-proBNP over time correlates with invasively monitored hemodynamic improvement.


RESULTS
Twenty consecutive patients with acute exacerbation of chronic heart failure (New York Heart Association class III-IV) were included in this prospective study. NT-proBNP and hemodynamic measurements by balloon-tipped pulmonary artery catheter were performed simultaneously. Recompensation strategies included vasodilators, diuretics, and inotropes. The patients were divided in 2 subgroups. Group A, by definition, had a hemodynamic improvement over 24 hours with an increase of cardiac index of >30% and a decrease of pulmonary capillary wedge pressure of >30%. Group B did not show a hemodynamic improvement. Group A had a decline of NT-proBNP levels to 42% of the baseline value over 32 hours. In group B, the NT-pro BNP levels did not change significantly over 32 hours.


CONCLUSIONS
The decrease of NT-proBNP correlates with hemodynamic improvement in patients with decompensated heart failure. The relative changes of NT-proBNP seem to be a reliable diagnostic tool in monitoring these patients. There results have been confirmed in a larger patient group.
Knebel
Fabian
F
Medical Clinic for Cardiology, Angiology, and Pneumology, Charité Campus Mitte--University Medicine, Berlin, Germany.
Schimke
Ingolf
I
Pliet
Kathleen
K
Schattke
Sebastian
S
Martin
Salim
S
Borges
Adrian C
AC
Baumann
Gert
G
D015415:Biomarkers / Q000097:blood; D002407:Catheterization, Swan-Ganz; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D014655:Vascular Resistance
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain