title: Correlation between serial measurements of N-terminal pro brain natriuretic peptide and ambulatory cardiac filling pressures in outpatients with chronic heart failure.
abstract: BACKGROUND
  Serial measurements of N-terminal pro brain natriuretic peptide (NT-proBNP) have been suggested for the management of outpatients with chronic heart failure (CHF). The relationship between NT-proBNP plasma levels and central haemodynamic parameters in this setting is not known.
  
  
  METHODS
  In 19 outpatients with CHF, NT-proBNP was related to central haemodynamic information, continuously measured with an implanted haemodynamic monitor (IHM) during 24 h of daily living activities ("24 h") and during supine rest ("rest"). In 13 patients, three to seven serial measurements were obtained with a mean time interval of 39 days (range 19-113).
  
  
  RESULTS
  At the first visit (n=19), NT-proBNP plasma levels were dispersed over a wide range of filling pressures and not correlated with the 24 h median of the right ventricular systolic pressure (RVSP) and the estimated pulmonary artery pressure (ePAD). However, in the individual patient, serial measurements yielded significant positive correlations between NT-proBNP and RVSP (p=0.006) and ePAD (p=0.001). During "24 h" compared with "rest", the median RVSP and ePAD were elevated by 20+/-16% and 32+/-18%, respectively, and corresponded better with NT-proBNP (p<0.05).
  
  
  CONCLUSIONS
  In outpatients with CHF, single measurements of NT-proBNP are not correlated with cardiac filling pressures. However, serial measurements of NT-proBNP in each individual patient show a significant positive correlation with central haemodynamic parameters and reflect changes in the haemodynamic state over time.
authors.affiliation: Department of Cardiology, Karolinska University Hospital, 171 76, Stockholm, Sweden. frieder.braunschweig@karolinska.se
authors.forename: Frieder
authors.initials: F
authors.lastname: Braunschweig
authors.forename: Astrid
authors.initials: A
authors.lastname: Fahrleitner-Pammer
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mangiavacchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghio
authors.forename: Parwis
authors.initials: P
authors.lastname: Fotuhi
authors.forename: Uta C
authors.initials: UC
authors.lastname: Hoppe
authors.forename: Cecilia
authors.initials: C
authors.lastname: Linde
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010045:Outpatients; D010446:Peptide Fragments / Q000097:blood*; D013997:Time Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain