title: Does NT-proBNP remain a sensitive biomarker for chronic heart failure after administration of a beta-blocker?
abstract: BACKGROUND
  Beta-blockers exert complex effects on plasma N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level.
  
  
  OBJECTIVE
  We aimed to investigate whether NT-proBNP was still able to mirror the severity of chronic heart failure and predict the prognosis of the disease after administration of a beta-blocker.
  
  
  METHODS
  Forty-four patients with chronic congestive heart failure were enrolled in the study to randomly receive carvedilol or bisoprolol in addition to background therapy. These patients underwent clinical measurement and blood sampling for NT-proBNP measurement at baseline and 3 or 7 months after the addition of the beta-blocker. The patients were followed-up for 3 years in order to register the occurrence of all-cause death.
  
  
  RESULTS
  NT-proBNP level showed a positive correlation with the severity of heart failure as evaluated by New York Heart Association (NYHA) classification both before and after administration of either beta-blocker. The relationship between NT-proBNP and NYHA class was not weakened with the duration of therapy. Furthermore, NT-proBNP was the only independent predictor of all-cause mortality both before and after administration of either beta-blocker. Left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), age, NYHA class and treatment group were not independently predictive of mortality in this study.
  
  
  CONCLUSIONS
  The ability of NT-proBNP to reflect the severity and to predict the endpoint in chronic heart failure is not undermined after administration of a beta-blocker, suggesting that NT-proBNP remains a sensitive biomarker for chronic heart failure both before and after administration of a beta-blocker.
authors.affiliation: Clinical Pharmacology Center, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Na
authors.initials: N
authors.lastname: Li
authors.forename: Yishi
authors.initials: Y
authors.lastname: Li
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Jiang
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Xu
authors.forename: Lu
authors.initials: L
authors.lastname: Hua
authors.forename: Congxiao
authors.initials: C
authors.lastname: Hua
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Feiou
authors.initials: F
authors.lastname: Li
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers; D017298:Bisoprolol / Q000008:administration & dosage / Q000627:therapeutic use; D002227:Carbazoles / Q000008:administration & dosage / Q000627:therapeutic use; D000077261:Carvedilol; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011412:Propanolamines / Q000008:administration & dosage / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index